Pulmonary Embolism: Spot the Signs, Save a Life

Pulmonary embolism: Overview

Blood clots, fat, and tumors clog pulmonary arteries, causing pulmonary embolism. A blood clot that passes through your heart and blocks a lung artery is the most common cause of pulmonary embolisms. DVTs from the lower extremities produce most pulmonary embolisms, which often resolve on their own. Occasionally, pulmonary embolism causes abrupt death.

Possible causes of pulmonary embolism:

• Right-sided heart venous clots or circulatory system tumors
• Others include amniotic fluid, air, fat, bone marrow, and foreign substances.

Symptoms

Embolism patients may have:

• An abrupt cough with bloody mucus, visible blood, or mildly blood-streaked phlegm
• Sudden shortness of breath at rest or effort
• Lightheadedness
• Fainting
• Dizziness
• Sweating
• Anxiety
• Fast breathing
• Fast heartbeat
• Chest pain:
• Under the breastbone or side
• Cutting, scorching, hurting, or heavy feeling
• Maybe worst at night
• It may affect the shoulder, arm, neck, jaw, or elsewhere.
• Deep breathing, coughing, eating, bending, or stooping can worsen it.

If you suspect a pulmonary embolism or have any of these symptoms, get medical help right away. Physicians are able to identify whether your symptoms are due to a pulmonary embolism or another illness.

Possible Risks

All can have pulmonary embolism. Risk factors:

• Prolonged bed rest or inactivity, including long car or aircraft trips
• Taking birth control tablets
• Surgery
• Prenatally, throughout, and postnatally
• Cancer
• Stroke
• A heart attack
• Heart surgery
• Hip or femur fractures
• Prior DVT

Treatment

The video explains the treatment option for PE

• If you suspect a pulmonary embolism, please seek medical attention.
• If you have a lung or leg blood clot, your doctor will prescribe warfarin and heparin. Discuss all anticoagulant adverse effects with your doctor and pharmacist.
• Clot dissolvers may be prescribed by your doctor. Clots normally dissolve on their own, but you may use medications to speed up the process. These medications have hazards and are usually given in emergencies.

Term of Treatment

Anticoagulation (blood thinners) begins immediately and lasts at least 3 months.

• Longer Therapy:
• 3–6 months: Surgery, trauma-induced PE.
• 6–12 months or longer: Unprovoked PE or high recurrence risk.
• Recurring PE or clotting issues are lifelong.

Recovering and Monitoring

• Breathlessness and exhaustion may recover within weeks, but some individuals have months-long consequences.
• Clot resolution can be assessed at 3–6 months with follow-up imaging.
• Risk of Recurrence: Highest in the first year; strict monitoring required.

Prevention

• DVT (leg clots) can be detected and treated early to lower the pulmonary embolism.
• After surgery, your doctor may recommend walking and exercising to lessen the risk. In addition to leg workouts, compression stockings may help prevent clots. For long-term bed rest, subcutaneous heparin treatment may be administered at modest doses.

Traveling prevention

It is unlikely that you will get a blood clot while traveling. Anybody who travels more than four hours by bus, train, automobile, or airplane runs the risk of getting blood clots. When traveling, get up and move around a lot to strengthen your calves. Break from sitting to stretch your legs. Some airlines feature seat pocket magazines with workouts.

How to Diagnose Pulmonary Embolism?

An organized, multi-step strategy that balances speed, accuracy, and patient safety is needed to diagnose a pulmonary embolism (PE), a potentially life-threatening lung blood clot. Typically, this is done:

Diagnostic Process Steps

1. Clinic Evaluation

• History and symptoms: Sudden shortness of breath, chest discomfort, rapid heartbeat, bloody coughing, and fainting.
• Surgery, immobilization, malignancy, DVT/PE, or coagulation disorders increase risk.
• Based on clinical indications and history, scoring systems like the Wells Score assess PE risk.

2. Blood tests

• Elevated D-dimer levels indicate clot development, not just in PE.
• Arterial Blood Gas (ABG): Low oxygen or high carbon dioxide.
• The Clotting Profile checks for hereditary thrombophilias.

3. Imaging Exams

• CT pulmonary angiography (CTPA): The gold standard for pulmonary artery clot detection. Usually, A  contrast dye.
• A V/Q scan compares lung airflow and blood flow. Used when CT is contraindicated (kidney disease, pregnancy).
• Chest X-ray: Rules out other reasons but doesn't prove PE.
• Leg ultrasound: Detects DVT, which typically precedes PE.
• When other diagnostics fail, a pulmonary angiography is accurate yet invasive.

Emergency situations

Bedside ultrasonography, ECG abnormalities, and fast clinical judgment may diagnose unstable individuals without imaging.

PE duration

Depending on severity, treatment, and health, pulmonary embolism (PE) duration can vary. An organized breakdown clarifies:

Pulmonary embolism timeline

Start and Progress

• Large clots might cause acute PE symptoms between minutes to hours.
• Fatal Risk Window: 25% of PE patients cause sudden death without symptoms. Larger clots can kill in minutes if untreated.
• Subacute or chronic PE: Smaller clots may produce modest symptoms for days to weeks. Some develop CTEPH over months.

Also, read https://www.singhealth.com.sg/symptoms-treatments/pulmonary-embolism.

PE complications

Depending on clot size, location, and treatment timing, pulmonary embolism (PE) can cause immediate and long-term consequences. The overview is structured as follows:

Major Pulmonary Embolism Complications

1. Sudden Death

• Massive PEs can block lung and heart blood flow, causing cardiac arrest or shock.
• Rapid diagnosis and treatment are essential.

2. Lung Infarction

• When blood flow is restricted, lung tissue may die from oxygen deficiency.
• Hemoptysis, pleuritic chest discomfort, and protracted recovery can result.

3. Pleural effusion

• Lung fluid buildup generally results from infarction or inflammation.
• Can make breathing harder and require drainage.

4. Arrhythmias

• PE can strain the right ventricle, causing atrial fibrillation.

5. Cor Pulmonale: Right Heart Failure

• Pulmonary artery pressure makes the right heart work harder.
• This can cause right-sided cardiac failure.

6. CTEPH

• This is a rare but significant long-term problem.
• High pulmonary artery pressure from persistent clots causes weariness and shortness of breath.

7. Recurrence

• PE can return without anticoagulation.
• Unprovoked PE, inherited clotting problems, and malignancy increase risk.

8. Anticoagulant bleeding

• Lifesaving blood thinners can cause brain and GI hemorrhage.
• Needs close observation and dose modification.

9. Pregnancy Problems

• PE causes most maternal deaths.
• Treatment must balance clot prevention and fetal safety.

Conclusion:

Pulmonary embolism requires immediate diagnosis and treatment. Its symptoms might be subtle or sudden, but the consequences—lung damage to heart failure—can be catastrophic. Most patients recover well with prompt imaging and blood testing and adequate anticoagulant medication.

Long-term management includes preventing recurrence, monitoring for CTEPH, and treating risk factors. Understanding PE helps clinicians, caregivers, and patients act decisively and improve outcomes.