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February 6, 2012
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Pulmonary Embolism

Medical Author:
Charles Patrick Davis, MD, PhD

Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.

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Medical Editor:
George Schiffman, MD, FCCP
George Schiffman, MD, FCCP
George Schiffman, MD, FCCP

Dr. Schiffman received his B.S. degree with High Honors in biology from Hobart College in 1976. He then moved to Chicago where he studied biochemistry at the University of Illinois, Chicago Circle. He attended Rush Medical College where he received his M.D. degree in 1982 and was elected to the Alpha Omega Alpha Medical Honor Society. He completed his Internal Medicine internship and residency at the University of California, Irvine.

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Living With Pulmonary Embolism

Pulmonary embolism (PE) usually is treated in a hospital. After leaving the hospital, you may need to take medicine at home for 6 months or longer. It's important to:

  • Take all medicines as prescribed, and have blood tests done as your doctor advises.
  • Talk with your doctor before taking blood-thinning medicines with any other medicines, including over-the-counter products. Over-the-counter aspirin, for example, can thin your blood. Taking two medicines that thin your blood may increase your risk of bleeding.
  • Ask your doctor about your diet. Foods that contain vitamin K can affect how well warfarin (Coumadin) works. Vitamin K is found in green leafy vegetables and some oils, such as canola and soybean oils. It's best to eat a well-balanced, healthy diet.
  • Discuss with your doctor what amount of alcohol is safe for you to drink if you're taking medicine.

Medicines used to treat PE can thin your blood too much. This can cause bleeding in the digestive system or the brain. If you have signs or symptoms of bleeding in the digestive system or the brain, get treatment at once.

Signs and symptoms of bleeding in the digestive system include:

  • Bright red vomit or vomit that looks like coffee grounds
  • Bright red blood in your stool or black, tarry stools
  • Pain in your abdomen

Signs and symptoms of bleeding in the brain include:

  • Severe pain in your head
  • Sudden changes in your vision
  • Sudden loss of movement in your legs or arms
  • Memory loss or confusion

Excessive bleeding from a fall or injury also may mean that your PE medicines have thinned your blood too much. Excessive bleeding is bleeding that won't stop after you apply pressure to a wound for 10 minutes. If you have excessive bleeding from a fall or injury, get treatment at once.

Once you've had PE (with or without deep vein thrombosis (DVT)), you're at higher risk of having the condition again. During treatment and after, continue to take steps to prevent DVT.

Check your legs for any signs or symptoms of DVT, such as swollen areas, pain or tenderness, increased warmth in swollen or painful areas, or red or discolored skin.

If you think that you have DVT or are having symptoms of PE, contact your doctor right away.

SOURCE:
National Heart Lung and Blood Institute. Living With Pulmonary Embolism.

Pulmonary Embolism (PE) Overview

A pulmonary embolism (PE) is a blood clot in the lung. The clot usually forms in smaller vessels in the leg, pelvis, arms, or heart, but occasionally the clot can be large. When a clot forms in the large veins of the legs or arms, it is referred to as a deep venous thrombosis (DVT). The pulmonary embolism occurs when part or all of the DVT breaks away and travels through the blood in the veins and lodges in the lungs.

The clot travels through the vessels of the lung continuing to reach smaller vessels until it becomes wedged in a vessel that is too small to allow it to continue further. The clot blocks all or some of the blood from traveling to that section of the lung. These blockages result in areas in the lung were the disruption of blood flow does no allow the carbon dioxide waste to be delivered to the air sacs for removal (ventilation). Similarly, since blood is blocked to certain portions of the lung, oxygen can not be extracted from these same air sacs (perfusion). The process of matching the lungs ventilation with the blood flow through the lungs is disrupted, resulting in ventilation-perfusion inequalities. In other words, areas in the lung are ventilated (get air) but get no blood to exchange the waste product carbon dioxide with oxygen.

If the pulmonary embolism is large, it may be capable of such a large mismatch, the patient cannot get enough oxygen into the blood and can be become acutely short of breath. In some instances, clots are so large that blood flow is blocked from the right side of the heart entering the lungs. This can result in instantaneous death. In other patients, the mismatch is not so profound, but still causes symptoms, especially when oxygen demand increases (for example, during exercise). Pulmonary infarction (death of lung tissue due to arterial blockage) is unusual because of collateral circulation.

Pulmonary Embolism Causes

Several risk factors can make a person more likely to develop a blood clot that can eventually break loose and travel to the lung. Virchow's triad explains the reasons why clots form. This triad includes 1) immobilization (which reduces flow), 2) damaged vessel wall (which forms a location for clot to start, and 3) Hypercoagulable state (which makes it easier for blood to clot.

  • Immobilization: A stroke, broken bone, or spinal cord injury can result in confinement to bed so that clot formation can occur in either the arms or legs.
  • Travel: Prolonged travel, such as sitting in an airplane or a long car trip, allows the blood to sit in the legs and increases the risk of clot formation.
  • Recent surgery (includes hypercoagulable state due to surgical damage and the body trying to repair itself. It is also often associated with immobility and sometimes vessel damage depending on the surgery)
  • Trauma or injury (especially to the legs)
  • Obesity
  • Heart disease (such as an irregular heartbeat)
  • Burns
  • Previous history of blood clot in the legs (DVTs) or pulmonary embolism

Conditions that increase clotting of the blood

Picture of a Blood Clot

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Pulmonary Embolism (Blood Clot In The Lung) - Treatments

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What was your treatment for your pulmonary embolism

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Pulmonary Embolism (Blood Clot In The Lung) - Describe Your Symptoms

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Please describe your symptoms of pulmonary embolism (blood clot in the lung).

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Pulmonary Embolism

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Topic Overview

What is pulmonary embolism?

Pulmonary embolism is the sudden blockage of a major blood vessel (artery) in the lung, usually by a blood clot. In most cases, the clots are small and are not deadly, but they can damage the lung. But if the clot is large and stops blood flow to the lung, it can be deadly. Quick treatment could save your life or reduce the risk of future problems.

What are the symptoms?

The most common symptoms are:

  • Sudden shortness of breath.
  • Sharp chest pain that is worse when you cough or take a deep breath.
  • A cough that brings up pink, foamy mucus.

Pulmonary embolism can also cause more general symptoms. For example, you may feel anxious or on edge, sweat a lot, feel lightheaded or faint, or have a fast heart rate or palpitations.

If you have symptoms like these, you need to see a doctor right away, especially if they are sudden and severe.

What causes pulmonary embo...

Read the Pulmonary Embolism article »


Read What Your Physician is Reading on Medscape

Pulmonary Embolism »

Pulmonary embolism (PE) is a common and potentially lethal disease; unfortunately, the diagnosis is often missed because patients with PE present with nonspecific signs and symptoms.

Read More on Medscape Reference »

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