Venous Thromboembolism Pulmonary Embolism (PE)

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Pulmonary embolism is a type of venous thromboembolism (VTE) that occurs when a blood clot breaks loose and travels through the bloodstream to the lungs. Usually, pulmonary embolisms come from blood clots in the deep veins of the leg (deep vein thrombosis (DVT)).

You may not have any symptoms of pulmonary embolism. Other times, symptoms come on quickly, within seconds to minutes. Or they may come on more slowly — over days to weeks — and can start off mild, then become more serious as time goes on.

Common pulmonary embolism symptoms include:

• Shortness of breath
• Pain with deep breathing
• Rapid breathing
• Higher heart rate

Less common symptoms of pulmonary embolism include:

• Coughing, with or without blood
• Feelings of anxiety or dread
• Lightheadedness or fainting
• Sweating

Your healthcare provider will diagnose a pulmonary embolism based on your symptoms, medical history, a physical exam, and various imaging or blood test results.

• Computed tomography pulmonary angiography (CTPA) takes pictures of your blood vessels and looks for blood clots in the lungs. It is the main test to diagnose pulmonary embolism.
• Blood tests measure substances in the blood that may be signs of a blood clot. D-dimer tests measure a substance in the blood that is released when the fibrin proteins (proteins that help stop bleeding) in a clot dissolve. If the test shows high levels of the substance, you may have DVT, which can lead to PE. These tests may be used as a first step to look for signs of a blood clot in otherwise healthy people. Your provider can also check the oxygen levels in your blood. Low blood oxygen can be a sign of a blood clot.
• Ventilation perfusion (V/Q) scan measures air flow (ventilation) and blood flow (perfusion) in the lungs. If your lungs do not get the right amount of air or blood, you may have PE.
• Pulmonary angiography confirms pulmonary embolism if, after other testing, your healthcare provider suspects you have one. This test requires inserting a tube into your blood vessel. It also uses X-rays to create video of the blood flow to your lung so your provider can identify any blood clots.
• Other imaging tests look at blood flow through your veins, heart function, and lung function if the results of previous tests could not diagnose or rule out pulmonary embolism.

Pulmonary embolism occurs when an embolus (blood clot) from a deep vein blood clot breaks loose, travels to the lungs, and blocks an artery within the lung. Blood clots can develop in veins damaged by surgery or trauma, or they can develop as a result of inflammation caused by an infection or injury. Pulmonary embolism can also develop directly in the small blood vessels of the lungs, even if there are no clots in the arms or legs.

Learn more about what causes blood clots to form abnormally in the deep veins.

Most people can treat blood clots with medicines at home. Sometimes, more serious blood clots require you to stay in the hospital for treatment.

Your provider will likely prescribe blood-thinning medicines. If you are unable to take blood thinners, other medicines and procedures can help. Learn more about treatments.

If left untreated, pulmonary embolism can cause heart attack, shock , stroke, or death.

As you recover from pulmonary embolism, talk to your provider about steps you can take to stay healthy.

• Be aware of possible complications. Pulmonary embolism can cause pulmonary hypertension, which raises blood pressure in the vessels leading to your lungs and can result in heart failure. Signs of pulmonary hypertension include difficulty breathing (especially after exercise), swelling, coughing up blood, and fainting. You may feel tired or like your heart is beating too hard or too fast. If you have pulmonary hypertension several months after pulmonary embolism treatment, your provider may refer you to a surgeon to discuss removing any remaining lung clots.
• Prevent a repeat DVT. Talk with your provider about your risk, get regular checkups, and take all medicines as prescribed to help lower your chance of having repeat blood clots.
• Make healthy lifestyle changes. Talk to your provider about changes you may need to make, including choosing heart-healthy foods, getting physically active, aiming for a healthy weight, and quitting smoking.
• Take care of your mental health. Anxiety, fear, and stress can be common after a blood clot. Reach out to your healthcare provider if you need support.