A pulmonary embolism (PE) is a blockage in one of the pulmonary arteries in your lungs. Usually occurs when a blood clot travels through your bloodstream into your lungs from your lower extremities (most often from your legs). When they develop in other parts of the body, like the lower extremities, are sometimes classified as deep vein thrombosis.
A pulmonary embolism that goes untreated can cause permanent damage to your lungs. The low oxygen levels in your blood associated with PE can also damage other organs due to lack of oxygen. You must take the proper measures to prevent a blood clot in your leg. So, it is essential to know if you are predisposed to blood clots or believe you might be at risk for why one, it is imperative that you seek treatment immediately.
Who is at Risk for an Embolism?
While anyone can be at risk for developing PE, some people are at higher risk than others. Individuals at higher risk of developing a pulmonary embolism include:
- If you suffer from blood clotting disorders
- If you are inactive or immobilized for long periods due to illness
- Females who take oral contraceptives or hormone replacement
- Being older than 60
- If you have undergone chemotherapy for cancer
Also, pregnant women, smokers, and people who have undergone certain types of recent surgery, like hip replacement, are at higher risk of developing an embolism.
What are the Signs of a Pulmonary Embolism?
The signs and symptoms of a pulmonary embolism will vary. It will depend on the size of the clot and how much of your lung is affected. Also, if you have lung or heart disease, this can play a significant role in how your body reacts.
If you develop any of the following symptoms, you should call emergency services right away:
- Shortness of breath
- Chest pain
- Coughing that comes on suddenly
- Cough up bloody or blood-streak sputum
Some other signs and symptoms of a pulmonary embolism may also include:
- Rapid or irregular heartbeat
- Back pain
- Sweat more than usual
- Rapid breathing
- Lightheaded or dizzy
- Blue lips or nails
- Clammy or discolored skin
If your blood clot forms deep in the vein of your leg, you can develop deep vein thrombosis (DVT). You should see your doctor right away if you have the following symptoms of DVT (if found early, your doctor can stop it from becoming a PE):
- Swelling of your leg or arm
- Leg pain: tender when you stand or walk
- Red or discolored skin on the affected arm or leg
- Veins in your arm or leg appear larger than normal
How is PE Diagnosed?
If you believe you are at risk for or are suffering from a pulmonary embolism, your doctor will start by giving you a physical exam. Your doctor will look closely at your legs to see if they’re swollen, tender to touch or when you walk or stand, warm, or discolored.
Next, your doctor will order several tests that might include:
- Chest x-ray: Allows your doctor to see your heart and lungs in detail to see if there are any problems with your lungs
- Computed tomographic angiography (CTPA): A special x-ray that is the main one doctor’s use to see if you have a pulmonary embolism. Your doctor will inject a contrast due into your veins so they can see the blood vessels in your lungs on an x-ray.
- Ventilation/perfusion scan: Used if CTPA isn’t available or not a good match for you. Using a radioactive material, doctors can see what parts of your lungs aren’t getting enough air or blood flow.
- Pulmonary angiography: The most accurate test for detecting PE. Your doctor will make a small incision and insert a long, thin catheter into a large vein, your groin, and in the arteries of your lungs. After injecting a special dye, the doctor will be able to see the blood vessels of your lungs.
- MRI: The scan uses radio waves and a magnetic field to produce detailed images
- Duplex venous ultrasound: The test uses radio waves to visualize the blood flow and to check for blood clots in your legs.
Remember, the key to successful treatment is early diagnosis, so make sure you get any test your doctor orders.
What are the Treatment Options?
Treatment modalities may vary, depending on the severity of your pulmonary embolism. The main goal of most treatment options is to safely dissolve the embolism before it has the chance to travel to another part of your body.
Some drugs your doctor may prescribe:
- Anticoagulation: Blood thinners are used to prevent new clots from forming and also keep any clot from enlarging. Heparin is one of the popular choices for treating an embolism. It’s given via IV or injection for faster therapeutic effect. Other types of oral anticoagulants include Warfarin, Xarelto, Pradaxa, and Eliquis. These types of medications are only available with a prescription from a physician.
- Clot dissolvers (thrombolytic): The drug speeds up the breakdown of a clot. It is only used for emergencies because of the dangerous side effects (can cause sudden bleeding). Prescribed if you have large clots that cause serve symptoms or serious complications.
If drugs don’t help dissolve the clot, you might need surgery. Surgery is necessary to remove problematic clots, including those that restrict blood flow to your heart or lungs. Surgical options include:
- Vena cava filters: Are also viable treatment options for some people. The filter is inserted into the vena cava, a large vein in the patient’s body, and left in place to prevent blood clots from forming.
- Clot removal: A catheter is inserted and suctions out large clots from your artery. Not always effective, so this is not a preferred treatment method for most cases.
- Open surgery: Only used in emergencies. Doctors only use this option when the person is in shock or medications aren’t working.
How Can You Prevent a Pulmonary Embolism?
If you are at a higher risk of developing a pulmonary embolism, there are things you can do to help lower your risk. How to prevent a pulmonary embolism includes:
Compression socks and stockings: Steadily squeeze your legs, which helps the veins and muscles of your legs move more efficiently. Promote circulation and keeps your blood from becoming stagnate, especially after general surgery.
- Elevate your legs
- Increase your physical activity
- Pneumatic compression: Treatment uses thigh-high or calf-high cuffs that automatically inflate with air and deflate every few minutes to massage and squeeze the veins of your legs to improve blood flow
- Don’t sit or stand for extended periods: Get up, move, and stretch.
- Maintain a healthy weight
- Stay hydrated
- Quit smoking
If you suspect you may have a blood clot or if you have a family history of PE, reach out to your physician for examination and treatment. Prevention is the best medication.
While suffering from a pulmonary embolism can be life-threatening if you take the proper prevention methods, you can avoid serious complications.