Pulmonary Embolism

A lung condition in which a blood clot blocks the blood flow to the lung’s artery is called pulmonary embolism. Mostly, this blood clot appears in a deep vein in the leg and goes to the lung. In rare cases, this blood clot that reaches the lung’s artery can develop in other body parts. The condition in which blood clots form in deep veins of the body is called deep vein thrombosis (DVT).

Moreover, pulmonary embolism is a life-threatening condition and without treatment, it may lead to death. That’s why taking measures to prevent blood clot formation anywhere in the body is important.

Symptoms

The symptoms usually differ among patients because it depends on how much a lung is involved, the size of blood clots, and underlying lung or heart disease. Check below some common pulmonary embolism symptoms:

Breathing problems that appear suddenly and often worsen with physical activity.
Chest pain that feels like a myocardial infarction. Commonly, the pain feels sharp, especially when you breathe deeply.
Fainting is caused by syncope (when a person experiences a sudden drop in heart rate or blood pressure).

However, people may experience other symptoms too. Check below some of them:

Dizziness
Lightheadedness
Fever
Excessive sweating
Cyanosis (discolored or clammy skin)
Swelling or pain in one or both legs
Irregular or fast heartbeat
Bloody cough

If you experience any of the previous symptoms and think you have this lung disease, immediately seek medical attention.

Causes

Mostly, multiple blood clots are involved in the lung’s artery blockage. Affected lung parts (that do not get blood) may begin to die (also known as pulmonary infarction). As a result, lung function is reduced which leads to less oxygen for the rest of the body. Sometimes, artery blockages can occur due to other substances, not due to blood clots. For example:

Tumor parts
Air bubbles
Fat that comes from a broken long bone

Risk Factors

Anyone can develop blood clots and potentially pulmonary embolism. However, certain factors could elevate your risk of this lung condition. Check below some risk factors:

Family History, Health Conditions, and Treatments

Family history – Your risk of developing a blood clot increases with a family history of blood clots. For instance, if a family member (such as parents or sibling) has blood clots your risk elevates.
Heart disease – Blood vessel or heart disease (such as heart failure) can lead to blood clot formation.
Cancer – Some cancers also can elevate your risk of blood clots. For example cancer of the brain, ovary, pancreas, colon, stomach, lung, and kidney. Furthermore, chemotherapy also may put you at high risk of developing blood clots.
Surgery – This is one of the most common causes of blood clots. Thus, physicians often prescribe blood clots medicines before and after major surgery (including joint replacement).
Inherited Disorders – There are some hereditary diseases that negatively affect blood and lead it to clot.
Coronavirus disease 2019 (COVID-19) – Those who suffer from severe COVID-19 symptoms are at higher risk of getting pulmonary embolism.

In addition, those who are limited to bed rest for long periods (such as after surgery) or people who enjoy long trips (such as car trips) reduce the blood flow in the legs increasing the risk of blood clots.

Other Risk Factors

These include:

Cigarette smoking – Experts do not completely understand why smoking elevates the risk of blood clots.
Increased body weight – Excess body weight also increases the risk of blood clots, especially those with other risk factors.
Estrogen – People who administer Estrogen either through birth control pills or hormone replacement therapy are at higher risk of developing blood clots.
Pregnancy – In some cases, the baby’s weight can put pressure on the veins in the pelvic region, which makes less blood flow to the legs.

Complications

Unfortunately, 30% of people with this lung condition are undiagnosed and do not get treatment. Such people commonly do not survive. The risk of death decreases significantly with treatment.

People with pulmonary embolism can also experience pulmonary hypertension (an increased blood pressure in the lungs). Moreover, lung artery blockages also put extra strain on the heart, which can cause the weakening of the heart muscle.

Rarely, small clots (emboli) can remain in the lungs and lead to the scarring of the lung arteries over time. In such cases, it may lead to chronic pulmonary hypertension.

How to Prevent Pulmonary Embolism?

The only way to prevent this lung condition is to prevent blood clot development. Check below some tips that help to prevent blood clots:

Anticoagulants (blood thinners) – This group of medications is usually given to people with a high risk of blood clots. These include people before and after surgery or who suffer from cancer complications, stroke, myocardial infarction, and others.
Compression stockings – These stockings help veins and leg muscles move blood more efficiently.
Leg elevation – An effective option to prevent blood clots in the legs is to elevate your legs during nighttime. You can do that by raising the bottom of the bed using blocks or books.
Physical activity – It is advised to move as soon as possible after surgery. That’s why your doctor may push you to get up and walk nonetheless pain.
Pneumatic compression – This is a special treatment that helps improve blood flow through the legs. It involves special cuffs that inflate with air and deflate every few minutes.

Diagnosis

Sometimes, it is challenging to diagnose this lung disease, especially if you have an underlying lung or heart condition. Thus, physicians will analyze your medical history, ask some questions about your symptoms, and perform a physical examination. They can also order you to do some tests that will help to confirm the condition. These include:

Blood tests – These tests are done to determine the levels of a substance called D dimer (a substance used to dissolve the clots). In case the D dimer levels are high, it may mean you have blood clots. Moreover, a blood test can determine how much oxygen and carbon dioxide in the blood you have.
Chest X-ray – This test is used to exclude other conditions that provoke similar symptoms and make detailed pictures of your lungs and heart.
Ultrasound – This is a test that uses sound waves to scan veins to check for deep vein blood clots.
CT pulmonary angiography – Doctors perform CT scans to get 3D pictures that help to identify pulmonary embolism.
Ventilation-perfusion (V/Q) scan – This test involves injecting a radioactive substance (tracer) into the vein in the arm which helps to do a V/Q scan. It usually is performed by doctors when the patient has pulmonary hypertension symptoms.
Pulmonary angiogram – This is one of the most accurate tests that help doctors to confirm pulmonary embolism. It makes detailed pictures of the blood flow in the lung arteries.
MRI scan – This test uses radio waves and a magnetic field that helps make clear images of the body tissues and organs. This test is commonly used in pregnant women.

Treatment

The treatment goal is to prevent blood clots from getting bigger and preventing the formation of new blood clots. It often includes medicines, surgery, and other procedures. Check below some examples:

Medications

Anticoagulants – The most commonly prescribed medicine is Heparin but doctors can also recommend Warfarin. However, you can discuss with your doctor about newer oral blood thinners because they work more effectively and have fewer interactions with other drugs.
Clot dissolvers – In some cases, people need thrombolytics (medications that dissolve clots). However, these medicines can provoke severe and sudden bleeding. That’s why doctors use them for life-threatening situations only.

Other Treatment Options

Clot removal – Physicians use a thin and flexible catheter threaded to the blood vessels to remove a dangerous blood clot from the lungs.
Vein filter – This procedure prevents the blood clot from reaching the lungs. It is an effective procedure for people who cannot take anticoagulants or do not experience any improvements after using them.

Frequently Asked Questions

What is the primary cause of pulmonary embolism?

This lung condition often happens due to multiple blood clots that travel usually from the leg to the lung artery. In such cases, people also experience deep vein thrombosis (DVT) which is a condition in which blood clots form in the deep veins of the body.

What are the main pulmonary embolism symptoms?

Breathing problems, chest pain, and sudden loss in blood pressure are the most common symptoms of this lung disease. Immediately contact a doctor if any of them happen.

What are the potential complications of pulmonary embolism?

Pulmonary infarction or hypertension
Pleural effusion (fluid buildup in the pleura – a membrane around the lungs)
Cardiac arrhythmia (irregular heart rate)
Cardiac arrest

Ask your healthcare provider if you have additional questions.