Published by Bupa's Health Information Team, June 2010.
This factsheet is for people who have a pulmonary embolism, or who would like information about it.
A pulmonary embolism is a blockage of a blood vessel in the lungs. It can be fatal if the obstruction is very large and blocks the main blood supply to the lungs.
A pulmonary embolism happens when a blood clot or a piece of a blood clot gets stuck in one of the blood vessels in your lungs. The clot forms somewhere else in your body and is carried to your lungs in your blood. It usually forms in one of the deep veins that run through the centre of your legs. A clot in one of these veins is called deep vein thrombosis (DVT).
Symptoms of a pulmonary embolism include:
The symptoms you have and how severe they are will depend on how big your pulmonary embolism is. If you have a small embolism you may not have any symptoms at all. However, a large embolism can cause more severe symptoms, shock and sudden collapse.
Although not necessarily a result of a pulmonary embolism, if you have any of these symptoms, you should see your GP. If your symptoms are severe, call for emergency help.
Most pulmonary embolisms are a result of DVT in your legs. A DVT can develop if you're inactive for a long period of time. When you move your legs your muscles contract pumping blood through your veins. However, when your legs are inactive, the blood flow slows down and blood can start to pool in your veins. This can eventually lead to a DVT.
You're more likely to get a pulmonary embolism if you:
Heavy smoking (smoking more than 25 cigarettes per day) may increase the risk of pulmonary embolism even further in women.
If you visit your GP with minor symptoms, he or she will ask about your symptoms and examine you. Your GP may also ask you about your medical history.
Your GP will try to work out the likelihood of you having a pulmonary embolism by asking you a series of questions. He or she may also examine your legs for signs of DVT.
If your GP thinks you may have a pulmonary embolism, he or she will refer you to a hospital for further tests and treatment. You may have an electrocardiogram (ECG) to rule out other conditions that could be causing your symptoms. An ECG measures the electrical activity in your heart to see how well it's working.
About half of people who have a pulmonary embolism get it when they are already in hospital or long-term care for another problem. You may also be admitted to hospital as an emergency if you're having trouble breathing or have collapsed.
Tests commonly used to diagnose pulmonary embolism include the following.
Once you get to hospital, you may be given oxygen through a mask to help you breathe. You may also be given painkillers.
If your doctor strongly suspects that your symptoms are caused by a pulmonary embolism, you will be given injections of a medicine called heparin before your diagnosis has even been confirmed. Heparin is a type of medicine called an anticoagulant. Anticoagulants are used to prevent blood clots forming, or to stop existing blood clots getting any worse.
If it's confirmed that you have a pulmonary embolism, you will be prescribed ongoing treatment with an anticoagulant that can be taken by mouth, such as warfarin. You will usually need to take the medicine for at least six months, but this will depend on what has caused your embolism and whether you're likely to get another one. If you develop an embolism twice for no obvious reason, or are thought to be at high risk of developing another pulmonary embolism, you may need lifelong treatment.
If you have a large pulmonary embolism, you may also be given a medicine called a thrombolytic (eg alteplase) to try and dissolve your blood clot. This will be given as an injection into a vein.
Occasionally, your doctor may suggest putting a filter into the main vein carrying blood to your heart (the inferior vena cava). He or she will usually only recommend this procedure if you're at high risk of getting another pulmonary embolism or you can't take anticoagulant medicines. The filter stops any other clots that have formed in your legs from travelling up to your heart and lungs.
Your risk of getting a blood clot increases when you're pregnant. Having pre-eclampsia (a condition that affects pregnant women and causes high blood pressure) and having a caesarean delivery increase this risk even more.
During your first antenatal visit, your doctor or midwife will ask if you have had DVT or a pulmonary embolism before and whether you have a family history of either condition. If you have, you may be offered screening for a blood clotting disorder (thrombophilia).
If your doctor thinks you're at particular risk of getting a blood clot, you may be given heparin injections during your pregnancy and for six weeks after you have given birth. You may also be given elastic compression stockings to wear. You might be at high risk if you had DVT or a pulmonary embolism during a previous pregnancy, or while taking the contraceptive pill.
If you're in hospital for an operation or because of illness, the staff will assess your risk of developing DVT. Your doctor may suggest some exercises you can do, to make sure you keep your legs moving. You will be encouraged to drink enough fluids (or you may be given fluids through a drip if you're unable to drink).
If you're thought to be at a high risk of DVT, you may be asked to wear compression stockings on your legs to help maintain your circulation. Compression stockings come in different sizes and will be checked by nursing staff every day to make sure they are the correct size and fit for you. You might be asked to wear them after you have had surgery.
Alternatively, you may be given an intermittent pneumatic compression device. This device inflates regularly, putting pressure on your legs to keep the blood flowing. Intermittent pneumatic compression device are usually used immediately before or during surgery.
If you're having major surgery, particularly to your legs or abdominal area (tummy) you may be given injections of heparin after your operation to reduce your risk of getting DVT or a pulmonary embolism. You may need to have these injections for up to six weeks. In some instances, you may be given an anticoagulant medicine that you can take by mouth as an alternative to heparin injections.
For answers to frequently asked questions on this topic, see Common questions.
For sources and links to further information, see Resources.
For peace of mind book a health assessment today including a lung function test and chest x-ray by calling 0845 600 3458 and quoting ref. HFS100.
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This information was published by Bupa's Health Information Team and is based on reputable sources of medical evidence. It has been reviewed by appropriate medical or clinical professionals. Photos are only for illustrative purposes and do not reflect every presentation of a condition. The content is intended only for general information and does not replace the need for personal advice from a qualified health professional. For more details on how we produce our content and its sources, visit the About our Health Information page.
Publication date: June 2010
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