How to Spot the Warning Signs of a Pulmonary Embolism

A blood clot in the lung is a serious, life-threatening medical condition. Knowing how to spot the symptoms of a pulmonary embolism may save your life.

A pulmonary embolism (PE) is a serious medical condition requiring immediate medical intervention. Although PE refers to a blood clot in the lungs, PE clots start in the legs as deep vein thrombosis (DVT). When the DVT clot breaks away and lodges in the lungs, it blocks blood flow and causes severe symptoms, such as shortness of breath, chest pain, and a cough that can produce bloody mucus.

According to the American Lung Association, PE affects 1 in every 1,000 people in the U.S. annually. Knowing the warning signs of PE and DVT can help you avoid a potentially life-threatening medical emergency. If you suspect a PE clot, immediately consult with your physician.

Risk Factors for Pulmonary Embolism

Certain risk factors increase your chances of a PE and its related condition, DVT, the most common being a lack of activity for long periods of time. When sedentary for many hours, your legs muscles don’t contract to help push blood through the leg veins. As the blood pools in the vein, the blood cells risk clumping to form a clot, which could travel to the lungs. For example, wearing compression stockings on a lengthy plane trip can improve blood flow. It's also recommended that you move about the cabin whenever safely possible to improve circulation.

Advanced age, smoking, and obesity all can contribute to the development of blood clots in the legs, as well. Some individuals may be more prone to clots due to a gene, V Leiden, which accelerates the blood clotting process.

Recent studies, like one from Taiwan in 2018, have also suggested a heightened risk of DVT in those who have varicose veins.

The Warning Signs of Pulmonary Embolism

Because DVT and PE are closely related, your first sign of a potential PE would most likely be a DVT symptom. DVT will typically cause pain, swelling, reddish skin, and a feeling of warmth in one leg. If you notice those symptoms, consult with your doctor immediately. Your best chance of preventing a PE is to treat the DVT as soon as it is detected..

If the clot has progressed to the lungs, you may experience significant chest pain (especially when you cough or take a deep breath), shortness of breath, dizziness, racing pulse, and even signs of blood when you cough. These symptoms will need swift medical intervention in an emergency room.

To diagnose a PE, your doctor will do a series of imaging tests, such as computerized tomography (CT) scan, to detect the presence of a clot. A blood test to determine if you have an abnormal level of a protein produced by blood clots, D dimer, may also be ordered.

Fortunately, PE can be successfully treated if caught early. The goal is to stop the clot from growing and prevent new ones from forming. Treatment will depend on the location of the clot, the severity of the clot, and other risk or health factors present.

Therapy for PE begins with medications known as anticoagulants, also known as blood thinners, either given orally or intravenously in the hospital. Warfarin and Heparin are two commonly prescribed blood thinners. How long you need to take anticoagulants depends on your situation. Still, a duration of three months is usually the standard. Talk to your doctor about possible side effects because blood thinners can cause excess bleeding. In most instances, the clot will eventually dissolve.

If those medications fail to treat the clot, you may be prescribed a class of drugs called thrombolytics, known as clot busters. If the clot is large and life-threatening, your doctor may remove it through a catheter inserted into the blood vessels. In some cases, a metal filter may be placed in the inferior vena cava (the largest vein in your body below the heart), which will catch the clot before it reaches the lungs.

About two percent to four percent of PE patients will experience long-term damage to the lungs. Even after therapy, chronic thromboembolic pulmonary hypertension or pulmonary hypertension may cause severe shortness of breath, making it difficult to exercise. If left untreated, pulmonary hypertension can lead to heart failure.

After successful treatment for PE, you’ll return to normal activities. To lessen the chance of another clot, stay active, manage your weight, eat healthily, wear compression stockings, and most importantly, avoid smoking.

Don’t Ignore the Signs of a Pulmonary Embolism

PE and DVT are serious vascular disorders and should be treated immediately by a vein specialist. Center for Vein Restoration has three locations in the Atlanta area, all supervised by experienced vein specialists. Keith S. Moore, MD, is board-certified in general surgery specializing in vein procedures. Louis Prevosti, MD, FACS, is board-certified in thoracic and cardiovascular surgery. James Fonger, MD, FRCS, holds a dual board certification in general surgery and cardiovascular surgery. Contact their offices today for a consultation.

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