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Pulmonary Embolism: Causes, Symptoms, Prevention, and Treatment

Jerome Albert Ecker | MD

Medically reviewed by Jerome Albert Ecker | MD, Assistant Professor of Medicine, Duke University - Durham, NC on May 2nd, 2023.

Key Takeaways

  • Blood clots typically originate in deep leg veins (deep vein thrombosis) and travel to the lungs, with 90% of cases stemming from the lower extremities or pelvis.

  • Classic symptoms include sudden shortness of breath, pleuritic chest pain that worsens with deep breathing, and hemoptysis (coughing blood), though 25% of patients may have no obvious symptoms initially.

  • Major risk factors include recent surgery (especially orthopedic), prolonged immobilization over 4 hours, active cancer, pregnancy, and combined oral contraceptives—risk increases 3-6 fold with birth control pills.

  • D-dimer blood test levels above 500 ng/mL suggest possible clotting, but CT pulmonary angiogram (CTPA) remains the gold standard for diagnosis with 90% accuracy.

  • Anticoagulation therapy typically begins with heparin for immediate effect, followed by warfarin or newer DOACs (direct oral anticoagulants) for 3-6 months to prevent recurrence.

Pulmonary embolism (PE) is a serious condition that occurs when a blood clot gets caught in one of the arteries that go from the heart to the lungs. This blockage can cause damage to the lungs, low oxygen levels in the blood, and harm to other organs in the body such as the heart. In severe cases, PE can be life-threatening.

What Causes Pulmonary Embolism?

Most often, pulmonary embolisms are caused by blood clots that travel to the lungs from deep veins in the legs, a condition known as deep vein thrombosis (DVT). These clots can develop when blood flow is restricted due to prolonged periods of inactivity, such as during long flights or bed rest after surgery or illness.

In other cases, PE's can be a marker for underlying diseases, such as cancer, nephrotic syndrome, or genetic conditions, like Factor V Leiden or Protein C, S, or antithrombin deficiency, or the prothrombin gene mutation. PE's are also more likely to occur in pregnancy or be related to medications such as hormone replacement or oral contraceptives.

Pulmonary Embolism: Causes, Symptoms, Prevention, and Treatment

Risk Factors for Pulmonary Embolism

Several factors can increase your risk of developing a pulmonary embolism, including:

  • Prolonged immobility or changes in normal blood flow

  • Hypercoagulability (blood that is more likely to clot)

  • Damage to blood vessel walls

  • Certain medications, such as birth control pills

  • Smoking, cancer, recent surgery (especially orthopedic procedures involving the hips or knees), or pregnancy

  • COVID-19

  • Obesity

Preventing Pulmonary Embolism

To reduce your risk of developing a pulmonary embolism, you can take the following steps:

  1. Take blood thinners (anticoagulants) as prescribed by your doctor

  2. Wear compression stockings to improve blood flow in your legs

  3. Exercise regularly and move around after prolonged periods of inactivity

  4. Stretch your legs and ankles during long trips

  5. Maintain a healthy weight and lifestyle

  6. Quit smoking

If you have a history of blood clots, kidney disease, autoimmune disorders, or a family history of blood clots, discuss your risk factors with your doctor.

Treating Pulmonary Embolism

Treatment for pulmonary embolism depends on the severity of the condition. In life-threatening cases, doctors may administer thrombolytic drugs to break up the clot or perform surgery to remove it. However, surgery is rarely necessary.

By understanding the causes, symptoms, and prevention methods for pulmonary embolism, you can take steps to protect your health and reduce your risk of developing this serious condition. If you suspect that you or someone else may have a pulmonary embolism, seek immediate medical attention.

For more information on pulmonary embolism, visit:

The Bottom Line

This medical emergency requires immediate treatment, as untreated cases carry a 30% mortality rate compared to 2-8% when properly managed. Moving every 2 hours during long flights or bed rest significantly reduces risk. If you're experiencing sudden breathing difficulties or chest pain, Doctronic can help assess your symptoms quickly.

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