What is a Pulmonary Embolism?
A pulmonary embolism occurs when one or more blood clots move from somewhere in your body to the lungs. The clot becomes lodged in a pulmonary (lung) artery and blocks the blood flow. A pulmonary embolism can be life-threatening and requires prompt medical treatment.
Pulmonary Embolism Symptoms
Pulmonary embolisms generally have no symptoms until the clot stops or significantly decreases blood flow. When you notice symptoms, you should seek medical attention quickly.
Symptoms usually appear suddenly. Watch for the signs of a pulmonary embolism:
- Cough that may produce blood
- Difficulty breathing or shortness of breath
- Dizziness or lightheadedness
- Low blood pressure
- Rapid heartbeat
- Sharp pain in the chest
Does Pulmonary Embolism Pain Come and Go?
Pulmonary embolism symptoms do not come and go and do not decrease with medication, rest, stretching, or massage. Exercise or coughing may aggravate your symptoms.
Get Emergency Treatment for Pulmonary Embolism
A pulmonary embolism requires immediate care. If you are experiencing symptoms, call 911 or visit your nearest emergency room.
To contact the emergency department at the University Hospital, call 801-581-2291 or call 801-213-4500 for the emergency room at South Jordan ÐÇ¿Õ´«Ã½ Center.
How Long Can You Have a Pulmonary Embolism Without Knowing?
The number and size of the blood clots in your lung determine the severity of your symptoms. Larger clots cause more damage to your lung tissue and put more stress on your heart. Therefore, with larger clots you’re more likely to have noticeable symptoms. On the other hand, if the clot is small, you may have no symptoms. It’s possible to have a small pulmonary embolism and never know it.
Pulmonary Embolism Causes
When your blood vessels are injured, parts of your blood clump together to create a clot. In most cases, your body breaks down and reabsorbs the clot. However, a medical condition, medication, or lifestyle factor may stop your body from dissolving the clot or may lead to excessive clot formation.
Blood clots are either provoked or unprovoked. Provoked blood clots are more common for people who’ve had recent joint or abdominal surgery or an injury to the lower extremities. Unprovoked blood clots occur for no identifiable reason. People with this type of clot are at greater risk of having another.
Clots often start deep inside your leg veins but can also begin in your arms or pelvis. Sometimes, the clot breaks off and moves to your lungs, causing a pulmonary embolism.
Pulmonary Embolism Risk Factors
Some medical conditions increase your risk of developing a blood clot. For example, cancer, pregnancy, kidney, heart disease, some autoimmune disorders, and clotting disorders called thrombophilias put you at greater risk.
Other risk factors include:
- estrogen hormone therapy,
- extended bed rest at home or in the hospital,
- long trips in a car or plane,
- personal or family history of blood clots, and
- smoking.
Why Choose University of Utah ÐÇ¿Õ´«Ã½?
Our team will diagnose pulmonary embolisms in our emergency rooms and offer the most advanced treatment therapies. University of Utah Hospital’s emergency department is an . As such, it provides the highest level of care and achieves the best patient outcomes.
How to Diagnose a Pulmonary Embolism
A pulmonary embolism often mimics other conditions, such as a panic attack, heart attack, or pneumonia. Your doctor will discuss your health history, perform a physical exam, and order tests to diagnose a pulmonary embolism.
Pulmonary Embolism Tests
A D-dimer is a blood test that measures blood protein levels that signal the presence of a clot. If the D-dimer test is positive or if your history or exam suggest a high risk for a pulmonary embolism, your provider will order a computed tomography (CT) scan. A CT scan allows your doctor to see the blood clot in your lungs. Patients who can’t have CT scans due to kidney disease or contrast (dye) allergies can have ventilation-perfusion scans (V/Q) to test blood flow through their lungs.
Pulmonary Embolism Treatment
If you have a pulmonary embolism, you need prompt treatment to prevent serious complications or death. Treatment aims to keep the existing clot from becoming larger and prevent new clots from forming.
Pulmonary Embolism Medication
Anticoagulant medications (sometimes called blood thinners) are the most common treatment method. These medications prevent blood from clotting and help your body break down existing clots naturally. You may receive an anticoagulant as a pill, an injection, or intravenously (through your vein). Some of the most common anticoagulant medications are warfarin, rivaroxaban, apixaban, and heparin.
You will need to take the medication for at least three months to allow your body to break down the clot and to prevent new clots from forming. You may need a longer treatment course if you have certain risk factors.
Patients with life-threatening pulmonary embolisms may receive a thrombolytic medication to break down the clot quickly. ÐÇ¿Õ´«Ã½ care providers reserve these medications for critically ill patients since they can cause complications and excessive bleeding.
Pulmonary Embolism Surgery
Large clots that don’t respond to medication require surgery to remove them. A suction thrombectomy is a minimally invasive surgical procedure to remove a blood clot from a lung artery. Your interventional radiologist or cardiologist will make a small incision (cut) in your artery and use a catheter (small tube) to suck the clot out.
The most severe clots may require a surgical pulmonary embolectomy. During this procedure, a cardiothoracic (heart, lungs, and esophagus) surgeon opens your chest cavity and removes the blood clots from your pulmonary artery.
Pulmonary Embolism Recovery
You will stay in the hospital for a few days if you’ve had surgery or if your provider wants to monitor your condition. If your provider can treat your blood clots with an oral medication and you don’t have significant risk factors, you may not need to stay in the hospital.
Take anticoagulation medications as directed. As the medicine helps your body break down and absorb the blood clot, your symptoms will decrease and possibly disappear. Follow your provider’s instructions for resuming physical activity and listen to your body’s signals. During recovery, you may become tired more easily or find yourself short of breath.
Recovery time varies, depending on the size and number of blood clots in your lungs. Most people recover within a few weeks. Others may experience shortness of breath and other symptoms for several months after diagnosis. While rare, some people may always experience some discomfort in their chest.
Pulmonary Embolism & Mental ÐÇ¿Õ´«Ã½
After a pulmonary embolism, some people develop anxiety or fear of having another one. Talk to your provider if your feelings don’t improve, if you refrain from activities you enjoy, or if you have increased negative thoughts. These feelings could signal depression, which requires treatment.
Can You Have a Pulmonary Embolism While on Blood Thinners?
While not impossible, it’s unlikely to have a pulmonary embolism while taking blood thinner medications. Patients with other health conditions, like cancer or a clotting disorder, are at the highest risk for a pulmonary embolism while taking anticoagulation.
For the medications to work correctly, you need to take anticoagulants exactly as prescribed by your health care provider. Other medications, herbal supplements, some foods, and alcohol can change how blood thinners work. Be sure to ask your provider before taking new medications, including over-the-counter ones.
How to Prevent a Pulmonary Embolism
Once you’ve had a pulmonary embolism, your risk of having another blood clot may increase. You shouldn’t take birth control pills or estrogen hormone therapy if you have a history of blood clots. Additionally, start moving as soon as possible after surgery or illness to encourage blood flow through your veins and arteries. When traveling, take frequent breaks to walk and stretch your legs.
Making healthy lifestyle choices will also help prevent blood clots:
- Drink plenty of fluids.
- Eat a balanced diet.
- Get regular exercise.
- Maintain a healthy weight.
- Quit smoking.
- Take your medication as prescribed.