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Pulmonary embolus

Venous thromboembolism; Lung blood clot; Blood clot - lung; Embolus; Tumor embolus; Embolism - pulmonary; DVT-pulmonary embolism; Thrombosis - pulmonary embolism

A pulmonary embolus is a blockage of an artery in the lungs. The most common cause of the blockage is a blood clot.

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Pulmonary embolus

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Causes

A pulmonary embolus is most often caused by a blood clot that develops in a vein outside the lungs. 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 where it lodges.

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 has a history of blood clots or certain clotting disorders. A pulmonary embolus may occur:

Disorders that may lead to blood clots include:

Symptoms

Main symptoms of a pulmonary embolism include chest pain that may be any of the following:

Other symptoms may include:

Exams and Tests

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:

Blood tests may be done to check if you have an increased chance of blood clotting, including:

Treatment

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.

Outlook (Prognosis)

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.

When to Contact a Medical Professional

Go to the emergency room or call the local emergency number (such as 911), if you have symptoms of pulmonary embolus.

Prevention

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 provider 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 for 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. Smoking increases your risk of developing blood clots.

Related Information

Deep venous thrombosis
Cancer
Stroke
Heart attack
Broken bone
Pulmonary hypertension
Taking warfarin (Coumadin, Jantoven) - what to ask your doctor
Taking warfarin (Coumadin)
Deep vein thrombosis - discharge

References

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. PMID: 22315257 www.ncbi.nlm.nih.gov/pubmed/22315257.

Kline JA. Pulmonary embolism and deep vein thrombosis. In: Marx JA, Hockberger RS, Walls RM, et al, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 8th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 88.

Weitz JI. Pulmonary embolism. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 98.

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Review Date: 12/4/2015  

Reviewed By: Yi-Bin Chen, MD, Leukemia/Bone Marrow Transplant Program, Massachusetts General Hospital, Boston, MA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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