What is a pulmonary embolism?
A pulmonary embolism (PE) is a blood clot in the blood vessels of your lung. This happens when a clot in another part of your body (often your leg or arm) moves through the veins to your lung. A PE restricts blood flow to your lungs, lowers oxygen levels in your lungs and increases blood pressure in your pulmonary arteries.
Without quick treatment, a pulmonary embolism can cause heart or lung damage and even death.
What are the warning signs of a pulmonary embolism?
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. You may cough up bloody mucus.
If you have these symptoms, get medical attention right away. Pulmonary embolism is serious but very treatable. Quick treatment greatly reduces the chance of death.
What are the symptoms of a pulmonary embolism?
Symptoms of pulmonary embolism vary, depending on the severity of the clot. Although most people with a pulmonary embolism experience symptoms, some don’t.
Pulmonary embolism symptoms may include:
- Sudden shortness of breath — whether you’ve been active or at rest.
- Unexplained sharp pain in your chest, arm, shoulder, neck or jaw. The pain may also be similar to symptoms of a heart attack.
- Cough with or without bloody mucus.
- Pale, clammy or bluish skin.
- Rapid heartbeat (pulse).
- Excessive sweating.
- In some cases, feeling anxious, lightheaded, faint or passing out.
- Wheezing.
If you have any symptoms of pulmonary embolism, get medical attention immediately.
Because you can have a blood clot and not have any symptoms, discuss your risk factors with your healthcare provider.
How is a pulmonary embolism treated?
Healthcare providers usually treat a PE in a hospital, where they can monitor your condition closely.
The length of your pulmonary embolism treatment and hospital stay will vary, depending on the severity of the clot.
The main treatment for a PE is an anticoagulant (blood thinner).
Depending on the severity of your clot and its effect on your other organs such as your heart, you may also undergo thrombolytic therapy, surgery or interventional procedures to improve blood flow in your pulmonary arteries.
Anticoagulant medications
In most cases, treatment consists of anticoagulant medications (blood thinners). Anticoagulants decrease your blood’s ability to clot. This prevents future blood clots.
As with any medicine, it’s important to understand how and when to take your anticoagulant and follow your provider’s guidelines.
Your diagnosis will determine the type of medication you’ll take, how long you need to take it, and the type of follow-up monitoring you’ll need. Be sure to keep all scheduled follow-up appointments with your provider and the laboratory so they can monitor your response to the medication.
While taking anticoagulants, your follow-up will include frequent blood tests (prothrombin time test) to see how fast your blood clots. This helps your provider know if you’re taking the right dose.
Compression stockings
Compression stockings (support hose) improve blood flow in your legs. People with deep vein thrombosis often use them. You should use them as your provider prescribes. The stockings are usually knee-high length and compress your legs to prevent your blood from pooling.
Talk with your provider about how to use your compression stockings, for how long and how to care for them. It’s important to wash compression stockings according to directions to prevent damaging them.
Procedures
If a PE is life-threatening, or if other treatments aren’t effective, your provider may recommend using surgery or a catheter to remove the blood clot from your pulmonary artery. Thrombolytic therapy (next section) is another option.
Thrombolytic therapy
Thrombolytic medications (“clot busters”), including tissue plasminogen activator (TPA), dissolve the clot. People always receive thrombolytics in the intensive care unit (ICU) of a hospital where a provider can monitor them. You may receive this type of medication if you have a special situation, such as low blood pressure or an unstable condition because of the pulmonary embolism.
Side effects of the treatment
Bleeding is a possible side effect of medications for pulmonary embolism treatment. A provider will give you the dose of anticoagulants or thrombolytics that fits your situation. Keeping you in the hospital allows them to monitor your condition.