In a respiratory emergency, you may have just minutes to act. This holds true for pulmonary embolism. Knowing the causes, signs, and treatments for pulmonary embolism pain and other symptoms could save your life.
What is a pulmonary embolism?
The pulmonary artery carries deoxygenated blood from the right side of the heart to the lungs. Divided into left and right branches, this artery splits and diverts to either the left or right side of the lungs.
The pulmonary artery is part of the heart-lung circulatory system. It is responsible for removing waste products from major organs via the blood. It also “cleans it” before recirculating it throughout the body.
Pulmonary embolism (PE) is a sudden blockage of the pulmonary artery by a blood clot. Other materials that can cause a clot in rare cases include:
- An air bubble
- Collagen or other soft tissue
- A tumor
- Fat from the marrow of a broken bone
In most cases, pulmonary embolism is cause by deep vein thrombosis (DVT). Estimates of incidence vary, but somewhere between 300,000 and 600,000 people in the U.S. will experience pulmonary embolism in the U.S every year. Other causes are being investigated as well.
This is no minor condition. Pulmonary embolism can:
- Cause damage to the lungs due to lack of blood flow
- Cause blood oxygen levels to drop
- Damage other major organs due to lack of oxygen
Approximately 30% of people who experience pulmonary embolism will die within hours of the first signs of pulmonary embolism pain. The good news is that with fast treatment, full recovery with few complications is possible.
How to diagnose a pulmonary embolism
Diagnosis of a pulmonary embolism utilizes a variety of tools, including:
- Blood tests
- Chest X-rays
- Spiral CT scan
- Pulmonary angiogram
Because pulmonary embolism can be challenging to diagnose in patients with other lung or heart issues, several diagnostics are necessary to confirm the diagnosis.
What causes a PE?
There are seven common causes of pulmonary embolism.
- Deep vein thrombosis
- Genetic factors
- Complications from birth control
- Varicose veins
- Cancer treatment
Deep vein thrombosis
The most common cause of pulmonary embolism is deep vein thrombosis (DVT).
This condition occurs when sluggish blood flow in the legs causes clots. Clots can also occur in the brain, eyes, liver, and kidneys. These clots then travel from wherever they are into the right side of the heart as waste. They move to the pulmonary artery, where they cause a pulmonary embolism.
Risk factors for developing deep vein thrombosis include:
- Sitting for a long time: Long flights in a pressurized airplane decrease circulation in the entire body
- Being bedridden: Less activity means less circulation in all systems of the body
- Breaking a bone or undergoing surgery: Surgery or injury decreases activity overall but may also decrease it specifically to the area experiencing injury or surgery
- Smoking: Smoking decreases circulation in every system in the body and is especially damaging to lung function
Factor V Leiden is a genetic condition that increases blood clotting. It is named after a specific gene mutation that causes thrombophilia. This condition results in an increased tendency for blood clotting.
People with factor V Leiden are more prone to developing DVT, the major cause of pulmonary embolism.
For every ten years over age 60, the risk of pulmonary embolism for both men and women doubles.
Complications from birth control
Any type of hormone therapy or birth control pills can increase the chances of developing a pulmonary embolism.
Also specific to women, pregnancy and the six-week postnatal period are also high-risk periods for developing deep vein thrombosis that leads to pulmonary embolism.
Varicose veins are the twisty, prominent veins that sometimes appear in the lower legs as we age. Valves control the flow of blood into the legs. When these valves weaken, blood begins to pool in the veins of the legs, causing varicose veins. Blood flow through these veins can become sluggish, allowing the blood clots to form.
In most cases, blood clots that do occur in varicose veins are superficial and not considered serious. However, there is a possibility that deeper blood clots can occur, causing deep vein thrombosis and increasing your chances of a pulmonary embolism. Pulmonary embolism is rare but does occur in those who suffer from severe varicose veins.
Cancer patients who receive a central venous catheter (also called a central line) have an increased risk of pulmonary embolism.
Perhaps a combination of factors increases the risk of pulmonary embolism in overweight people. If the weight gain is due to inactivity, surgery, or broken bones, the chances of pulmonary embolism increase. Smokers tend to carry more weight than non-smokers do, which also increases a person’s risk.
Unfortunately, some people who suffer from pulmonary embolisms can point to no known causes for why it occurred.
In 2016, a definitive study from the National Institutes of Health found that, contrary to previous theories, anemia alone is not associated with pulmonary embolism.
What are the warning signs of a pulmonary embolism?
Pulmonary embolism symptoms appear suddenly and without warning in many cases. Here is what to look for. Doing so could save your life.
Pulmonary embolism chest pain
Chest pain all on its own is a common and alarming symptom of pulmonary embolism.
You may experience pain that especially gets worse when you breathe, cough, or move. Pain does not decrease with rest and only worsens with activity. There is no stretching or massaging the pain away.
Pulmonary embolism back pain
Pulmonary embolism back pain is similar to pulmonary embolism chest pain except for its location. This pain is located in the back, between the shoulder blades, with some people describing it as a knife-like pain in the middle of the back.
If you experience either pulmonary embolism chest pain or pulmonary embolism back pain, do not hesitate: get to an emergency room immediately. This is a life-threatening situation that warrants a trip in an ambulance if you are unable to drive yourself or have a friend who can help.
Other pulmonary embolism symptoms
Other warning signs and symptoms of pulmonary embolism include:
- Shortness of breath: Shortness of breath on its own may not be alarming, but if you have other symptoms of pulmonary embolism, this could mean you have a partial blockage. If you ever have unexplained shortness of breath, visit a doctor immediately.
- Symptoms related to deep vein thrombosis: In some cases, these may be the only symptoms you experience. If you have recently been in an airplane and are experiencing leg pain and tenderness, swelling in the leg along the vein, or increased warmth in the leg, it is time to see your doctor.
- Coughing (with or without blood): Coughing, especially when accompanied by blood, is an alarming symptom of pulmonary embolism.
- Arrhythmia: An irregular heartbeat can mean many things. It is an important symptom of pulmonary embolism when accompanied by other symptoms.
- Emotional symptoms: Feelings of anxiety or dread are common with pulmonary embolism.
- Other physical symptoms: Some people experience light-headedness or fainting, rapid breathing, and sweating as symptoms.
At the very least, these symptoms should be reviewed at an urgent care facility, especially if you have risk factors that predispose you to pulmonary embolism. Do not wait for a regular doctor’s appointment – go immediately to your nearest urgent care or emergency room. Time is critical to treat pulmonary embolism and prevent complications.
How do you prevent pulmonary embolisms?
Prevention is the very best treatment for pulmonary embolism. If you know you will be traveling or sitting for extended periods of time, you can take the following precautions.
Stand up whenever possible
If you know you are predisposed to pulmonary embolism but have to go visit Hawaii (or another far off land), take frequent breaks from sitting.
Walk the aisles of the airplane and stretch your legs when possible. For long drives, stop every hour or so to walk around.
Fidget and stretch
Circle your ankles and flex your feet as you sit to promote circulation.
Wear compression socks or stockings
These snug, stretchy socks and stockings promote circulation and the movement of fluid in the lower legs.
For women taking birth control pills or who are pregnant or in their postnatal period, taking anticoagulants to prevent clots can help reduce the risk of pulmonary embolism.
What are common pulmonary embolism treatments?
If you are experience a pulmonary embolism, there are several treatment options that your doctor may pursue.
These drugs are also often referred to as blood thinners. They prevent blood clots from forming and work not only as a first line treatment for pulmonary embolism but also as a preventative for patients at risk.
If you’ve suffered from a PE, you’ll work closely with your doctor to find the correct dosage and type of drug that works best for you. All of them do come with their own risks, so talk openly to your doctor about how to manage these and prevent further complications.
Your vascular surgeon injects a clot-dissolving drug directly into the clot itself. This can be done as soon as a clot is located, whether it is in your leg or your pulmonary artery.
Doctors use this treatment when a patient is unable to take blood thinners. These filters trap large clots before they reach the pulmonary artery.
Using a catheter inserted in the artery, your vascular surgeon injects salt water directly into the blood clot to dissolve it.
This surgery is performed when a clot is life-threatening.
What should I know about pulmonary embolism recovery pain?
The most important part of recovery from pulmonary embolism is to follow your doctor’s orders exactly.
Every patient has a different health history and experiences a different recovery. In some cases, patients will experience lingering pulmonary embolism recovery pain that can range from mild to moderate. This may be because of the treatment, or it may be the lingering effects of the blockage. It is important to keep your doctor apprised of your pain levels, especially if they worsen.
For most patients, recovery from pulmonary embolism includes the following.
Medication and monitoring
Many patients continue to take anti-coagulant medications for a few months after the event. This reduces your chances of having another one in the high-risk months following the first PE.
Your doctor will also closely monitor different health indicators, such as blood pressure and iron levels, during this time. Visiting your doctor on a regular basis to monitor progress with recovery is important. They can help keep you on track with your weight loss, monitor proper activity levels, and offer support as you recover.
The amount of exercise will vary depending on the cause of the pulmonary embolism but will likely include some form of movement every day. Start slowly and gradually increase intensity and duration, following your doctor’s instructions.
Consuming plenty of water and juice while avoiding alcohol and caffeine keeps circulation strong and healthy.
If you smoke, quitting smoking now is the best thing you can do for every aspect of your health.
Obesity puts you at risk for all kinds of health issues, from pulmonary embolism to Type 2 diabetes. Take this opportunity to embark on a weight loss journey for improved health.
Elevating your feet
Elevating your feet above the level of your heart daily can help circulate blood from your legs back to your heart. Make legs up the wall part of your daily ritual for 30 minutes at the end of each day. This simple posture also helps decrease blood pressure and promotes relaxation.
Have you suffered from a pulmonary embolism? Was there pain or other symptoms that made you go to a doctor?