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Pulmonary Embolism


What is a pulmonary embolism?

A pulmonary embolism (PE) is the sudden blockage of a blood vessel in the lungs by an embolus. An embolus is a small piece of blood clot, fat, air, or tumor cells. The embolus cuts off the blood supply to your lungs. A pulmonary embolism can become life-threatening.

What increases my risk for a PE?

  • Obesity
  • Smoking
  • Birth control pills
  • Certain blood diseases, such as thrombophilia and hyperhomocysteinemia
  • Medical conditions, such as a deep venous thrombosis (DVT) or cancer
  • Pregnancy and childbirth
  • Recent surgery
  • Sitting or lying in one position for a long time, such as when you travel by plane

What are the signs and symptoms of a PE?

  • Sudden shortness of breath or fast breathing
  • Sudden chest pain that is worse when you take a deep breath
  • Fast heartbeat
  • Fever and coughing up blood
  • Bluish nails
  • Cold, pale, clammy skin
  • Fainting

How is a PE diagnosed?

Ask your healthcare provider about these and other tests you may need:

  • Blood tests may show signs of the PE or how well your organs are working.
  • An EKG test records your heart rhythm and how fast your heart beats. It is used to check for abnormal heart function.
  • A chest x-ray may show signs of a lung infection or other damage.
  • A CT scan may show the PE. You may be given contrast liquid to help your lungs show up better in the pictures. Tell the healthcare provider if you have ever had an allergic reaction to contrast liquid.
  • A lung scan , or V/Q scan, may show how well blood and oxygen flow in your lungs. A small amount of contrast liquid is used to study your airflow (V) and blood flow (Q). First, you breathe in medical gas. Then, contrast liquid is injected into a vein. Pictures are taken to see how well your lungs take in oxygen.

How is a PE treated?

  • Medicines:
    • Clot busters are emergency medicines that work to dissolve blood clots. They cannot be used during pregnancy or in people with medical conditions that increase their risk of bleeding.
    • Blood thinners help treat the PE and prevent new clots from forming. Examples of blood thinners include heparin, rivaroxaban, apixiban, and warfarin. The following are general safety guidelines to follow while you are taking a blood thinner:
      • Watch for bleeding and bruising. Watch for bleeding from your gums or nose. Watch for blood in your urine and bowel movements. Use a soft washcloth on your skin, and a soft toothbrush to brush your teeth. This can keep your skin and gums from bleeding. If you shave, use an electric shaver. Do not play contact sports.
      • Tell your dentist and other healthcare providers that you take a blood thinner. Wear a bracelet or necklace that says you take this medicine.
      • Do not start or stop any medicines unless your healthcare provider tells you to. Many medicines cannot be used with blood thinners.
      • Tell your healthcare provider right away if you forget to take the blood thinner , or if you take too much.
      • Warfarin is a blood thinner that you may need to take. The following are additional things you should be aware of if you take warfarin:
        • Foods and medicines can affect the amount of warfarin in your blood. Do not make major changes to your diet. Warfarin works best when you eat about the same amount of vitamin K every day. Vitamin K is found in green leafy vegetables and certain other foods. Ask for more information about what to eat or not to eat.
        • You will need to see your healthcare provider for follow-up visits. You will need regular blood tests to decide how much warfarin you need.
  • A vena cava filter may be placed inside your vena cava to prevent another PE. The vena cava is a large vein that brings blood from your lower body up to your heart. The filter traps blood clots and prevents them from going into your lungs.
  • Surgery , called a thrombectomy, may be done to remove the PE. A procedure called thrombolysis may instead be done to inject a clot buster that helps break the clot apart.

How can I decrease my risk for another PE?

  • Wear pressure stockings. The stockings are tight and put pressure on your legs. This improves blood flow and helps prevent clots. Wear the stockings during the day. Do not wear them when you sleep.

  • Exercise regularly. Ask about the best exercise plan for you. When you travel by car or work at a desk, take breaks to stand up and move around as much as possible. Rotate your feet in circles often if you sit for a long period of time.
  • Maintain a healthy weight. Ask your healthcare provider how much you should weigh. Ask him to help you create a weight loss plan if you are overweight.
  • Do not smoke. Nicotine and other chemicals in cigarettes and cigars can damage blood vessels and increase your risk for another PE. Ask your healthcare provider for information if you currently smoke and need help to quit. E-cigarettes or smokeless tobacco still contain nicotine. Talk to your healthcare provider before you use these products.

Call 911 for any of the following:

  • You feel lightheaded, short of breath, and have chest pain.
  • You cough up blood.
  • You have a seizure.
  • You have slurred speech, increased sleepiness, or problems seeing, talking, or thinking.
  • You have weakness or cannot move your arm or leg on one side of your body.

When should I seek immediate care?

  • You feel faint.
  • You have a severe headache.
  • Your heart is beating faster than normal.

When should I contact my healthcare provider?

  • The skin on any part of your legs or hips turns purple.
  • Your gums or nose bleed.
  • You see blood in your urine or bowel movements.
  • Your bowel movements are black or darker than normal.
  • You have questions or concerns about your condition or care.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

© 2016 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.