Pulmonary embolism (PE) is triggered by a blockage in a lung artery, usually a blood clot (deep vein thrombosis or DVT) that travels from the legs or arms, but sometimes other substances like fat or tumor pieces. Key triggers include prolonged immobility (long flights, bed rest), surgery/trauma (especially leg, hip, pelvic), cancer, pregnancy, heart/vascular conditions, certain medications (like birth control), smoking, obesity, and genetic clotting disorders.
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.
Older age. Cancer and cancer therapy. Certain medical conditions, such as heart failure, chronic obstructive pulmonary disease (COPD), high blood pressure, stroke, and inflammatory bowel disease. Certain medicines, such birth control pills and estrogen replacement therapy.
Sometimes, increases in clotting factors along with decreased flow in the veins from the expanding uterus can cause blood clots to develop in the legs. When a clot breaks free and travels to the lungs, it becomes a medical emergency known as pulmonary embolism (PE).
In most patients with pulmonary embolism (PE), the cause or the trigger for thrombosis is apparent and might be an inherited thrombophilia, a recent hip fracture, a recent major operation, hormonal replacement therapy, central lines, a pregnancy, etc.
Risk factors include prolonged immobility, having a family history of deep vein thrombosis or pulmonary embolism, being older than age 60, having certain cancers, being a smoker, and using oral contraceptives or hormone therapy.
A recent meta-analysis of a Chinese team published in 2021 has reached the conclusion of an increased risk of pulmonary embolism in patients receiving antipsychotic drugs compared to non-users, with a pooled odds ratio of 3.68 (95% confidence interval, 1.23, 11.05), especially with haloperidol (case 1), olanzapine (all ...
Early signs of a pulmonary embolism (PE) are often sudden and severe, including sudden shortness of breath, sharp chest pain that worsens with breathing, rapid heart rate and breathing, coughing (sometimes with blood), and lightheadedness or fainting, often accompanied by leg pain/swelling from a deep vein thrombosis (DVT). Because PE is life-threatening, seek immediate emergency care (like calling 911 or going to the ER) if you experience these symptoms.
You may feel like you're having a heart attack. The pain is often sharp and felt when you breathe in deeply. The pain can stop you from being able to take a deep breath. You also may feel it when you cough, bend or lean over.
Who is more likely to develop a pulmonary embolism (PE)?
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.
Early blood clot symptoms often involve swelling, pain/tenderness, warmth, and redness/discoloration in a limb, typically the calf or thigh, feeling like a cramp or charley horse but with added swelling. Key signs include a heavy ache, visible veins, and skin that's warm or darkened. If the clot travels to the lungs (pulmonary embolism), symptoms are sudden shortness of breath, chest pain, rapid pulse, or coughing blood, requiring emergency care.
Mild pulmonary embolism symptoms could be found gradually because of small clot accumulation. However, a large clot that is positioned directly in the middle of the artery between the two main arteries, known as a saddle pulmonary embolism, can be fatal in as little as 30 minutes up to 2 hours without treatment.
Seven common red-flag warning signs of a PE include: Sudden shortness of breath. Sharp chest pain when inhaling. Rapid breathing or wheezing.
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.
What is the main cause of an embolism? Most emboli are pulmonary emboli that originate from blood clots that start in the leg veins (deep vein thrombosis). Sometimes, deep vein thrombosis in the arm veins can also lead to pulmonary embolism.
One of the reasons PE is often misdiagnosed is that these symptoms overlap other lung conditions, like pneumonia or asthma. In fact, patients with PE are often misdiagnosed with pneumonia or asthma and sent home from the hospital or doctor's office.
While many blood clots dissolve with the help of blood thinners, some dangerous clots require fast-acting clot-busting medications called thrombolytics. Because thrombolytics can cause severe bleeding, doctors usually give them only to people with large, severe clots that increase risk of pulmonary embolism.
How long can you have a pulmonary embolism without knowing? Some people have mild symptoms that appear over a number of days or even weeks. Over time, the symptoms get worse and get your attention. But some people get symptoms just minutes (or even seconds) after a pulmonary embolism happens.
A pulmonary embolism can be diagnosed in several ways, including: Computed tomography (CT): Scan of the chest with Doppler ultrasound of the legs (the most common method of diagnosing a PE and DVT) Chest X-ray: Provides a picture of the lungs and chest and helps rule out other possible conditions.
This process happens incredibly fast. According to Pulmonary Physiology, blood cells typically move through the pulmonary circulation in just four to five seconds, meaning a clot can lodge in the lungs mere moments after detaching. Once in the lungs, the clot can block blood flow, leading to a pulmonary embolism (PE).
Pulmonary Embolism
Sudden shortness of breath. Chest pain that's sharp and stabbing; may get worse with deep breath. Rapid heart rate. Unexplained cough, sometimes with bloody mucus.
The most common causes of pulmonary embolism (PE) are:
Cancer, heart diseases (including congestive heart failure atrial fibrillation), heart attack, and stroke, among other conditions, can make it more likely for a blood clot or PE to form.
Some medications can raise your risk of blood clots — particularly those that contain hormones. These include: Birth control pills with estrogen. Estrogen-based oral treatments that help with menopause symptoms.
Aspirin reduces the risk of venous thromboembolism (VTE) by 20%, deep vein thrombosis (DVT) by 18%, pulmonary embolism (PE) by 21%, and VTE-related mortality by 56% compared with placebo.