Pulmonary Embolism (PE)

What Is Pulmonary Embolism?

A pulmonary embolism (PE) is a blockage in one or both of the pulmonary arteries in your lungs, typically caused by a blood clot that travels from the deep veins in your legs (a condition called deep vein thrombosis, or DVT). This blockage prevents normal blood flow, reduces oxygen levels, and can damage lung tissue or other organs. Pulmonary embolism is a life-threatening emergency that requires immediate medical attention.

Who Is Affected?

Pulmonary embolism can affect anyone, but it is more common in adults who:

• Are inactive for long periods (such as during travel)
• After trauma or during recovery from surgery
• Have certain medical conditions or take specific medications
• Have a family history of blood clots

What Causes Pulmonary Embolism?

Most pulmonary embolisms result from blood clots that form in the deep veins of the legs, travel through the bloodstream, and lodge in the lungs.

Risk Factors

Not Controllable

• Inherited blood clotting disorders
• Age (especially over 60)
• Cancer or cancer treatments
• History of previous clots or PE or DVT
• Family history of PE or DVT
  
  

Controllable

• Prolonged immobility (long flights, bed rest)
• Recent surgery or trauma
• Smoking
• Obesity
• Hormone therapy or birth control pills
• Pregnancy or recent childbirth
  
  

Who Is Most at Risk?

• Individuals who have had recent surgery, especially orthopedic
• People with cancer or heart disease
• Pregnant women and those in the postpartum period
• Anyone immobilized for extended periods (hospitalization, travel)
• People with a history of clots or genetic clotting disorders
  
  

How to Reduce Your Risk

• Stay active—move regularly during long travel or recovery
• Wear compression stockings if prescribed
• Quit smoking
• Maintain a healthy weight
• Take blood thinners if recommended after surgery
• Know your family history and discuss it with your doctor

What Are the Symptoms?

Symptoms of PE can appear suddenly and range from mild to severe. Common symptoms include:

• Sudden shortness of breath
• Chest pain that may worsen with deep breathing or coughing
• Cough, sometimes producing bloody mucus
• Low oxygen levels detected by a pulse oximeter
• Rapid heart rate
• Lightheadedness or fainting
• Anxiety or a sense of doom

How Is Pulmonary Embolism Diagnosed?

A prompt and accurate diagnosis is critical to prevent serious complications.

Common Diagnostic Tests:

• D-dimer blood test: Measures a substance released when clots break down
• CT pulmonary angiography: The most commonly used and accurate imaging test
• Ventilation-perfusion (V/Q) scan: Assesses airflow and blood flow in the lungs
• Ultrasound of the legs: Checks for DVT as the clot source
• Echocardiogram: Evaluates heart strain caused by the blockage of pulmonary arteries
• Chest X-ray or EKG: Rules out other conditions

How Is Pulmonary Embolism Treated?

Treatment focuses on breaking up or removing the clot, preventing new clots, and supporting heart and lung function.

Lifestyle

• Stay active
• Avoid long periods of immobility
• Maintain a heart-healthy lifestyle
  ​

Devices

• Compression stockings: Prevent clots in the legs
• Inferior vena cava (IVC) filter: Implanted in rare cases to catch clots before they reach the lungs
  
  

Medical Treatment

• Anticoagulants (blood thinners): Mainstay of treatment. Blood thinners prevent new clots from forming and help prevent existing clots from growing larger.
• Thrombolytics: “Clot-busting” drugs used in severe or life-threatening cases
• Oxygen therapy to maintain oxygen levels
  
  

Surgical Treatment

• Catheter-directed thrombolysis: A catheter delivers medication directly to the clot.
• Catheter-directed thrombectomy: A catheter is inserted through the vein, and the clots are extracted out.
• Surgical embolectomy: Rarely performed, removes the clot directly from the artery
  
  

Other Therapies

• Pulmonary rehabilitation: May be recommended for patients recovering from a severe PE

When to Seek Care

When to See Your Doctor

Call your provider if you experience:

• Unexplained shortness of breath
• Swelling or pain in your legs
• New chest discomfort
  
  

When to Seek Emergent Medical Care

Seek emergency care immediately if you experience:

• Sudden difficulty breathing
• Chest pain or tightness
• Fainting or severe lightheadedness
• Coughing up blood
  
  

These may be signs of a life-threatening pulmonary embolism.

What Should You Do Next?

If you’re at risk for pulmonary embolism or have symptoms:

• Seek immediate medical attention
• Talk to your doctor about preventive measures
• Learn about your risk factors, especially after surgery or travel
• Follow your treatment plan if you've had a PE in the past