Pulmonary embolus
| Pulmonary embolism | |
|---|---|
 |
|
| Chest spiral CT scan with radiocontrast agent showing multiple filling defects both at the bifurcation ("saddle" pulmonary embolism) and in the pulmonary arteries. | |
| Specialty | Hematology, cardiology, pulmonology |
| Symptoms | Shortness of breath, chest pain, coughing up blood |
| Complications | Passing out, abnormally low blood pressure, sudden death |
| Usual onset | Older people |
| Risk factors | Cancer, prolonged bed rest, smoking, stroke, certain genetic conditions, estrogen-based medication, pregnancy, obesity, after surgery |
| Diagnostic method | Based on symptoms, D-dimer, CT pulmonary angiography, lung ventilation/perfusion scan |
| Treatment | Blood thinners such as heparin or warfarin |
| Frequency | ~450,000 per year (USA), 430,000 (Europe) |
| Deaths | 50,000-200,000 per year (USA) |
| Classification | |
|---|---|
| External resources |
Pulmonary embolism (PE) is a blockage of an artery in the lungs by a substance that has traveled from elsewhere in the body through the bloodstream (embolism). Symptoms of a PE may include shortness of breath, chest pain particularly upon breathing in, and coughing up blood. Symptoms of a blood clot in the leg may also be present such as a red, warm, swollen, and painful leg. Signs of a PE include low blood oxygen levels, rapid breathing, rapid heart rate, and sometimes a mild fever. Severe cases can lead to passing out, abnormally low blood pressure, and sudden death.
PE usually results from a blood clot in the leg that travels to the lung. The risk of blood clots is increased by cancer, prolonged bed rest, smoking, stroke, certain genetic conditions, estrogen-based medication, pregnancy, obesity, and after some types of surgery. A small proportion of cases are due to the embolization of air, fat, or amniotic fluid. Diagnosis is based on signs and symptoms in combination with test results. If the risk is low a blood test known as a D-dimer will rule out the condition. Otherwise a CT pulmonary angiography, lung ventilation/perfusion scan, or ultrasound of the legs may confirm the diagnosis. Together deep vein thrombosis and PE are known as venous thromboembolism (VTE).
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