Pulmonary embolism – spot the symptoms

A pulmonary embolism (PE) happens when a blood clot travels to the lungs, dangerously blocking blood flow. Find out what causes it and how to minimize your risk, to prevent this life-threatening condition from happening to you.

What are the symptoms?

What causes it and who’s affected?

When to see a doctor 

Getting diagnosed

What are the treatments?

Reducing your risk of PE

Where to get support 

A pulmonary embolism (PE) happens when a blood clot causes a blockage and stops blood flow to your lungs. It is serious and even life-threatening, which is why knowing the symptoms and taking steps to reduce your risk are not just important – they could save your life.

A pulmonary embolism is a serious and potentially life-threatening condition that needs urgent medical attention.

It happens when a blood clot – which often starts in a leg vein – breaks free and travels to the lungs, blocking blood supply. 

Spotting the symptoms of a pulmonary embolism, and getting medical treatment as soon as possible, is key to making a full recovery. 

Make sure you know the signs to look out for plus how to reduce your risk of a blood clot forming in the first place – or another clot happening if you’ve already had a pulmonary embolism.


## What are the symptoms?

A pulmonary embolism is a medical emergency because it happens suddenly, restricting blood flow to your lungs, affecting oxygen levels and blood pressure. 

It can also cause lung damage, and put a strain on your heart, potentially causing heart failure. 

Symptoms of pulmonary embolism vary depending on the location and size of the clot, plus whether you have a heart or lung condition. Common symptoms include:

- sudden difficulty in breathing
- chest pain – particularly when breathing in
- fainting – if your heart rate or blood pressure suddenly drops
- coughing up blood.

You may also have pain, redness, or swelling in your calf or leg – these are signs of a blood clot called a deep vein thrombosis (DVT). __Get emergency medical help if you are experiencing DVT symptoms.__ 

Other symptoms of pulmonary embolism can include:

- racing heartbeat
- dizziness
- sweating or clammy skin
- fever. 

__If you find it suddenly hard to breathe or you’re coughing up blood, [see a doctor urgently.](https://www.livehealthily.com/health-library/conditions/pulmonary-embolism#when-to-see-a-doctor)__ 

__Severe difficulty in breathing, upper chest or back pain, a fast heartbeat, and passing out (fainting) can be signs of pulmonary embolism or another serious condition, and you need emergency medical attention.__  

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## What causes it and who’s affected?

A pulmonary embolism is when a blood clot gets stuck in an artery in your lungs, blocking blood supply to this vital organ.

This is usually caused by a deep vein thrombosis (DVT): a blood clot that forms in your leg but then breaks free and travels up to your lungs through your veins. 

Less common things that can lead to a pulmonary embolism include part of a tumor, air bubbles, or fat that comes from the inside of a broken bone. 

Certain risk factors make the chance of having a pulmonary embolism more likely, including:   

- medical conditions – such as cardiovascular disease, [heart attack](https://www.livehealthily.com/health-library/conditions/heart-attack), [stroke](https://www.livehealthily.com/health-library/conditions/stroke), diabetes, high blood pressure, or cancer 
- a family history of blood clots, or a blood clotting disorder
- traveling via plane, train, or car for long distances without moving regularly
- smoking 
- being overweight or obese 
- being over the age of 60 
- having had recent surgery. 

Women are also at greater risk of developing a pulmonary embolism if they:

- take hormonal medication (HRT or birth control) 
- are pregnant or who have recently given birth (within the last 6 weeks), although this is rare. 


## When to see a doctor 

If you have signs of [deep vein thrombosis (DVT)](https://www.livehealthily.com/health-library/conditions/deep-vein-thrombosis), and have pain, redness, or swelling in your calf or leg, get emergency medical help. 

You should also seek emergency help if you have other symptoms that can indicate pulmonary embolism, including:

- severe breathing problems 
- pain in your chest or upper back
- a fast heartbeat
- fainting.

See a doctor urgently if you are:

- suddenly finding it difficult to breathe
- coughing up blood. 


## Getting diagnosed

To diagnose a pulmonary embolism your doctor will inspect your legs for any evidence of a deep vein clot, listen to your heart and lungs, and check your blood pressure.

You will also need further tests and scans to check your lungs, veins, and heart. These tests may include:

- __blood tests__ to detect clot formation
- __chest X-ray__ to rule out other heart and lung conditions 
- __ultrasound__ to measure blood flow
- __CT scan__ to analyze blood vessels
- __pulmonary angiogram__ to show blood clots in the lungs
- __ventilation-perfusion (VQ) scan__ to check flow of air and blood
- __electrocardiogram__ to check heart activity
- __echocardiogram__ to measure heart function. 


## What are the treatments?

If your doctor suspects you have a pulmonary embolism, you will usually be given anticoagulant medication in hospital. 

This helps by thinning the blood and can stop clots from getting bigger or prevent new ones from forming. 

If a clot is confirmed you will need a short-term course of anticoagulant injections followed by a course of medication. 

In some cases, a procedure to remove the clot will be required, usually through a vein (percutaneous thrombectomy). Surgery may also be necessary in life-threatening cases and some patients may need to have a filter fitted into the main vein near the heart. 

It is usually possible to make a full recovery from a pulmonary embolism – provided it is spotted and treated early – however there can be complications, such as bleeding from anticoagulants, and recurrent blood clots. 

You may require ongoing treatment to manage or prevent these.


## Reducing your risk of PE

You can minimize your risk of a pulmonary embolism by reducing chances of a deep vein thrombosis (DVT) from forming in the first place.

As blood clots are often associated with traveling, particularly on long-haul flights, try:

- sitting with plenty of legroom, if possible
- getting up and moving around regularly
- helping your circulation by bending and straightening your legs, feet, and toes every half hour in your seat, and pressing down the balls of your feet from time to time
- wearing flight socks. 

Try to avoid:

- drinking alcohol
- drinking too much coffee or other caffeine-based drinks
- taking sleeping pills
- staying in your seat without moving.

Generally speaking, following an active and healthy lifestyle will help reduce your risk of future DVT or PE clots. 

If you are inactive due to illness, injury, pregnancy, or bedrest, take precautions to avoid blood clots forming, including:

- keeping your leg raised when sitting
- moving around as much as you can
- wearing support or compression stockings 
- avoiding prolonged immobility, for instance when traveling 
- taking medication prescribed by your doctor
- making lifestyle changes such as exercising more and eating a balanced diet. 


## Where to get support 
These support organizations can help you feel less isolated while you recover from a pulmonary embolism and manage the condition moving forward.

- [The American Blood Clot Association (US)](https://bloodclot.org/)
- [National Blood Clot Alliance (US)](https://www.stoptheclot.org/peer-support/)
- [The National American Thrombosis Forum (NATF) (US)](https://thrombosis.org/)
- [Thrombosis UK](https://thrombosisuk.org/)


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References

Juliet Blank

Jo Wheatley

Dr Ewan O'Farrell

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