7 Warning Signs of a Pulmonary Embolism
For one-quarter of the people with this frightening condition, sudden death can be the first and only symptom. Here's what you need to know.
What is a pulmonary embolism (PE)?
A serious condition, a pulmonary embolism happens when a blood clot blocks a blood vessel in the lung. The clot usually develops in another part of the body, most often the leg. "For unclear reasons, it dislodges and travels through the abdomen, into the heart, and then in the lung," explains Adhir Shroff, MD, an interventional cardiologist at the University of Illinois Hospital & Health Sciences System in Chicago. When a clot is as big as the artery or blood vessel, it dams it up and blocks blood flow to part of the lung, he explains.
Who's vulnerable to having a pulmonary embolism?
While it can happen to anyone, the National Institutes of Health (NIH) say that certain people are more likely to develop a blood clot, which then can become a pulmonary embolism. This includes those who've had recent surgery, are obese, have cancer, heart or lung disease, or a broken hip or leg bone. If you've given birth in the last six weeks, you also have a higher risk.
As many as 900,000 people may suffer from pulmonary embolism or the related condition of deep vein thrombosis per year in the United States, according to the Centers for Disease Control & Prevention.
Read this if you're taking hormonal birth control
Combination oral contraceptives—containing both estrogen and progestin—will increase levels of clotting factors in the blood, according to the National Blood Clot Alliance. They note that the uptick in risk is small: 1 in 1,000 women every year on these meds will have a clot, but if you have a known clotting disorder, like thrombophilia, talk to your doctor about a progestin-only contraceptive like an IUD. Here are 9 signs you're on the wrong birth control.
Always keep moving
If you aren't vigorously pumping blood through your veins, you can be at greater risk of a blood clot. "This can happen for people who are sitting for a prolonged period of time, such as traveling on a plane or in a bus or car," says Dr. Shroff. Stand up and walk around regularly to boost circulation. Now, brush up on these 18 health risks of airplane travel.
Warning sign: pain or redness in the legs
Some patients feel the blood clot in their leg first, says Dr. Shroff. What is that like? Pain, swelling, and redness, he says. This condition is called deep vein thrombosis (DVT). From there, the clot can travel into the lungs and trigger a pulmonary embolism. Call your doctor if you notice cramping pain in your calf, red skin on your leg, or a feeling of warmth in the leg, notes the Mayo Clinic.
Warning sign: shortness of breath
For some patients, the first sign of a pulmonary embolism is after the clot has traveled into the lung. The most common symptom then is shortness of breath. "The onset is usually pretty quick and relatively dramatic. Patients will say 'I was doing great last night and this morning got up to go to the bathroom and was having trouble breathing,'" says Dr. Shroff.
Warning sign: chest pain
If you take a deep breath, does it hurt? Chest pain is another warning sign of a pulmonary embolism. When part of the lung's function is compromised, less oxygen can get to the heart, resulting in pain, which may be sharp and stabbing and worsen with a deep breath, says the National Blood Clot Alliance. These are the 7 times you definitely shouldn't ignore chest pain.
Warning sign: coughing up blood
One of the most frightening symptoms is a cough that produces mucus mixed with blood. This is less common than the other symptoms on this list, like shortness of breath, says Dr. Shroff. But this is one sign that will get your attention—it could also be a sign of lung disease, including lung cancer. If you have this symptom, call your doctor.
Warning sign: Lightheadedness
Typically if you feel dizzy or faint, the head quickly clears. But if you're experiencing a pulmonary embolism, that lightheadedness may lead to passing out, according to the Society for Vascular Surgery. Remarkably, a New England Journal of Medicine study found that 17 percent of patients suffering from fainting spells had a blood clot in their lungs.
Warning sign: an impending sense of doom
Feelings of anxiety or dread may signal that you're experiencing a pulmonary embolism, according to the Cleveland Clinic. This may be in part due to anxiety-provoking physical symptoms like a racing heart. Don't ignore signs that something isn't right; get help.
Warning sign: no symptoms
While you would assume you'd know when you're experiencing a pulmonary embolism, you may not: Half of those with PE have no symptoms, according to the NIH. Many conditions are not noticeable right away; here are 15 other silent signs that something is seriously wrong with your health.
What if it's not PE?
If this list of symptoms has you thinking, that sounds like a heart attack, you're right. PE "is very confusing to patients and physicians. It can look like heartburn, a heart attack, heart failure, pneumonia, and other conditions," says Dr. Shroff. While it's not up to you to correctly identify what's going on (that's the physician's role), you should definitely seek medical attention for these symptoms. Regardless of the reason behind your shortness of breath or chest pain, the underlying problem needs to be addressed.
Tests, including ultrasounds, a chest X-ray, CT scan, or MRI, can help doctors diagnose pulmonary embolism "quickly and with confidence," says Dr. Schroff. Treatments include blood thinners, clot-dissolving medications, or surgical procedures to remove or bust up the clot. At the very least, ask your physician if getting rid of the clot is an option for you. "There's enough evidence to suggest that removing or dissolving large blood clots improves outcomes for patients," he says. Better breathing (and heart health) lies ahead. These are the 7 blood clot symptoms everyone should know.