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A pulmonary embolus is a blockage of an artery in the lungs. The most common cause of the blockage is a blood clot.
Venous thromboembolism; Lung blood clot; Blood clot - lung; Embolus; Tumor embolus; Embolism - pulmonary
A pulmonary embolus is most often caused by a blood clot in a vein. The most common blood clot is one in a deep vein of the thigh or in the pelvis (hip area). This type of clot is called a deep vein thrombosis (DVT). The blood clot breaks off and travels to the lungs.
Less common causes include air bubbles, fat droplets, amniotic fluid, or clumps of parasites or tumor cells.
You are more likely to get this condition if you or your family have a history of blood clots or certain clotting disorders. A pulmonary embolus may occur:
Main symptoms include chest pain that may be any of the following:
Other symptoms may include:
The health care provider will perform a physical exam and ask about your symptoms and medical history.
The following lab tests may be done to see how well your lungs are working:
The following imaging tests can help determine where the blood clot is located:
Other tests that may be done include:
A pulmonary embolus requires treatment right away. You may need to stay in the hospital:
Whether or not you need to stay in the hospital, you will likely need to take medicines at home to thin the blood:
If you cannot take blood thinners, your doctor may suggest surgery to place a device called an inferior vena cava filter (IVC filter). This device is placed in the main vein in your belly. It keeps large clots from traveling into the blood vessels of the lungs. Sometimes a temporary filter can be placed and removed later.
How well a person recovers from a pulmonary embolus can be hard to predict. It often depends on:
Some people can develop long-term heart and lung problems.
Death is possible in people with a severe pulmonary embolism.
Go to the emergency room or call the local emergency number (such as 911) if you have symptoms of pulmonary embolus.
Blood thinners may be prescribed to help prevent DVT in people at high risk, or those who are undergoing high-risk surgery.
If you had a DVT, your doctor will prescribe pressure stockings. Wear them as instructed. They will improve blood flow in your legs and reduce your risk of blood clots.
Moving your legs often during long plane trips, car trips, and other situations in which you are sitting or lying down for long periods can also help prevent DVT. People at very high risk of blood clots may need shots of a blood thinner called heparin when they take a flight that lasts longer than 4 hours.
Do not smoke. If you smoke, quit. Women who are taking estrogen must stop smoking.
Guyatt GH, Akl EA, Crowther M, et al. Executive summary: antithrombotic therapy and prevention of thrombosis, 9th ed. American College of Chest Physicians evidence-based clinical practice guidelines. Chest. 2012;141(2suppl):7s-47s.
Weitz JI. Pulmonary embolism. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 24th ed. Philadelphia, Pa: Elsevier Saunders; 2011:chap 98.