What is pulmonary embolism?

A pulmonary embolism occurs when a blood clot travels through the bloodstream and becomes lodged in an artery in your lungs. These blood clots usually form in the deep veins of the legs. If they detach from the wall of a vein, they can move to the lungs. The clot may then block an artery, reducing blood flow through the lungs and to the heart. This can damage the heart and even be fatal.

How does it occur?

A pulmonary embolism occurs when a blood clot breaks off from the wall of a vein and travels to the lungs.

Blood clots form if blood flows very slowly through the veins or if disease or medicines cause your blood to clot more. Your risk of developing blood clots increases if:

• You are immobile as a result of surgery, disability, or illness.

• You have cancer, heart failure, or other heart diseases.

• You have problems with veins such as phlebitis (inflammation of the wall of a vein) or varicose veins.

• You have a leg or hip fracture.

• You have had a stroke or a heart attack.

• You have had blood clots before.

• You use birth control pills or certain other drugs.

• You are overweight.

What are the symptoms?

Symptoms of pulmonary embolism may include:

• shortness of breath

• rapid or irregular heartbeat

• dizziness

• sharp chest pain that gets worse when you take a deep breath

• fever

• coughing up blood

• swelling of the veins in the neck.

How is it diagnosed?

The doctor will examine you and take your medical history. To confirm the diagnosis and determine how severe any damage is, your doctor will order tests and scans, which may include:

• chest x-ray

• electrocardiogram, or ECG (a recording of the heart's electrical activity)

• measurement of the level of oxygen in your blood

• lung scan

• ultrasound scan of legs

• pulmonary angiogram (x-ray using special dye to highlight arteries of the lungs).

How is it treated?

In the emergency room you will be given medicine to dissolve the blood clot and to prevent further clots from forming. You will need several days of bed rest and blood-thinning medication in the hospital. Blood thinners, or anticoagulants, help prevent new clots from forming and breaking off.

Sometimes a blood clot may need to be surgically removed. This happens only if you aren't feeling any better after treatment and your doctor determines that the medicines are not able to dissolve the clot.

You will need to take blood thinners several weeks to several months after you leave the hospital.

How long will the effects last?

How long the effects last will depend on:

• the size of the clot

• how easily the medicines dissolve the clot

• the reason the clot formed.

Many of the symptoms will improve with treatment, but you may have less energy and stamina for several weeks.

How can I take care of myself?

Follow the treatment prescribed by your doctor. In addition:

• Don't smoke.

• Put your legs up and wear special elastic stockings if prescribed by your doctor.

• Drink plenty of fluids.

• Keep your circulation active by exercising according to your doctor's recommendations.

• Watch for signs of swelling or discoloration in your legs.

• If you are taking blood-thinners:
  • Make sure you understand how you are to take the medications and follow the instructions closely.

  • Avoid taking aspirin and other drugs containing aspirin unless your doctor specifically tells you to take them.

  • Avoid massage that is too forceful.

  • Try to avoid cutting yourself. These medicines will make you bleed more than usual. To help prevent cuts, consider wearing rubber gloves or garden gloves for household and outdoor work. Don't walk barefoot. Use an electric razor for shaving.

What can be done to help prevent a pulmonary embolism?

People who are bedridden or recovering from major surgery may be given small dosages of a blood thinner to prevent clots from forming due to inactivity.