The diagnosis of pulmonary embolism (PE) means a blood clot has become wedged in the lung. PE often occurs from blood clots that first form in the leg veins. These leg vein clots become dislodged and travel through the veins into the heart and out to the large arteries leading into the lungs, where the blood clot becomes stuck. This process of blood clot formation and travel to the pulmonary arteries is called venous thromboembolic (VTE) disease.
Pulmonary embolism symptoms
Chest pain and shortness of breath are the most common symptoms of PE. Cough, fever, and/or lightheadedness may also occur.
Various tests help to diagnose PE:
- Combination Studies: Computed tomography (CT) of the chest in combination with Doppler ultrasound of the legs has become the safest, quickest, and best overall method to diagnose a PE.
- Chest X-ray: A chest x-ray is usually ordered to rule out other pulmonary reasons for the symptoms.
- Electrocardiogram (ECG): An ECG can help distinguish a PE from a heart attack.
- Other Tests: Depending on each patient's circumstances, other tests may be necessary to help make a diagnosis of PE.
Pulmonary embolism treatment
Treatment for PE and VTE involves "thinning" of blood (called anticoagulation). Anticoagulant medications, which may be given intravenously or orally, help the body to break down formed blood clots. Anticoagulation medications also help to prevent the formation of new blood clots. Most patients receive at least 3 months of anticoagulation therapy after being diagnosed with a PE. Some patients may require lifelong anticoagulation medicines.
Why blood clots form
Blood clots tend to form for 3 basic reasons:
- The body requires constant movement of blood to prevent clotting. If blood movement becomes too slow, the blood tends to clot and can result in blood clot formation. For example, people riding in a car for many hours at one time may be more likely to develop slowed blood movement. This is why it's important to take breaks from sitting too long.
- Trauma to veins can lead to injury with blood clot formation. For example, patients who have leg surgery might be in this category. For most patients undergoing major surgery and staying in the hospital for recovery, anticoagulant medications are given to prevent blood clots.
- Some individuals may be medically predisposed to forming clots. These medical conditions, such as atrial fibrillation of the heart, require lifelong anticoagulant medication.
PE Research at Henry Ford
Henry Ford Pulmonary and Critical Care Medicine has long been involved in the care of patients with pulmonary embolism and in the research of PE to help prevent and successfully treat this potentially life-threatening condition. We have participated in two National Institutes of Health studies in pulmonary embolism (PIOPEDI and PIOPEDII) which looked into the best tests for the diagnosis of pulmonary embolism.