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.
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An embolism is caused by a lump of material, called an embolus, that is floating in the blood. The embolus is usually a blood clot, but can also be an 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.
A pulmonary embolism from a blood clot most often starts in a vein in the legs or pelvis.
Factors that may increase your chance of 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 evaluate the lungs and surrounding structures. These may include:
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.
Medications called anticoagulants (blood thinners) are used to break up and control the clot. After the initial period, the blood thinner will be switched to a longer-acting anticoagulants.
Another type of medication may be needed to dissolve the clot. These are called thrombolytics. This type of medication is usually only used in people with a pulmonary embolism that is very large or is causing severe illness. Thrombolytics will not be used in those with 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 vein of abdomen (vena cava). The filter will trap clots before they can travel to the lungs.
To help reduce your chance of a pulmonary embolism:
People at high risk of developing blood clots can do the following:
American Lung Association
American Society of Hematology
Wärntges S, Konstantinides S. Progress in the management of acute pulmonary embolism. Curr Opin Pulm Med. 2015 Sep;21(5):417-24.
Philbrick JT, Shumate R, Siadaty MS, Becker DM. Air travel and venous thromboembolism: a systematic review. J Gen Intern Med. 2007;22(1):107-114.
Pulmonary embolism (PE). EBSCO DynaMed Plus website. Available at:http://www.dynamed.com/topics/dmp~AN~T115857/Pulmonary-embolism-PE. Updated July 7, 2017. Accessed August 25, 2017.
Pulmonary embolism. Society for Vascular Surgery website. Available at: https://vascular.org/patient-resources/vascular-conditions/pulmonary-embolism. Accessed August 25, 2017.
10/5/2010 DynaMed Plus Systematic Literature Surveillancehttp://www.dynamed.com/topics/dmp~AN~T115857/Pulmonary-embolism-PE: 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 Plus Systematic Literature Surveillancehttp://www.dynamed.com/topics/dmp~AN~T115857/Pulmonary-embolism-PE: 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 Plus Systematic Literature Surveillancehttp://www.dynamed.com/topics/dmp~AN~T115857/Pulmonary-embolism-PE: 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 2017 by EBSCO Medical Review Board Michael Woods, MD, FAAP Last Updated: 8/4/2015