A pulmonary embolism is serious, and can cause damage to the heart and lungs and even death. But if caught early, PE can be treated and is not often fatal, according to the Cleveland Clinic. There are also steps you can take to reduce the risk of blood clots and PE. According to Mayo Clinic, common signs of pulmonary embolism include:
Shortness of breath, even while resting and gets worse with physical activityChest pain that feels sharp and worsens when you take a deep breath, cough, or bend overFainting from a sudden drop in heart rate or blood pressure
With a pulmonary embolism, you may also experience:
A feverDizziness or lightheadednessLeg pain or swellingFast or irregular heartbeatCoughing up bloodExcessive sweatingSkin that is clammy or discolored
Not everyone with a PE will have symptoms, but most people do, per the Cleveland Clinic. If you have symptoms of a pulmonary embolism, seek medical treatment right away. Anyone can develop DVT that can lead to a PE, but it is more common in certain populations. According to Mayo Clinic, risk factors for pulmonary embolism include:
A past history of blood clotsA genetic risk of blood clots (your parent or sibling has had blood clots, for example)Extended periods of inactivity, most commonly bed rest after surgeryCertain medical conditions, including heart disease, cancer, COVID-19, kidney disease, and blood clotting disordersTaking birth control pillsHormone replacement therapyPregnancyBeing overweight or obeseSmoking tobaccoLong trips in a car or on a plane
To diagnose a pulmonary embolism, a healthcare provider will take a full medical history and complete a physical exam. If your doctor suspects PE, one or more of the following tests may be ordered:
Blood Tests These may include a D Dimer test, which measures the levels of a clot-dissolving substance in the blood. Other blood tests can determine the amount of oxygen in your blood and check for inherited clotting disorders.Ultrasound In this noninvasive test, a wand-shaped device scanned over the skin uses sound waves to check veins for deep vein blood clots in the thighs, knees, calves, and arms.Chest X-Ra This will allow your doctor to view images of your heart and lungs. A PE may not be visible on a chest X-ray, but it can help rule out other health conditions.CT Pulmonary Angiography This produces 3D images of the arteries in the lungs and can detect changes like PE. A contrast, or dye-like substance, is injected into a vein so the arteries can be seen more clearly.Ventilation-Perfusion Scan (VQ scan) This alternative test is used when a medically vulnerable person needs to avoid the radiation or contrast from a CT scan. With a VQ scan, only a small amount of radioactive substance is injected into the vein, which tracks airflow to the lungs.Pulmonary Angiogram A catheter (a thin, flexible tube) is inserted into the groin up to the heart and pulmonary artery. Contrast is injected into the catheter so X-rays can be taken that provide images of the blood flow in the lung’s arteries. This is the most accurate way to diagnose a PE, according to Mayo Clinic, but because of potential side effects, is typically only done if a diagnosis can’t be made using other tests.
However, some symptoms may linger. According to one study of 101 people who experienced PE, 47 percent experienced shortness of breath and 25 percent had impaired quality of life at a six-month follow up. Long-term complications, such as pulmonary hypertension can also occur, which may become chronic. Treatment typically takes place in a hospital and involves medication or surgery.
Medication
In most cases, a PE can be treated with anticoagulant medication, or blood thinners, which decrease the blood’s ability to clot. Your doctor may also prescribe thrombolytics, or medication that dissolves clots, if the clot isn’t dissolving on its own.
Surgery
If a PE is life-threatening, or if other treatments aren’t working, your doctor can remove the clot through surgery or by threading a catheter through the blood vessel to the site of the PE. PE can also lead to pulmonary hypertension, characterized by shortness of breath and decreased ability to exercise. About 2 to 4 percent of people with PE have chronic pulmonary hypertension, according to the Circulation report. If left untreated, PE can lead to heart failure. Blood thinners that treat PE can have their own set of complications, including excessive bleeding. Per Johns Hopkins Medicine, signs of bleeding in the digestive system include blood in the stool, abdominal pain, and vomiting up blood, while signs of bleeding in the brain include severe headache, sudden change in vision, memory loss or confusion, and sudden loss of feeling or movement in the legs or arms. If you experience any of these symptoms, seek medical attention right away.
Blood Thinners These are typically prescribed post surgery and after a person has experienced a heart attack or stroke to prevent blood clots.Compression Stockings These improve blood flow in the legs. Talk to your doctor about what type of compression stockings to get and how to wear them.Elevating Legs if you are on bedrest or have limited mobility, such as after surgery, then elevating your legs is recommended.Returning to Physical Activity Do so as soon as you can following surgery.
Preventing Blood Clots While Traveling
The risk of DVT and PE while traveling is quite low, but long-haul flights do increase the risk. If you’re at an increased risk of blood clots, talk to your doctor about steps you can take to stay safe during long-haul travel. These may include:
Get up and walking around every hour on an airplane. On a road trip, stop every so often to get out of your car and walk around.Stay hydrated by drinking plenty of fluids, especially water. Avoid alcohol, which can lead to dehydration.Wear compression stockings, which can improve blood flow in your legs.Move your legs in your seat with circular ankle movements and toe raises every 15 to 30 minutes.
Among people who have had blood clots, 33 percent will have a recurrence within 10 years. The CDC estimates that between 60,000 to 100,000 Americans die from DVT or PE each year. Certain medical conditions make blood clots more likely, including obesity, heart failure, and inflammatory bowel disease, per Mayo Clinic. Certain types of cancer, including those involving the stomach, brain, lungs, uterus, ovaries, and kidneys, also increase the risk of blood clots, according to the CDC. Cancers of the blood, including lymphoma and myeloma, also raise the risk. Additionally, elements of cancer treatment, such as prolonged hospitalization, chemotherapy, hormonal therapy, and surgery, increase the chances of blood clots. Blood clots are also more common during pregnancy, childbirth, and up to three months postpartum. There are a number of reasons for this, including limited mobility and less blood flow to the legs during pregnancy. A woman’s blood also clots more easily during pregnancy to prevent excess blood loss during labor and delivery. According to the CDC, pregnant women are 5 times more likely to have a blood clot than women who aren’t pregnant.
Organizations
National Blood Clot Alliance The National Blood Clot Alliance (NBCT) offers a variety of helpful articles on the signs, treatment, and prevention of blood clots. You can also fill out risk assessment tools that you can share with your healthcare provider at your next exam. NBCT offers an online peer support group and a page of patient stories where you can read about others’ experiences with blood clots and PE. You can even submit your own story to share. North American Thrombosis Forum The North American Thrombosis Forum is a nonprofit organization committed to improving the lives of people affected by blood clots and related diseases. The organization provides credible information on blood clot topics, including management of PE, as well as a patient newsletter, which shares the latest research in the thrombosis field, patient stories, and expert interviews. American Heart Association (AHA) The AHA provides evergreen information about blood clots, as well as advice for living a heart-healthy lifestyle, which can help prevent blood clots and PE. Blood Clot Recovery Network Created by a blood clot and PE survivor, the Blood Clot Recovery Network provides a community for people affected by blood clots, as well as their friends and families, to find information and support one another on their recovery journeys. The site includes a section called “Recently Diagnosed? Start Here.” loaded with helpful resources as you begin yours.
Peer Support Groups
NBCA’s Stop the Clot Support Group The National Blood Clot Alliance offers an online peer support group where you can connect with others who have been affected by blood clots and PE. It is free to join and the organization also offers a Facebook group. Pulmonary Embolism Support Group This Facebook group has more than 6,000 members who actively engage and support one another in coping with recovery from PE. American Blood Clot Association The American Blood Clot Association is a nationwide nonprofit organization dedicated to educating the public and healthcare providers about life-threatening blood clots and complications, including PE. The organization offers a Facebook support group for people who have experienced blood clots, as well as a list of community support groups.
