Pulmonary Embolism

What is Pulmonary Embolism?

Pulmonary embolism is a medical term used to define a blood clot in the lung that results from a clot in another part of the body (most commonly an arm or the leg). It moves through the bloodstream and eventually gets stuck in the lung (blood vessels). The condition affects the smooth flow of blood to the lungs and reduces oxygen levels in the lungs. It also increases blood pressure in the pulmonary arteries.

In case the clot develops inside a vein and gets stuck, it is referred to as a thrombus. Sometimes the clot detaches from the vein's wall and moves through other body parts. This clot is known as an embolus.

Pulmonary embolism is a severe condition and must be considered a medical emergency. It should be treated without delay to avoid serious damage to the heart and lungs. Delay in treatment may even cause death.

Stages and Types of Pulmonary Embolism

There are three types of PE: acute, subacute, and chronic. Below is a deeper look into each of these types.

• Acute: The condition is common but difficult to diagnose. Symptoms of the condition may vary between individuals. Common symptoms include chest pain, dyspnea, cough, and pleuritic chest pain.
• Subacute: The condition develops at a slow pace and is tough to diagnose. Delay in diagnosis leads to further delay in treatment and poor treatment results. Individuals with subacute PE are known to have a higher mortality rate than those with acute PE. The symptoms of the condition can develop over 2–12 weeks.
• Chronic: The condition is characterized by residual blood clots getting stuck to the walls of the pulmonary vessels after treatment. It causes chronic thromboembolic pulmonary hypertension (CTEPH).

Symptoms of Pulmonary Embolism

Symptoms of Pulmonary Embolism may vary, depending on the severity of the clot. Most individuals with PE experience symptoms. However, some may not experience them at all. In most cases, the earliest signs of this condition are a pain in the chest and shortness of breath. These symptoms get worse when the patient exerts. Some patients may also cough up bloody sputum. All of these symptoms need immediate medical care. Immediate medical treatment significantly reduces the chance of death.

The most common symptoms may include the following:

• Sudden shortness of breath (while exerting or at rest)
• Sharp pain in the chest, arm, shoulder, neck, or jaw (similar to signs of a heart attack)
• Cough with or without bloody sputum (mucus).
• Excessive sweating
• Wheezing
• Pale, sweaty, or bluish-colored skin
• Rapid heartbeat (pulse)

Rare Symptoms:

• Anxiety
• Light-headed
• Faint/passing out

It is also possible to have a blood clot and no symptoms, so discuss your risk factors with your healthcare provider.

Risk Factors of Pulmonary Embolism

Recovery from PE is aimed at preventing additional blood clots from forming. Hence, it is important to understand the risk factors of the conditions. The following risk factors increase your risk for blood clots:

• Older age
• Cancer
• Stroke
• Heart attack
• Heart failure
• Obesity
• Infections, such as COVID-19
• Pregnancy
• History of blood clots

Certain health conditions can also put you at greater risk of developing PE:

• Major trauma such as breaking a hip/leg, a spinal cord injury
• Genetic conditions that put one at higher risk of developing blood clots (factor V Leiden thrombophilia)
• Taking hormone-based medications (hormone replacement therapy, birth control pills, surgical procedures)
• Long periods of immobilization (long-distance traveling, bed rest)

Causes of Pulmonary Embolism

A pulmonary embolism occurs due to a blocked blood vessel in the lungs. In most cases, the blockage is caused due to a blood clot that occurs all of a sudden. A blood clot travels up from one of the deep veins in the body, generally in the leg. This blood clot is called deep vein thrombosis (DVT).

Sometimes, the blood clot occurs due to a change in one's physical condition (surgery or pregnancy). In about 20-30 percent of PE cases, the medical professional may be unable to find the exact cause. Such cases are termed an 'unprovoked' pulmonary embolism.

Prevention of Pulmonary Embolism

It is possible to reduce the overall risk of blood clotting by making some healthy and positive changes in life and leading a healthier lifestyle:

Quit Smoking: This is the foremost step you should take if you are a smoker. It can make a massive difference to your health.

Stay Active: It is essential to exercise regularly, at least five days a week. You can start by adding a daily walking/jogging routine, yoga, or aerobics.

Avoid Sitting for Too Long: Most individuals doing desk jobs are prone to develop pulmonary embolism. Set an alarm and get up every 2 hours for at least 15 minutes.

Drink Up: Drink at least 8-10 glasses of water daily to avoid dehydration.

Lose Weight: This is important if you are overweight or obese. Maintaining a healthy weight by eating a healthy balanced diet and cutting down sugar and unhealthy fats from the daily diet.

Prevent Deep Vein Thrombosis (DVT): Most people do not know that DVT usually causes PEs. Hence, it is crucial to take ample steps to prevent DVT. For instance, if you have had surgery for any other condition recently, take steps to prevent you from getting DVT under the doctor's guidance. You should move around or do leg exercises as soon as you get a green signal from a doctor after surgery.

Travel-related DVT on long-haul journeys can be prevented by wearing loose, comfortable clothes. Try doing leg stretching exercises while sitting, drinking ample water, wearing flight socks, and walking whenever possible.

Frequently Asked Questions

• Diagnosis and Treatment