Blood Clot in the Lung: What You Should Know

A pulmonary embolism (PE) occurs when a blood clot, typically originating in the deep veins of the legs, travels to an artery in the lungs, obstructing the blood flow. This can lead to severe consequences, such as a pulmonary infarction, reduced oxygen supply to the body, and even life-threatening conditions like pulmonary hypertension. This blog will provide comprehensive information about pulmonary embolism, including its symptoms, causes, risk factors, diagnostics, and treatment options.

A blood clot in the lung, also known as a pulmonary embolism (PE), is a serious and potentially life-threatening condition that requires immediate medical attention. Understanding the risk factors, symptoms, diagnosis, and treatment options for pulmonary embolism is crucial for early detection and effective management.

Risk Factors for Pulmonary Embolism

Pulmonary embolism occurs when a blood clot forms in a vein, typically in the legs, known as deep vein thrombosis (DVT), and then travels to the lungs, where it becomes lodged in a pulmonary artery. Several factors increase the risk of developing blood clots and subsequently experiencing a pulmonary embolism. These include:

• Sedentary lifestyle: Prolonged periods of inactivity, such as sitting for long hours during travel or bed rest after surgery, can increase the risk of blood clots.
• Surgery: Major surgical procedures, particularly those involving the lower extremities, pelvis, or abdomen, can increase the risk of developing blood clots.
• Medical conditions: Certain medical conditions, such as cancer, heart disease, obesity, and inflammatory disorders, can predispose individuals to blood clot formation.
• Pregnancy: Pregnancy and childbirth increase the risk of blood clots due to hormonal changes, increased pressure on the veins, and decreased mobility during pregnancy and postpartum recovery.
• Smoking: Tobacco use damages blood vessels and increases the risk of clot formation.
• Family history: A family history of blood clots or inherited clotting disorders can increase an individual's susceptibility to pulmonary embolism.

Per Johns Hopkins Medicine, DVT is the most common cause of a pulmonary embolism. Other less frequent causes of PE are a fat embolus (often linked to a significant bone break), amniotic fluid embolus, air bubbles, and deep vein thrombosis in the upper body.

Symptoms of Pulmonary Embolism

According to the Mayo Clinic, the symptoms of pulmonary embolism can vary depending on the size and location of the blood clot. Common signs and symptoms include:

1. Shortness of breath: Sudden onset of difficulty breathing, especially with exertion, is a hallmark symptom of pulmonary embolism.
2. Chest pain: Sharp chest pain that worsens with deep breathing, coughing, or movement may indicate a blood clot in the lung.
3. Rapid heart rate: An elevated heart rate, also known as tachycardia, may occur as the body attempts to compensate for decreased oxygen delivery.
4. Cough: A persistent cough, sometimes accompanied by bloody sputum, can occur with pulmonary embolism.
5. A feeling of anxiety: Described as an overwhelming sense of unease, fear, or impending doom, individuals experiencing PE-related anxiety may feel restless, agitated, and unable to calm their thoughts or emotions. They may also exhibit physical symptoms such as trembling, sweating, and a rapid heart rate, which further contribute to feelings of distress.
6. Bluish lips or nails: Also known as cyanosis, it can occur as a symptom of pulmonary embolism (PE) due to the impaired oxygenation of the blood resulting from decreased blood flow to the lungs. It is a concerning symptom as it suggests that the blood clot is causing a substantial obstruction in the pulmonary circulation, resulting in reduced oxygen supply to the body.
7. Leg swelling and pain: If a blood clot starts in the legs, you might notice swelling, redness, and pain in that leg. These symptoms of deep vein thrombosis (DVT). This is a serious medical condition because the blood clots formed in the veins can potentially detach and move through the bloodstream. These clots can become lodged in the lungs, obstructing blood flow and causing a PE. When deep vein thrombosis and pulmonary embolism happen simultaneously, it's called venous thromboembolism (VTE).

Remember that blood clots can be life-threatening, and early intervention is essential. That’s why Center for Vein Restoration (CVR) offers a same-day DVT-rule-out service. Our hotline is 877-SCAN-DVT (877-722-6388).

Note: not everyone with pulmonary embolism experiences all these symptoms; some individuals may have subtle or atypical presentations. It's essential to seek medical attention immediately if you experience any of these symptoms, as a pulmonary embolism can be life-threatening.

How Pulmonary Embolism is Diagnosed

Prompt diagnosis of pulmonary embolism is essential for initiating appropriate treatment and preventing complications. Healthcare providers use a combination of clinical assessment, imaging tests, and laboratory studies to diagnose PE. Diagnostic tools may include:

• CT pulmonary angiography (CTPA): This imaging test is considered the gold standard for diagnosing pulmonary embolism. It involves injecting a contrast dye into a vein and performing a CT scan to visualize the pulmonary arteries.
• D-dimer test: Elevated levels of D-dimer, a protein fragment produced when blood clots dissolve, may indicate the presence of a blood clot. However, this test is not specific to pulmonary embolism and may be elevated in other conditions.
• Ultrasound: Doppler ultrasound of the legs can detect deep vein thrombosis, which often precedes pulmonary embolism.
• Ventilation-perfusion (V/Q) scan: This nuclear medicine test evaluates airflow and blood flow in the lungs and can be helpful when CTPA is contraindicated or inconclusive.

Treatment for Pulmonary Embolism

Treatment for pulmonary embolism aims to prevent further clot formation, dissolve existing clots, and improve blood flow to the lungs. Depending on the severity of the condition and the patient's overall health status, treatment options may include:

Anticoagulant therapy:

Blood thinners, such as heparin and warfarin, are commonly prescribed to prevent new blood clots from forming and to allow the body's natural clot-dissolving mechanisms to work effectively.

Thrombolytic therapy:

In severe pulmonary embolism associated with hemodynamic instability or massive clot burden, thrombolytic medications may be administered to dissolve blood clots rapidly.

Inferior vena cava (IVC) filter:

In some situations, a small filter may be inserted into the inferior vena cava, the large vein that returns blood from the lower body to the heart, to trap blood clots and prevent them from traveling to the lungs.

Surgical embolectomy:

In rare cases when other treatments are not feasible or effective, surgical blood clot removal from the pulmonary artery may be necessary.

Prevention of Pulmonary Embolism

Preventing pulmonary embolism involves reducing modifiable risk factors and implementing strategies to promote circulation and mobility. These preventive measures may include:

Regular physical activity: Regular exercise and avoiding prolonged periods of immobility can help prevent blood clots from forming.

Smoking cessation: Quitting smoking reduces the risk of blood clot formation and numerous other health complications.

Compression stockings: Wearing compression stockings can improve blood flow in the legs and reduce the risk of deep vein thrombosis during long periods of sitting or standing.

Prophylactic anticoagulation: For individuals at high risk of developing blood clots, such as those undergoing surgery or hospitalized for medical illness, prophylactic anticoagulant therapy may be prescribed to prevent clot formation.

Understand your risk: Whether you're proactively managing risk factors or simply staying clot-aware, knowledge is your greatest ally to ensure a bright future without blood clots.

Trust Center for Vein Restoration with Your Vein Health

Johns Hopkins Medicine notes that severe varicose veins increase the risk of deep vein blood clots. Center for Vein Restoration (CVR) is the leader in diagnosing and treating chronic venous insufficiency, the root cause of varicose veins. As the foremost authority in vein care nationwide, CVR's board-certified vein specialists can identify and address compromised blood vessels before they lead to blood clot formation.

Call CVR at 240-965-3915 to speak to a Patient Services Representative or schedule your consultation online at a CVR near you.