Pulmonary Embolism
Sources consulted
This article is original patient-education content.
- WHO—Health topics A–Z(2024)
- NHS—Health A to Z(2024)
- CDC—Health topics(2024)
Based on international clinical guidelines
Overview
A pulmonary embolism (PE) is a blood clot that blocks one of the arteries in your lungs. The clot usually starts in a deep vein in your leg (a condition called deep vein thrombosis, or DVT) and travels through your bloodstream to your lungs. This can stop blood from flowing to part of your lung and is a medical emergency.
Key facts
- Pulmonary embolism is a serious condition that needs urgent medical care.
- It is treatable, especially if caught early.
- Many people recover fully with proper treatment.
Yes, pulmonary embolism is fairly common. It affects thousands of people each year, especially those who have been immobile (like after surgery or a long flight), have certain medical conditions, or are pregnant.
Pulmonary embolism can affect people of any age, but it is more common in adults over 60, people who are overweight, smokers, and those with a history of blood clots or certain conditions like cancer or heart disease.
Symptoms
- Sudden trouble breathing
- Sharp chest pain that does not go away
- Coughing up blood
- Fainting or feeling like you might pass out
- Rapid or irregular heartbeat with dizziness
- ⚠Unexplained shortness of breath with activity
- ⚠Pain in your leg that is swollen, red, or warm (may be a DVT sign)
- ⚠Chest pain that is mild but persistent
Common symptoms
- Sudden shortness of breath that gets worse with activity
- Sharp chest pain that may feel worse when you cough or breathe deeply
- Coughing up blood or pink-tinged mucus
- Rapid heart rate or irregular heartbeat
- Feeling lightheaded, dizzy, or fainting
- Anxiety or a sense of doom
Symptoms in children
- Symptoms in children are similar but may include rapid breathing, restlessness, or complaints of chest pain or belly pain. Children may also have a fever or cough without much mucus.
Symptoms in older adults
- In older adults, symptoms can be less obvious and may include confusion, sudden weakness, or a drop in blood pressure. They may not feel typical chest pain.
Causes
Main causes
- Most pulmonary embolisms start as a deep vein thrombosis (DVT) in the leg or pelvis. The clot breaks loose and travels through the bloodstream to the lungs.
- Less often, clots can form in other veins (like the arm or abdomen) or come from a tumor or fat particles.
Risk factors
- Prolonged immobility (long flights, bed rest, surgery recovery)
- Certain surgeries (especially hip or knee replacement)
- Cancer and cancer treatments
- Pregnancy and the first few months after giving birth
- Being overweight or obese
- Smoking
- A family history of blood clots
- Using hormone-based medications (birth control pills or hormone replacement therapy)
- Certain inherited blood disorders that make clots more likely
- Heart disease or lung disease
When to see a doctor
See a doctor urgently if:
- If you have sudden shortness of breath, chest pain, coughing up blood, or fainting — call your local emergency number immediately. Do not wait.
Book a routine appointment if:
- If you have a leg that is swollen, painful, red, or warm (possible DVT), see your doctor within a day or two, as this can lead to a pulmonary embolism.
Diagnosis
Your doctor will start by asking about your symptoms, medical history, and risk factors. They will listen to your heart and lungs and check your legs for swelling or tenderness. Based on that, they may order tests to confirm or rule out a pulmonary embolism.
Tests that may be done
- D-dimer blood test: a high level can suggest a clot, but it is not specific. This test helps rule out PE if levels are normal.
- CT pulmonary angiogram (CTPA): a special CT scan that uses dye to look for clots in the lung arteries. This is the most common test for diagnosis.
- V/Q (ventilation-perfusion) scan: a nuclear medicine test that compares airflow and blood flow in the lungs. Used if you cannot have CT dye (e.g., kidney problems).
- Ultrasound of the legs: to check for DVT, though a negative result does not rule out PE.
- Electrocardiogram (EKG): to check heart rhythm and rule out heart attack.
- Chest X-ray: often done first to look for other causes of your symptoms.
What to expect at your appointment
If a PE is suspected, you will likely be admitted to a hospital for tests and started on treatment right away. Depending on your condition, you may stay for a few days. Most people respond well to treatment.
Treatment
Treatment for pulmonary embolism focuses on preventing the existing clot from getting bigger, stopping new clots from forming, and helping your body dissolve the clot. Most people are treated with blood-thinning medicines (anticoagulants). In severe cases, more urgent procedures may be needed.
Self-care at home
- Take all your medications exactly as prescribed. Do not skip doses.
- Stay as active as your doctor advises. Avoid long periods of sitting or lying still.
- Wear compression stockings if recommended to improve blood flow in your legs.
- Monitor for signs of bleeding (bruises, nosebleeds, blood in urine or stool) and report them to your doctor.
- Keep all follow-up appointments.
Medical treatments
The main treatment is anticoagulation — medicines that make your blood less likely to clot. You may first receive injections or other fast-acting blood thinners in hospital, then be switched to pills. Treatment usually lasts at least 3 to 6 months, sometimes longer. Your doctor will adjust the dose based on your risk. In some cases, a filter may be placed in a large vein to catch clots before they reach the lungs.
When is surgery considered?
Surgery is rare and reserved for massive, life-threatening pulmonary embolisms. This may involve removing the clot directly (embolectomy) or using a catheter to break up or suction out the clot. These are done in critical care settings.
Living with this condition
After a pulmonary embolism, you will need to take blood thinners for several months or longer. You should avoid activities that could cause injury or bleeding (like contact sports or using sharp tools). Learn to recognize signs of bleeding or a new clot. Most people can return to normal activities gradually.
Lifestyle tips
- Stay active — walking is great, but check with your doctor before starting a new exercise program.
- Avoid smoking; it increases your risk of clots.
- Maintain a healthy weight.
- If you sit for long periods (work, travel), get up and move every hour.
- Wear seat belts and take care to avoid falls.
- Tell all your doctors and dentists that you are on blood thinners.
Diet and exercise
Eat a balanced diet rich in fruits, vegetables, and whole grains. If you are taking warfarin, keep your vitamin K intake steady (leafy greens, etc.) — do not suddenly eat much more or less. For other blood thinners, diet has less effect. Exercise as tolerated — start slow and build up. Walking, swimming, and cycling are good options.
Mental health and emotional wellbeing
Having a pulmonary embolism can be frightening and may cause anxiety about recurrence or side effects of medication. It is normal to feel worried or depressed. Talk to your healthcare provider about these feelings. Support groups or counseling can help.
Prevention
Many pulmonary embolisms can be prevented. The key is to prevent deep vein thrombi (DVTs) from forming. Simple steps include: moving regularly (especially during long trips or after surgery), staying hydrated, wearing compression stockings if you are at risk, and taking blood thinners when prescribed after surgery or for high-risk conditions. If you have a higher risk, your doctor may recommend preventive medications.
Screening programmes
Routine screening for pulmonary embolism is not recommended for the general public. However, if you have a strong family history of blood clots or a personal history of DVTs, your doctor may suggest testing for inherited clotting disorders.
Complications
If left untreated
- Death — a large untreated PE can be fatal.
- Pulmonary hypertension — high blood pressure in the lungs, which can cause long-term shortness of breath and heart strain.
- Chronic damage to the lung tissue at the site of the clot.
- Recurrent clots — if the underlying cause is not addressed.
Long-term outlook
With prompt treatment, most people survive a pulmonary embolism and recover fully. The blood clot is usually broken down by the body or dissolves with treatment. Some people may have long-term breathing problems or an increased risk of future clots, but these can often be managed. Following your treatment plan and making healthy lifestyle changes greatly improve your outlook.
Find support
International organisations
Local organisations
- NHS UK – Pulmonary Embolism Information ↗ · United Kingdom
- American Lung Association ↗ · United States
- Canada – Thrombosis Canada ↗ · Canada
Helplines
External links open third-party websites. Ruqelo Health is not responsible for external content. Listing an organisation does not imply endorsement.
Always verify with your doctor
Health guidelines vary by country and region. The information in this article is based on international clinical guidelines but may not reflect the specific guidelines, medications, or practices in your country. Always discuss your health concerns with your own doctor or healthcare provider, and refer to your local national health guidelines where available.
Important notice This information is for educational purposes only. It does not replace professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider about your specific situation. If you are experiencing a medical emergency, call your local emergency services immediately.