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Pulmonary Embolism: Know the Signs of a Blood Clot

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Posted by Parth M. Rali, MD

Pulmonary embolism is a serious lung condition — and one many people may not know how to recognize.

At the Temple Lung Center, we use the latest technologies and leading-edge approaches, including our groundbreaking Pulmonary Embolism Response Team, to rapidly identify and treat this life-threatening condition. But too many people don’t know they’re at risk for pulmonary embolism — or don’t know the signs it’s time to seek emergency care.

As a pulmonologist who specializes in advancing pulmonary embolism care, here’s what I wish everyone knew about recognizing the symptoms of a pulmonary embolism — or avoiding the condition altogether.

Pulmonary embolisms may be acute or chronic

A pulmonary embolism may be a chronic (long-term) condition or a sudden emergency. To understand why, it’s important to understand what the condition is. That starts with understanding how your heart and lungs work together to give your body the oxygen it needs. The heart pumps blood through the pulmonary artery to the lungs, which takes in oxygen from the air and distributes it to your blood cells. The oxygenated blood then flows back to the heart to be pumped throughout your body.

A pulmonary embolism is a blood clot in the lung. When the clot, also called an embolus, lodges in the pulmonary artery, it partially or completely blocks the flow of blood from the heart to the lung.

In about 10% to 15% of people with pulmonary embolism, the heart and lungs aren’t able to transport oxygen effectively throughout the body. This is a life-threatening emergency known as an acute (sudden) pulmonary embolism. In other cases, the condition may be chronic (long-term). In those cases, the clot forces the heart to work harder to send blood through the lungs, leading to increased blood pressure, known as pulmonary hypertension. And while pulmonary embolisms may start out as relatively small clots, they may grow larger over time, increasing the blockage.

Leg pain may be a serious sign

Many of my pulmonary embolism patients are surprised to learn that their lung condition began in another part of the body entirely — their leg. I explain that pulmonary embolisms often begin with deep vein thrombosis (DVT), a condition in which blood clots form in the major veins that move blood from the body to the heart and lungs. If DVT isn’t diagnosed and treated in time, the clot may break free and travel to the lungs, forming a pulmonary embolism. DVT usually occurs in the calf, thigh, or pelvis, although it may occur in other locations, such as the arm.

About half the time, patients with a DVT don’t experience symptoms. When they do, the discomfort caused by a clot may feel similar to a cramped muscle, such as a charley horse. DVTs may need immediate treatment, so it’s important to call a doctor right away if you experience these symptoms in a leg or arm:

  • Discoloration (reddish or bluish skin)
  • Pain or tenderness not caused by an injury
  • Swelling
  • Warmth

Anyone can develop a blood clot. But your medical condition and history may make it more likely — and knowing you are at an increased risk can make it easier to recognize the signs and symptoms of a blood clot, so you can get treatment faster. Factors that may raise the risk of blood clots include:

  • A family or personal history of blood clots
  • Certain medical conditions, including advanced cancer, heart disease, interstitial lung disease, COVID-19, and lupus
  • Obesity, especially among women who smoke or have high blood pressure
  • Recent inactivity, such as being on bed rest or sitting during air travel
  • Pregnancy
  • Smoking
  • Supplemental estrogen, such as hormone therapy or certain birth control medications

Pulmonary embolism symptoms are an emergency

While the clot that causes a pulmonary embolism may start in the legs, once a clot moves to the lungs, the symptoms move as well. A new or worsening pulmonary embolism is an emergency, and it may be life-threatening. Call 911 right away if you experience:

  • Fast or irregular heartbeat
  • Light-headedness, dizziness, or fainting
  • Sharp, stabbing chest pain — which may be worse when you breathe deeply
  • Sudden shortness of breath
  • Unexplained cough, which may include coughing up blood

Some patients tell me they thought the chest pain caused by a pulmonary embolism was a symptom of a heart attack — another medical emergency. If you suspect you might be having a heart attack or pulmonary embolism, don’t delay, even if you’re not sure: Call 911 and seek emergency medical care.

When you arrive at the emergency department, your medical team will start by evaluating your condition. They’ll perform a physical exam and ask you about your symptoms and health history. And they’ll perform tests, including blood tests and diagnostic imaging, to confirm the presence of a clot and determine the treatment that’s right for you.

Advanced care makes a difference

At the Temple Lung Center, I’m proud to be the leader of one of the only Pulmonary Embolism Response Teams in the region, which is leading the way in improving how pulmonary embolisms are treated. Our approach ensures patients with a possible pulmonary embolism are evaluated and treated by experienced experts — so they get the advanced, multidisciplinary care they need without delay.

As a leader in pulmonary embolism care, we are committed to improving patient outcomes every step of the way. For example, because rapid detection and treatment can be lifesaving for patients with pulmonary embolism, we’re using artificial intelligence to flag ultrasound images that may indicate serious problems. All scans are still reviewed by our team of specialists, but this technology alerts us about severe conditions in real time. It allows us to quickly mobilize and determine the best course of action. We’re privileged to use this new technology to improve patient care.

Once a clot is diagnosed, Temple offers a full range of treatment options, including:

Our team approach enables us to streamline care across the various services needed to effectively address pulmonary embolism. We have a variety of protocols and therapies available. In fact, we’re the only hospital in our region equipped to offer certain treatments, such as catheter-directed thrombolysis. And we are passionate about offering each patient the best possible care.

If you’re living with chronic pulmonary embolism or if you’re concerned about your risk for a repeat clot, schedule a consultation with the experts at Temple Lung Center. You can request an appointment online or by phone at 800-TEMPLE-MED (800-836-7536).

Helpful Resources

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Parth M. Rali, MD

Dr. Rali is a pulmonologist at the Temple Lung Center. His clinical interests include acute and chronic pulmonary embolism, post-pulmonary embolism syndrome, pulmonary hypertension and interstitial lung disease.

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