How to Recognize the Symptoms of Pulmonary Embolism
Given that about one-third of people who suffer from undiagnosed and untreated pulmonary embolism die from the condition, it is safe to say that it isn’t something to be taken lightly. According to the CDC, the precise number of people who are affected by the condition is unknown.1 However, it is estimated that around 900,000 people in the U.S. — or roughly one or two out of every 1,000 people — is affected by pulmonary embolism per year.
In approximately 25 percent of cases, the first symptom of pulmonary embolism is sudden death. Although roughly 60,000 to 100,000 people die from the condition per year, it is highly treatable. When diagnosed and treated in a timely manner, in fact, pulmonary embolism is very survivable. While people often associate it with those who are on bedrest or who must sit still for hours on end, the truth is that pulmonary embolism can happen to anyone.
What is Pulmonary Embolism?
Pulmonary embolism involves the blockage of one of the pulmonary arteries, which are located in the lungs.2 It is most commonly caused by blood clots that move into the lungs from the legs, which is associated with a condition called deep-vein thrombosis, but blockages can also be caused by other materials. Since clots can block blood flow to the lungs, pulmonary embolism can be life-threatening. Therefore, it is critical to seek medical attention at the first sign of trouble — and that is why it pays to be aware of the most common symptoms.
Causes and Symptoms
This condition most commonly occurs when clots in the legs, which are collectively known as deep-vein thrombosis, break away and travel into the pulmonary arteries. Oftentimes, several clots may become wedged into one of these arteries, which supply blood to the lungs. When blood supply becomes impeded, affected portions of the lungs may die. The resulting condition, pulmonary infarction, impedes the lungs’ ability to get oxygen to the body. This can lead to sudden or eventual death, so it is crucial to act quickly.
Common risk factors that are associated with pulmonary embolism include:
- heart disease
- a family history of pulmonary embolism
- cancer — especially ovarian, lung, or pancreatic cancer
- periods of prolonged inactivity
- taking supplemental estrogen
- being overweight
Although the above factors may increase someone’s risk for developing pulmonary embolism, it is important to note that the condition can strike anyone.
Since deep-vein thrombosis often precedes pulmonary embolism, it pays to be aware of its most common symptoms, which include:
- swelling of the affected leg
- redness or discoloration in the affected area
- pain and tenderness in the legs when standing or walking
- veins in the arms or legs are much larger than usual
- affected area may feel warm to the touch
The symptoms of pulmonary embolism vary widely depending on factors like the number and size of the clots; whether there’s an underlying condition like heart or lung disease; and how much of the lung is involved. Generally speaking, though, symptoms of pulmonary embolism may include:
- chest pain that gets worse when coughing, stooping, bending over, or breathing deeply
- shortness of breath that comes on suddenly and worsens with exertion
- blue lips or nails
- coughing that may be accompanied by bloody or blood-streaked sputum
- clammy or discolored skin
- rapid or irregular heartbeat
- excessive sweating
- dizziness or lightheadedness
Treatments and Side Effects
Common treatments for pulmonary embolism include:
Known also as blood thinners, anticoagulants like heparin and warfarin have long been used to treat pulmonary embolism. They prevent the development of new clots and stop the growth of existing ones. However, they can cause serious side effects like internal bleeding.
Special stockings, which are designed to be tighter near the bottom than at the top, may be worn to improve the efficiency of veins and muscles in the legs. This helps to prevent blood from pooling, or stagnating, which may help to ward off pulmonary embolism.
With pneumatic compression, cuffs that are placed around the thighs or calves are inflated and deflated by a machine. This motion helps to improve blood flow, which can treat and prevent pulmonary embolism.
Because these drugs can cause sudden, severe bleeding, they are only used in situations in which pulmonary embolism is truly life-threatening. They work by rapidly breaking up the clots in the lungs.
Another example of an emergency treatment for pulmonary embolism involves using a catheter to remove clots from the lungs. The long, thin, flexible tube is inserted into the thigh or arm vein and navigated into the lungs. Tools or medications are used to break up the clots.
For situations where the risk of pulmonary embolism is ongoing, doctors sometimes elect to have a filter installed in the patient’s inferior vena cava. This major vein delivers blood from the lower body to the heart, and the filter that is installed prevents clots from continuing into the lungs.
Surgery is only used to treat pulmonary embolism in very select cases. Because it is far more invasive than using a catheter, this option is reserved for very specific situations and is not considered an optimal form of treatment for most patients.
After experiencing pulmonary embolism once, the odds of developing it again increase substantially. As a result, one’s doctor might advise to make certain lifestyle changes that may reduce the risk of another bout.3 These lifestyle changes may also be recommended if one has experienced deep-vein thrombosis because they may be enough to prevent the development of pulmonary embolism. These lifestyle changes include:
If one is overweight, getting down to a healthy weight can help to reduce the risk of developing pulmonary embolism. Excess weight puts extra pressure on the veins in the legs, and it can also lead to high blood pressure. Dropping a few pounds could do a lot to improve blood flow, which will reduce overall risk.
Manage Existing Health Issues
Patients who suffer from health issues like diabetes and heart disease are encouraged to manage their conditions to reduce their risk of pulmonary embolism. This includes taking medications as prescribed and directed by one’s doctor, informing the doctor of any changes to one’s health, and watching one’s diet.
Chemicals that are found in tobacco can cause damage to blood vessels and blood cells. This can increase the risk of deep-vein thrombosis and, by extension, pulmonary embolism. Therefore, it is crucial to quit smoking if a person wants to reduce the risk of developing this condition and to improve overall health.
Take Care While Traveling
Prolonged periods of inactivity can lead to pulmonary embolism, and this often happens to people while they are traveling for extended periods of time. While on the road, take care to get up and move every hour or so. Drink plenty of water and avoid alcohol to stay well-hydrated, which helps keep the blood flowing. Wear compression stockings and make a point of flexing the ankles every 15 to 30 minutes.
Although anticoagulants like warfarin have been the standard treatment for pulmonary embolism for years, they pose many serious potential side effects. Recently, several non-vitamin K antagonist oral anticoagulants, a new class of medication, have been approved for the treatment of this condition.4 These drugs, including rivaroxaban, are anti-clotting medications, but they have caused far fewer cases of serious bleeding in clinical studies. They have been approved for the treatment of deep-vein thrombosis following knee and hip replacement surgery and for stroke prevention in patients who suffer from atrial fibrillation for some time. Although they are still not as widely prescribed as drugs like heparin, they are certain to become the standard treatment for this condition in years to come.