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You are in: Home > Chest Information > Chest Conditions > Pulmonary Embolism

Pulmonary Embolism (PE)

• What is pulmonary embolism?
• What causes pulmonary embolism?
• Who is at risk of pulmonary embolism?
• What to look out for
• What tests will I need?
• Treatment of pulmonary embolism
• Can pulmonary embolism be prevented?

If you want more detailed information on pulmonary embolism please call our Advice Line on 0845 077 6000.

What is pulmonary embolism?

Pulmonary embolism is the blockage of a blood vessel to the lungs. It is often referred to as a 'PE'.

• Pulmonary: simply means 'in the lungs' or 'about the lungs'.
• Embolus: a blood clot that has become detached and is free to travel through the blood stream. If it becomes lodged in an artery or vein and causes an obstruction it is known as an embolism.

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What causes pulmonary embolism?

The blockage is usually caused by a blood clot (thrombus) which has formed in the deep veins of the legs or pelvis. This condition is known as 'deep vein thrombosis' or DVT. A pulmonary embolism happens when a part of the clot becomes detached and travels to the lungs, lodging in an artery.

The broader term 'venous thromboembolism' (VTE) refers to DVT or pulmonary embolism or a combination of both.

More rarely, the embolism is caused by fat globules (associated with bone fractures), amniotic fluid (the fluid surrounding a baby in the womb), or air entering the blood stream following trauma (injury).

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Who is at risk of pulmonary embolism?

There are risk factors that can increase your chances of developing a pulmonary embolism. These are divided into major and minor risk factors.

Major Risk Factors (increase risk 5 – 20 times that of general population):

• Major and abdominal surgery
• Trauma or surgery to the pelvis or legs
• Lower leg problems, e.g. varicose veins, fractures
• Previous clot in a deep vein
• Malignant tumour: pelvic, abdominal or secondary tumours
• Pregnancy
• Reduced mobility, e.g. prolonged bed rest after surgery

Minor Risk Factors (increase risk 2 – 4 times that of general population):

• Heart related, e.g. congestive heart failure, congenital heart disease, high blood pressure or a heart attack
• Long–distance travel
• Congenital thrombophilia (a genetic increased tendency for blood to clot)
• Neurological disability, e.g. stroke
• Injury to veins resulting from minor trauma
• Oral contraception and hormone replacement therapy (HRT)
• Chronic obstructive pulmonary disease (COPD)
• Obesity
• Increasing age

Pulmonary embolism affects approximately 60–70 people in every 100,000. Of these, 50% are either in hospital or long–term care, 25% have some other risk factors and 25% have no identified cause.

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What to look out for

Pulmonary embolism can be difficult to diagnose as the symptoms can also be present in other illnesses. The severity of your symptoms depends on the size of the embolism and how much of your lung is affected.

Common symptoms include:

• Sudden shortness of breath with rapid breathing
• Chest pain
• Cough with blood–streaked sputum (phlegm)
• Fast heartbeat
• Dizziness or fainting
• Excessive sweating

Redness, tenderness or swelling over a leg vein can all be symptoms of a DVT.

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What tests will I need?

If your doctor suspects that you may have a pulmonary embolism you may need some tests. These can include:

• Chest x–ray
• Blood tests
• ECG
• Leg ultrasound
• Special heart and / or lung scans

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Treatment of pulmonary embolism

Usually treatment of pulmonary embolism involves taking anticoagulant medication. The aim is to prevent existing clots from enlarging and new clots forming.

The length of treatment can be up to 6 months. Sometimes your doctor may advise you that you need to take treatment for the rest of your life.

• A massive pulmonary embolism is a medical emergency and can be life–threatening. You may need treatment called thrombolysis. The clot is dissolved with special clot–busting drugs. Sometimes the clot is removed by a catheter or surgery. This is called an embolectomy. Your specialist would recommend what treatment is best for you.

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Can pulmonary embolism be prevented?

If you are in hospital you will be assessed to see if you are at risk of a pulmonary embolism. Preventative measures, which can reduce the incidence of post–operative pulmonary embolism, may include:

• The use of anticoagulant drugs before and after surgery
• The use of graduated compression stockings (if medically suitable)
• Early mobilisation and exercising limbs after surgery
• Avoiding dehydration

If you are travelling on long journeys, especially by air, you should:

• Exercise your legs to ensure good circulation: every half hour try to bend and stretch your legs, wiggle your feet and press the balls of your feet down hard against the floor. Get up regularly, if you can, for short walks
• Avoid, or limit, alcohol and caffeine before and during your flight as these can make you dehydrated. Drink plenty of fluids; take your own bottle of water and have regular sips throughout the journey
• Talk to your doctor / pharmacist to see if there are other measures you may need to take before you fly, e.g. graduated compression stockings

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