A pulmonary embolism is a blood clot or piece of fat blocking an artery in the lung. Clots can develop in any vein, break loose, and go to the lungs. 
Causes
Most pulmonary embolisms are clots that come from deep veins in the legs or pelvis. Fatty embolisms usually come from a break in a bone or, during pregnancy, from amniotic fluid. This type of embolism occurs less frequently. Chances of a blood clot forming increase if you sit or lie in one spot for a long time. Surgery, heart problems, and taking birth control pills also increase your chances of forming a clot.
Signs/Symptoms
The most common symptoms are trouble breathing and sudden chest pain that worsens with deep breathing. Other signs are faintness or fainting, coughing (sometimes with blood), a fast heartbeat, and a low fever.
Care
While in the hospital, you will have tests to find the blood clot. These may include a chest x-ray, pulmonary angiogram, venogram, or lung scan (also called a VP scan). These are all types of pictures of the chest, arteries, veins, and lungs. You may be given oxygen, blood thinners, and pain medicine, and surgery may be needed to remove the clot.
Risks
If the pulmonary embolism is not treated it can cause part of the lung to die. Thousands of people a year get a pulmonary embolism and some do die. But if you see your doctor right away, you can be treated safely with fewer problems. Without treatment, your chances of getting another potentially fatal embolism increase.
WHAT YOU SHOULD DO
- To keep blood clots from forming in your legs, do not rest in bed for long periods of time during an illness. If you must stay in bed, change the position of your legs frequently. Start walking as soon as possible, especially after surgery.
- Do not wear tight garters or girdles, and avoid tight pants as well. Do wear tight knee socks, especially when you must stay in bed.
- When traveling, stand and walk every 1 or 2 hours. Don't cross your ankles or legs for long periods of time. Don't smoke, especially if you're taking birth control pills.
Call Your Doctor If...
- While taking blood thinning medication for the embolism, you find yourself bruising easily and often, develop bleeding from your gums or nose, or have blood in your urine or stools.
- You have swelling or pain in the calf of your leg. This may be a sign of a leg clot. Inform your doctor immediately.
Seek Care Immediately If...
- You have sudden chest pain, have trouble breathing, or begin coughing-up blood. You may have another embolism. Call 911 or 0 (operator) to get to the nearest hospital.
IF YOU'RE HEADING FOR THE HOSPITAL...
What to Expect While You're There
You may encounter the following procedures and equipment during your stay.
- Taking Vital Signs: These include your temperature, blood pressure, pulse (counting your heartbeats), and respirations (counting your breaths). A stethoscope is used to listen to your heart and lungs. Your blood pressure is taken by wrapping a cuff around your arm.
- Oxygen: Your body may need extra oxygen at this time. It is given either by a mask or nasal prongs. Tell your doctor if the oxygen is drying out your nose or if the nasal prongs bother you.
- Pulse Oximeter: While you are getting oxygen, you may be hooked up to a pulse oximeter (ox-IM-uh-ter). It is placed on your ear, finger, or toe and is connected to a machine. It measures the oxygen in your blood.
- Activity: At first you may need to rest in bed with your head and feet slightly raised.
- Be sure to slowly move your legs around often. This keeps the blood from settling in your legs and causing more blood clots.
- You may be given tight knee socks or leg wraps. They keep blood from pooling in your legs and forming clots.
- Don't cross your legs or ankles.
- Blood: Usually taken from a vein in your hand or from the bend in your elbow. Tests will be done on the blood.
- Blood Gases: Blood is taken from an artery in your wrist, elbow, or groin and tested for oxygen.
- IV: A tube placed in your vein for giving medicine or liquids. It will be capped or have tubing connected to it.
- Medicines: You may be given any of the following medications.
- Heparin: This drug keeps the blood thin so no other clots form. It is given in an IV.
- Other Blood Thinners: Drugs that can be taken by mouth, such as aspirin or warfarin, will eventually be substituted for heparin. These also keep clots from forming.
- Clot Busters: These drugs break apart existing clots. They are given in your IV, usually at the same time as heparin. This medicine can make you bleed or bruise easily.
- ECG: Also called a heart monitor, an electrocardiograph (e-lec-tro-CAR-dee-o-graf), or EKG. The patches on your chest are hooked up to a TV-type screen or a small portable box (telemetry unit). This screen shows a tracing of each heartbeat. Your heart will be watched for signs of injury or damage.
- 12 Lead ECG: This test makes tracings from different parts of your heart. It can help your doctor decide whether there is a heart problem.
- Chest X-ray: This picture of your lungs and heart will help doctors decide whether there is a clot.
- Other Tests: One test is called a Ventilation-Perfusion scan. Another is called pulmonary (PULL-mun-air-ee) arteriography (r-tear-e-OG-ruf-e). Both tests help your doctor see whether your lungs are working normally and whether there is a clot blocking blood flow. The doctor may also get an x-ray of your veins (a venogram) to check for additional clots.
After You Leave
- Be certain to take your medicine exactly as directed by your doctor. If you feel it is not helping, call the doctor. Do not quit taking it on your own.
- If you are taking a blood thinner:
- Wear a medic-alert bracelet to warn people that you are taking a blood thinner.
- Notify your dentist and other care givers that you are taking a blood thinner.
- Watch for bleeding from your gums or nose, or in your urine or stools.
- Avoid contact sports since you will bruise more easily.
- Every couple of hours take 2 or 3 deep breaths.
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