Information From Your Health Care Provider

PULMONARY EMBOLISM

Basic information

description

Pulmonary embolism is a blood clot in one of the arteries carrying blood to the lungs. Rarely, other types of clots form that are made up of fat, air bubbles, tissue from a tumor, or bacteria. Pulmonary embolism is more common in adults.

FREQUENT SIGNS & SYMPTOMS

Sudden shortness of breath.
Faintness or fainting.
Pain in the chest.
Cough (sometimes with bloody sputum).
Rapid heartbeat.
Low fever.
These symptoms are often preceded by swelling and pain in the leg.

causes

In almost all cases, the blood clot begins in a deep vein of the leg (deep vein thrombosis or DVT), and rarely, another place in the body. The clot moves through the bloodstream, passing through the heart, and into an artery in the lungs. The blockage reduces breathing ability and can destroy lung tissue.

risk increases with

Previous embolism or deep-vein thrombosis.
Any injury or illness that requires prolonged bed rest.
Sitting for long periods, as on car or plane trips.
Recent surgery.
Heart disease, high blood pressure, or lung disorders.
Bone fractures, such as hip fracture.
Overweight.
Pregnancy.
Use of birth-control pills or hormone replacement therapy (risk increases if you smoke or are overweight).
Cancer, severe burns, or inflammatory bowel disease.
Smoking.
Inherited blood clotting conditions.

PREVENTIVE MEASURES

Avoid prolonged bed rest during illnesses. Wear compressive stockings during recovery (in or out of bed).
Start moving legs and walking as soon as possible after surgery.
Don't smoke, especially if you are a woman age 35 or older who takes birth-control pills.
Don't sit with your legs or ankles crossed. Elevate your feet higher than your hips if sitting for long periods. Raise the foot of your bed 4 to 6 inches.
When traveling, exercise while sitting, walk every 1 to 2 hours, wear support stockings, and drink fluids.

expected outcomes

Usually curable with treatment. Embolism may recur.

possible complications

High blood pressure in the lungs (pulmonary hypertension).
Heart damage (a condition called cor pulmonale).
Death (from a large clot that blocks the artery).

diagnosis & treatment

general measures

Your health care provider will do a physical exam and ask questions about your symptoms and activities. Medical tests may include chest x-ray, lung scan, pulmonary angiogram (a special x-ray study of blood flow), CT, blood studies, and other tests as needed.
Treatment is aimed at maintaining heart, blood vessel, and lung functions and preventing clot recurrence.
Hospital care is necessary. Supplemental oxygen will be provided. Drugs will be given through a vein (IV).
Rarely, surgery (embolectomy) is used to remove clot.
A filter may be placed (using a catheter) into the main vein (vena cava) leading to the heart and lungs to trap recurrent clots.

medications

Anticoagulant drugs to treat the clots will be prescribed. You may need indefinite treatment with these drugs to prevent a recurrence. Your health care provider will explain their risks and benefits.
Clot-dissolving (clot buster) drugs may be prescribed. They break down the blood clots.
Drugs to treat other disorders may be prescribed.

activity

Rest in bed until all symptoms of the clot improve. While in bed, move your legs often.

diet

No special diet. Drink plenty of fluids.

notify our office if

You or a family member has symptoms of pulmonary embolism. This is an emergency! Call 911.
The following occur during treatment: chest pain, coughing up blood, shortness of breath, or increased swelling and pain in the leg.