A pulmonary embolism is a blockage of an artery in the lungs. The embolism prevents blood and nourishment from getting to a specific area of the lungs. This may lead to the death of lung tissue in this area. Damage to the lungs may make it difficult for the lungs to work properly. In severe cases, a pulmonary embolism can lead to death.
Pathway of Pulmonary Embolism
Copyright © Nucleus Medical Media, Inc.
An embolism is caused by a lump of material, called an embolus, that is floating in the blood. An embolus can be a blood clot, air bubble, a piece of fat, bone marrow, or tumor tissue. The embolus travels from its original location and passes through larger blood vessels until it gets stuck in a smaller blood vessel. In this case, the embolus is trapped in an artery of the lungs.
The embolus in a pulmonary embolism is usually a blood clot. It most often starts in a vein in the legs or pelvis.
Factors that increase your chance of developing a pulmonary embolism include:
The symptoms of a pulmonary embolism vary depending on the size and location of the blockage. The area of lung affected by the lack of blood will also affect the symptoms. Pulmonary embolism may cause:
Your doctor will ask about your symptoms and medical history. A physical exam will be done. Your doctor may order the following tests:
Imaging tests create pictures of internal structures. Imaging tests may include:
If you are diagnosed with a pulmonary embolism, follow your doctor's instructions .
Treatment depends on the size and severity of the clot. Emergency treatment and hospitalization may be needed.
Emergency treatment for shock may include IV fluids, medications, and oxygen therapy.
Treatment includes medication, and in some cases, surgery.
The first step in treatment is an anticoagulant medications (blood thinners). These may include:
After the initial period, the blood thinner will be switched to a longer-acting anticoagulant. One example is warfarin .
Another type of medication may be needed to dissolve the clot. These are called thrombolytics. Examples include alteplase and urokinase. This type of medication is usually only used in patients with a pulmonary embolism that is very large or is causing severe illness. Thrombolytics will not be used if you have a high risk of bleeding.
Surgery to remove the clot may be needed if the blockage is very large, not responding to treatment, or the person is in shock. The surgery is called an embolectomy.
Some people may have repeated problems with blood clots. Others cannot take anticoagulant medications. In these cases, a surgical procedure will be done to place a filter in the main veins of the legs. The filter will trap clots before they can travel to the lungs.
Prevention of pulmonary embolism means preventing clots from forming.
You can help prevent clots with a healthy lifestyle. Suggestions include:
People at high risk of developing blood clots can do the following:
American Lung Association
American Society of Hematology
Gibson NS, Sohne M, etc. Prognostic value of echocardiography and spiral computed tomography in patients with pulmonary embolism. Curr Opin Pulm Med. 2005;11:380.
Guyatt GH, Norris SL, et al; American College of Chest Physicians. Methodology for the development of antithrombotic therapy and prevention of thrombosis guidelines: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest. 2012 Feb;141(2 Suppl):53S-70S.
Konstantinides S. Clinical practice. Acute pulmonary embolism. N Engl J Med. 2008;359:2804-2813. Review.
Philbrick JT, Shumate R, et al. Air travel and venous thromboembolism: a systematic review. J Gen Intern Med. 2007;22:107-114.
Pulmonary embolism. JAMA. February 2001.
Pulmonary embolism. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed.ebscohost.com/about/about-us . Updated August 22, 2013. Accessed August 28, 2013.
Pulmonary embolus. Canadian Lung Association website. Available at: http://www.lung.ca/diseases-maladies/a-z/embolus-embolie/index_e.php . Updated September 24, 2012. Accessed August 28, 2013.
Qaseem A, Snow V, et al. Current diagnosis of venous thromboembolism in primary care: a clinical practice guideline from the American Academy of Family Physicians and the American College of Physicians. Ann Intern Med. 2007;146:454-458.
Rubini G, Niccoli A, et al. Acute pulmonary embolism: comparison and integration of perfusion lung scintigraphy with multislice spiral CT. Radiol Med. 2007;112:174-184.
10/5/2010 DynaMed's Systematic Literature Surveillance https://dynamed.ebscohost.com/about/about-us : Parker C, Coupland C, Hippisley-Cox J. Antipsychotic drugs and risk of venous thromboembolism: nested case-control study. BMJ. 2010;341:c4245.
12/17/2010 DynaMed's Systematic Literature Surveillance https://dynamed.ebscohost.com/about/about-us : Grainge MJ, West J, Card TR. Venous thromboembolism during active disease and remission in inflammatory bowel disease: a cohort study. Lancet. 2010;375(9715):657-663.
1/26/2012 DynaMed's Systematic Literature Surveillance https://dynamed.ebscohost.com/about/about-us : Zöller B, Li X, Sundquist J, Sundquist K. Risk of pulmonary embolism in patients with autoimmune disorders: a nationwide follow-up study from Sweden. Lancet. 2012;379(9812):244-249.
Last reviewed September 2013 by Michael Woods, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
Copyright © 2012 EBSCO Publishing All rights reserved.
What can we help you find?close ×