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pulmonary embolism
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Quick Facts

A pulmonary embolism is a fancy word for a blood clot somewhere in the body that winds up breaking free and depositing in the lungs.Many times there are clues that a healthcare provider can see before a large clot becomes a pulmonary embolism.


Blood travels from the heart to the lungs through the pulmonary artery and its branches.  Once the blood reaches the lungs, it becomes oxygenated and travels back into the heart where it is then pumped out to the rest of the body.  The oxygen exchange which occurs in the lung is essential to supplying our body with the oxygen-rich blood needed to keep us alive.

A Pulmonary Embolism (PE) is a potentially life-threatening condition that occurs when a blood clot travels from another portion of the body and blocks blood flow to the pulmonary artery or one of its branches.

It is estimated that 90% of these clots, otherwise known as deep vein thromboses (DVTs), originate in the deep veins of the leg.  While most of these clots dissolve naturally, if a DVT dislodges from the wall of the vein where it formed and is attached, it can travel to the heart.  If  large enough, the DVT will become stuck in the pulmonary artery or one of its branches, thereby causing partial or complete blood flow obstruction to the lungs.  This is a life-threatening situation.

Because DVTs occur in the leg, it is essential that a doctor recognize the signs and symptoms of a DVT.  This includes leg swelling (most often in the calf region), pain and tenderness and reddish discoloration that is warm to the touch.  The presence of a DVT can be diagnosed by an ultrasound, a painless and noninvasive test that takes a short time to perform.

According to the U.S. Surgeon General’s estimate, between 350,000 and 600,000 patients suffer DVTs and PEs each year in the United States.  These DVTs and PEs result in excess of 100,000 deaths annually.   Tragically, the vast majority of these deaths were preventable with early diagnosis and treatment.

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Pulmonary Embolism Symptoms

Some PE victims may experience PE symptoms while others may experience no symptoms at all. In addition, some PE victims experience DVT symptoms only.  Because a PE is a medical emergency, it is important to seek medical attention if PE or DVT symptoms occur. Symptoms of a PE can include:

  • Chest pain.
  • Sudden shortness of breath or trouble breathing.
  • Cough or cough with blood.
  • Irregular heartbeat (arrythmia).
  • Dizziness, light-headedness or fainting.
  • Bluish tint to skin or paleness.
  • Increased or repaid breathing.
  • Increased heart rate.

Pulmonary Embolism and Blood Clot Risk Factors

The following is a list of medical conditions that may put you or a loved one at risk for developing a PE or DVT:

  • Current or previous diagnosis of blood clots or previous pulmonary embolism.
  • Recent surgery.
  • Recent period of immobilization (e., best rest or an immobilization cast).
  • Prolonged airplane or car travel.
  • Recent broken bone.
  • Heart Disease.
  • Pregnancy or recent birth.
  • Increased age.
  • Some medications, including hormonal birth control.
  • Previous stroke or heart attack.
  • Physical trauma or injury.
  • Recent spinal cord injury.
  • Family history of blood clots.
  • Inherited or genetic blood clotting condition which increased clotting.
  • Central venous catheter.
  • Varicose veins.
  • Current or recent infection.
  • Inflammatory bowel disease including Crohn’s or Ulcerative Colitis.

Diagnostic Testing

The type of diagnostic testing to confirm the existence or absence of potential PE is dependent upon the suspicion level.  The Wells Score (insert link) developed in 1995 is commonly used to predict the likelihood of a PE. Many physicians will use the Wells Score System or a modified Wells Score System to identify a particular patient as having a low clinical probability, an intermediate clinical probability or high clinical probability of suspicion for DVT.

  • Low or Moderate Level of Suspicion

    In these patients, a simple blood test called a D-Dimer is sufficient to exclude the possibility of a PE.

  • High Level of Suspicion

    In these patients, imaging is necessary to confirm or exclude a PE. CT pulmonary angiography and V/Q (ventilation/perfusion) scanning provide invaluable diagnostic information as to the presence or absence of a PE.

  • Treatment

    The most common treatment for a PE is anticoagulant (blood thinning) medication. This medication serves the dual purpose of keeping the clot from enlarging and new clots from forming. The common blood thinning medications prescribed for PEs include Coumadin and Heparin. If the patient is unable to take blood thinners, a filter can be inserted into the patient’s Inferior Vena Cava, a vein in the body that carries blood from the lower body to the heart. While the filter will not stop blood clots from forming, it will block the clot before it gets to the patient’s lung. Since most PEs come from clots that form in the deep veins of the leg, patients with DVTs are often prescribed compression stockings. These stockings act to compress the veins in the calf and prevent blood from becoming static and pooling, which can cause clots to form.

PEs are one of the leading cause of preventable patient deaths in hospitals. When DVT and PE symptoms are misunderstood, misdiagnosed or ignored by health care providers, the consequences can be deadly.