People can get pulmonary embolism (PE) at any age, but the risk significantly increases after 40, especially after 60, with risk doubling every decade, though it's surprisingly affecting younger adults more, with rising mortality in those 25-64. While uncommon in youth, PE becomes more frequent with age due to blood composition changes and vein issues, though many risk factors (like immobility, surgery, cancer, pregnancy) can strike at any life stage.
These data indicate that pulmonary embolism tends to have a subtle presentation in younger adults. When diagnosed and treated, the mortality rate is substantially less among younger as compared with older patients.
The clots happen to some 900,000 people every year in the United States, but most occur in people ages 60 years or older. “Pulmonary embolisms are unusual events in people at a young age,” said Dr. Todd Bull, a pulmonologist and director of the UCHealth Pulmonary Vascular Disease Clinic.
Common symptoms include:
Certain people are genetically disposed to blood clots, putting them at higher risk of a pulmonary embolism, so a family history can help your doctor identify the issue. Additionally, preexisting conditions like heart disease, interstitial lung disease, COVID-19, or many forms of cancers can make clotting more likely.
Pulmonary embolism is caused by a blocked artery in the lungs. The most common cause of such a blockage is a blood clot that forms in a deep vein in the leg and travels to the lungs, where it gets lodged in a smaller lung artery.
Seven common red-flag warning signs of a PE include: Sudden shortness of breath. Sharp chest pain when inhaling. Rapid breathing or wheezing.
The first signs of pulmonary embolism are usually shortness of breath and chest pains that get worse if you exert yourself or take a deep breath. If you have these symptoms, get medical attention right away. Pulmonary embolism is serious but very treatable.
The most common symptoms are: Shortness of breath that appears suddenly. Chest pain that may become worse when breathing in that is so sharply felt you may think you are having a heart attack. Lightheadedness, dizziness or passing out due to a sudden loss in blood pressure.
Leading an active lifestyle, quitting smoking, and staying as mobile as possible can decrease your risk of developing pulmonary embolism.
Pulmonary emboli affect about 900,000 people in the U.S. each year. They can happen to anyone at any stage of life, even very healthy people. Depending on the size of the clot and which blood vessels are blocked, a pulmonary embolism can be life-threatening.
28: Men's Health Essentials — Pulmonary Embolism, The Silent Killer. One-third of pulmonary embolism patients will die of cardiac arrest before they even realize they have a blood clot.
Symptoms of a pulmonary embolism typically come on suddenly, and you should seek urgent medical attention if you experience the following: A cough, which may contain blood. A heavy feeling in your chest, or chest pain. Dizziness or a feeling of being 'light-headed'
As I've explained to my patients, the body often dissolves blood clots on its own, but for many people, these clots don't go away completely. They stay in the lungs and lead to reactions in the blood vessels of the lungs, causing scar tissue to form that grows and lines the blood vessels.
Early blood clot symptoms often involve pain, swelling, warmth, and redness in a limb (like a leg or arm), usually in the calf or thigh, feeling like a cramp but with swelling. More serious clots can cause sudden shortness of breath, chest pain (worse with breathing), dizziness, coughing blood, or stroke-like symptoms (speech/vision issues, paralysis), requiring immediate emergency care.
Young people are less likely than older people to develop DVT. The cumulative chance of developing DVT over a lifetime ranges from 2 percent to 5 percent. While certain conditions can provoke DVT (such as cancer, surgery, and being confined to bed), this condition may also occur spontaneously.
What are the symptoms of a pulmonary embolism?
A chest X-ray or ECG are not diagnostic for PE, but they may be useful in the differential diagnosis. Chest X-ray features that may be present in people with PE include atelectasis, pleural effusion, or elevation of a hemidiaphragm.
Common Blood Tests at Urgent Care:
D-dimer Test: This is a point-of-care test often used in urgent care settings to help rule out blood clotting disorders, such as deep vein thrombosis or pulmonary embolism. It provides quick results, which is crucial in emergency situations.
Most common wrong diagnosis for PE include pneumonia, bronchitis, exacerbation of chronic obstructive pulmonary disease, and heart failure.
In pulmonary embolism, the chest examination is often normal, but if there is some associated inflammation on the surface of the lung (the pleura), a rub may be heard (pleura inflammation may cause friction, which can be heard with a stethoscope).
Signs of a Pulmonary Embolism
Symptoms usually begin suddenly and may include: Sudden shortness of breath. Sharp chest pain, often aggravated by coughing or movement. Pain in your back.
CT pulmonary angiography — also called a CT pulmonary embolism study — creates 3D images that can find changes such as a pulmonary embolism within the arteries in your lungs. In some cases, contrast material is given through a vein in the hand or arm during the CT scan to outline the pulmonary arteries.
If your calculated PASP is <60 mmHg and your measured PAT is <60msec then the 60/60 sign is positive and there is a high likelihood that PE is present. In fact, a validation study was done with the 60/60 sign and found that it was 94% specific at identifying PE.
The Homan's test has three steps: