Pulmonary Embolism

A Pulmonary Embolism – also called a “PE” – is when a blood clot gets stuck in a lung artery and stops blood from flowing to that part of the lung.

This usually happens when a clot in the legs (see ‘What is Deep Venous Thrombosis?’) breaks free and travels through the veins and heart into the lungs.

Occasionally, blockages in the lung arteries are caused by fat from the inside of a broken bone, part of a tumor, or air bubbles. A pulmonary embolism causes chest pain, breathlessness, and cough. It can be life-threatening and prompt treatment reduces the risk of death.

Pulmonary embolism is a blockage in an artery in the lungs. It occurs when a blood clot – usually from the legs (deep vein thrombosis) – breaks off, is carried through the bloodstream and lodges in the arteries in the lungs. This blocks the flow of blood through the heart, which may lead to death.

Symptoms

Chest pain – often sudden and sharp pain that worsens when taking a deep breath
Shortness of breath – often sudden trouble catching your breath when resting and gets worse with activity
Cough or Coughing up blood or bloody mucus
Fainting
Light headedness
Dizziness
Rapid or irregular heartbeat
Sweating
Fever

Chest pain (often sudden)
Shortness of breath
Sharp pain that worsens when taking a deep breath
Coughing up blood

Risk Factors

Heart disease – especially heart failure
Kidney disease
Presence of deep vein thrombosis or previous deep vein thrombosis
Inherited conditions that effect blood clotting, such as factor V Leiden
Previous pulmonary embolism
Cancer – especially breast, brain, ovary, pancreas, colon, stomach, lung and kidney cancers, and cancers that have spread
Recent chemotherapy
Sitting for long periods of time (for example in a car or on an airplane)
Pregnancy, including the six week period after pregnancy
Certain medications such as hormone therapy, birth controll pills, tamoxifen or raloxifene (Evista)
Obesity
Surgery – especially hip or knee replacement
Coronavirus disease 2019 – people who experienced severe COVID-19 have an increased risk of pulmonary embolism

Complications

Massive pulmonary embolism causes an overload of the heart and can cause sudden death.

The parts of a lung served by a blocked artery can’t get blood and may die. This is known as a pulmonary infarction and makes it more difficult for your lungs to provide oxygen to the rest of your body.

Pulmonary embolism can lead to pulmonary hypertension, where the blood pressure in the lungs is too high. Then the right side of the heart must work harder to push blood through the lungs. This restriction to blood flow weakens your heart.

Treatments

Oxygen
Blood thinners / anti-coagulants
“Clot buster” medications (thrombolytics)
Vein filter insertion
Clot removal

For further information please consult following chapters of Layman’s Handbook of Venous Disorders:

Learn more from our Handbook.