Pulmonary Embolism
A pulmonary embolism is the sudden blockage of a major artery in your lung, occurring when a blood clot that has developed in another part of your body breaks off and travels to the lungs. Pulmonary embolism is the most common type of cardiovascular disease, after heart attack and stroke.
Pulmonary Embolism Symptoms and Diagnosis
Pulmonary embolism is a life-threatening medical emergency. Symptoms tend to occur suddenly. Call 911 if you develop any of these symptoms:
- Sudden shortness of breath
- Sharp chest pain, often made worse with coughing or moving
- Sudden back pain
- Cough with or without blood
- Excessive sweating
- Rapid pulse or breathing
- Lightheadedness or passing out
- Blue lips or nail beds
If you recently had a blood clot in your arm or leg, you may also experience symptoms that include:
- Swelling in the affected limb
- Increased warmth in the swollen or painful area of the affected limb
- Leg pain or tenderness that you may only feel when walking or standing
- Redness or discoloration of your skin
- Vein enlargement in the affected limb
Risk Factors
- Recent surgery, in particular abdominal or orthopaedic surgery
- Trauma or bone fracture
- Extended bed rest or sitting for a long time, such as during a long flight or car trip
- Cancer and some cancer treatments, like chemotherapy
- Previous atrial fibrillation, heart failure, heart attack or stroke
- Previous pulmonary embolism
- Pregnancy and the first six weeks postpartum
- Smoking
- Obesity
- Birth control pills or hormones taken for symptoms of menopause
- Family history of blood clots
- Inherited blood disorders that make the blood thick (thrombophilia)
- Inflammatory bowel disease
- Auto-immune diseases, such as lupus or antiphospholipid syndrome
- Having a vein catheter, pacemaker or implantable defibrillator
If you are suspected of having a pulmonary embolism, tests to help with diagnosis may include:
- Chest X-ray
- CT scan
- Echocardiogram
- Leg vein ultrasound
- Ventilation Perfusing Lung Scan (VQ Scan)
- Pulmonary angiography
- Blood tests
Pulmonary Embolism Treatment at BIDMC
Medications that thin the blood are usually the prescribed treatment for pulmonary embolism. If you have severe symptoms, clot-busting medication can be given to immediately destroy a blood clot. This can be given through an IV line or a procedure can be performed through a pinhole in a vein in the neck or groin to place a catheter directly into the clot to deliver the medication.
Surgery to remove the blood clot is usually performed only when other treatments have not worked or are not safe.
Blood clots in the lung can take months or years to fully resolve after initial treatment. Patients treated for pulmonary embolism may develop pulmonary hypertension—high blood pressure in the heart-to-lung system.
IVC Filter Placement
If blood thinning medication cannot be given for other medical reasons, an inferior vena cava (IVC) filter may be placed to prevent large blood clots in the legs from traveling to the lungs. The filter is placed through a pinhole in a vein in the neck or groin without the need for surgery and positioned under x-ray guidance in the large abdominal vein that returns blood from the legs back to the heart.
These filters are often retrievable and once no longer needed, consultation with your interventional specialist is recommended to evaluate for removal.
Cardiovascular Medicine
Our expert cardiologists, along with our cardiac and vascular surgeons, offer prompt care and treatment for pulmonary embolism.Interventional Radiology
Our team of interventional radiologists provides expert care for a variety of conditions, including DVT, using minimally invasive, image-guided techniques. Call 617-754-2523 or email us for an appointment.