When someone is short of breath or having pain in the chest, they rarely think of pulmonary embolism (PE) — a blood clot that travels through your bloodstream (generally from your legs) and gets lodged in an artery in your lung.
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If PEs are not treated quickly, they can cause heart or lung damage and even death.
Are you at risk?
A pulmonary embolism can occur in anyone – young or old. Your risk of PE increases if you:
- Are inactive or immobile, due to bed rest or surgery or just sitting for an extended period of time for long airplane trips. Clots can form when blood pools anywhere in your body (generally the legs). PEs form when those clots travel to your lung.
- Have had recent damage to a vein, from an injury or surgery, for example.
- Have had heart disease (such as atrial fibrillation or heart failure or MI (heart attack)) or a recent stroke and become immobilized.
- Have abnormal blood clotting or history of blood clots. This condition can occur due to cancer treatment, inherited disorders, or taking hormone replacement therapy or birth control pills.
- Are pregnant or recently gave birth.
- Are overweight.
What a pulmonary embolism feels like
Most people have symptoms, including:
- Sudden shortness of breath
- Sharp pain in the chest, arm, shoulder, neck or jaw (similar to a heart attack) but often aggravated by breathing or movement
- Pale or clammy skin
- Rapid heartbeat
- Cough (sometimes with bloody sputum)
- Very low blood pressure, fainting or lightheadedness
Get to a doctor right away if you have any of these symptoms.
In some cases, if the clot is small, a patient may not have symptoms and the doctor may find the PE by imaging scans looking for another condition such as cancer.
Serious, but very treatable
“Pulmonary embolisms are serious, but they’re also very treatable,” says John R. Bartholomew, MD, Head of Vascular Medicine at Cleveland Clinic.
Anticoagulant (blood-thinner) medication is the primary treatment. It helps prevent new clots from forming.
Some clots dissolve on their own. Others need to be treated with “clot-buster” medications, especially if the patient’s blood pressure is dangerously low and their condition is unstable.
Patients who can’t take clot-busters may get a vena cava filter. This filter is inserted into a vein and placed in the major vein known as vena cava just below your kidneys. It traps clots before they enter the lungs.
“While PEs can be fatal, you probably won’t die of one if it’s diagnosed and treated properly. For severe PEs, it’s best to have an experienced, fast-moving team that uses an ‘all hands on deck’ approach. Then experts from different medical specialties can be alerted and rapidly convene to make complex treatment decisions,” says Dr. Bartholomew, a member of Cleveland Clinic’s Pulmonary Embolism Response Team (PERT).
The No. 1 prevention
If you’ve had one clot, you might be at risk for more, adds Dr. Bartholomew. You need to watch for symptoms and take precautions. Talk to your doctor about preventive treatment.
The No. 1 way to help prevent PEs? Stay active. Exercise regularly.
If you must stay seated or in bed for an extended time and can’t exercise, move your arms and legs regularly. You may also need to take a blood thinner during this time to prevent clots from forming, especially if you have had recent surgery or hospitalization. Compression stockings also can help promote blood flow.
- And avoid crossing your legs. Compression stockings also can help promote blood flow.
- Do not smoke and be sure you optimize treatment of your blood pressure, blood sugar and cholesterol levels if you have any of these problems.
- Maintain an optimal weight
- Talk to your doctor about your medical and family history of blood clotting disorders or history of blood clots.
It is important to first PREVENT blood clots and PE and then recognize the symptoms and get prompt treatment to prevent risk of death.