Imagine going about your day—working, traveling, or even just resting—when suddenly you're short of breath, your chest feels tight, and something doesn't feel right. These could be the subtle signs of a pulmonary embolism (PE), a medical emergency that often strikes without warning.
Risk Factors
PE is a blood clot that usually originates in the veins of the legs or pelvis and travels up to the lungs. The result is sharp chest pain, significant shortness of breath, and low oxygen levels in the bloodstream.
Risk factors for PE include being sedentary and engaging in prolonged periods of inactivity, such as long car rides or airplane flights, without taking breaks to walk, which can lead to slow blood flow in the leg veins and potential clot formation.
Some warning signs of PE are swelling or pain in the legs, particularly in the calf or thigh area. Some patients may have an increased risk of blood clotting due to genetic blood disorders, underlying cancer, or a prior history of blood clots.
Treatment Options
The hallmark treatment for PE is initially thinning the blood with an intravenous medication called heparin or using low-molecular-weight heparin. Occasionally, potent medicines that break up clots, called thrombolytic therapy, are given, but this carries a significant risk of major bleeding. These medicines are used acutely in the hospital. Sometimes, patients can be started directly on oral blood-thinning medicines if the PE is smaller and thus poses a lower risk. The purpose of using blood thinners is to reduce some of the clot burden and help the body's natural mechanism to dissolve clots.
Over the past five years, newer interventional therapies for PE have been developed, yielding improved results. In particular, large tubes called catheters can be inserted into the vein in the groin area and advanced up into the lungs to suction clots out of the vessels, vastly improving blood flow and oxygenation.
If you experience the symptoms described above or suspect you may have PE, it is essential to seek medical attention immediately. Pulmonary embolism does carry significant long-term health risks and can lead to death if left untreated. If untreated, the clot can lead to additional clots, causing acute life-threatening injury.
Prevention
Preventing PE can be achieved through some simple, common-sense actions. If you're going on a long car trip or plane ride, we recommend stopping the car to walk or getting up out of your airplane seat every hour. Wearing compression-type socks or stockings can also help reduce the risk of blood clots in the legs.
Remaining active with regular exercise, particularly aerobic activity, helps maintain good blood flow. Avoidance of major risk factors such as smoking will significantly reduce the risk of clotting. It is essential to inquire about family history to identify any potential genetic clotting disorders within the family.
Gregory R. Guigliano, MD, Lexington Medical Heart and Vascular Center
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