A pulmonary embolism (PE) is a blood clot that becomes wedged in a blood vessel in the lung. The clot blocks blood flow to the heart, preventing oxygen from reaching your body. Its symptoms are similar to a heart attack. It requires emergency treatment.
Henry Ford Medical System offers fast, expert assessment and treatment of PE. When patients come to us with a suspected embolism, we activate our pulmonary embolism response team (PERT). You’ll receive care right away from a coordinated group of experts in PE, including :
- Pulmonologists (lung specialists)
- Intensive care unit (ICU) physicians, many of whom are also trained in lung disease
- Cardiologists (heart specialists)
- Cardiothoracic surgeons, who specialize in heart, lung and chest surgery
- Interventional radiologists, who provide imaging to locate and treat the embolism
Why choose Henry Ford for PE care?
In addition to our PERT team, Henry Ford has a specialized ICU for lung patients. Our care for PE includes:
- Dedicated pulmonary and critical care team: Our critical care doctors also specialize in pulmonary care, which gives them deep expertise in caring for patients with lung issues. Our ICU has a specific unit for patients with pulmonary hypertension. Read more about Henry Ford’s pulmonary and critical care.
- Comprehensive lung team: Our pulmonary (lung and breathing) specialists are experts in diagnosing and treating PE. We work hand in hand with other doctors, including heart and vascular specialists, to identify the cause of PE and find the best way to treat you. One of our doctors is a pulmonologist and a cardiologist (heart specialist). Meet our pulmonary team.
- Research into new PE solutions: We study new ways to treat PE most effectively. We have participated in two National Institutes of Health studies in pulmonary embolism (PIOPEDI and PIOPEDII). These studies looked into the best tests for diagnosing PE.
What causes pulmonary embolism?
PE often occurs from blood clots that first form in the leg veins. When these clots dislodge from the leg, they can travel through the veins into the heart. From there, they can move and become stuck in the large arteries leading into the lungs.
This process, when a blood clot forms and travels to the pulmonary arteries, is called venous thromboembolism (VTE). The causes of VTE can include:
- Slow blood flow: The body requires blood to move constantly to prevent clotting. If the blood moves too slow, it may clot. For example, people riding in a car or plane for many hours at one time may be more likely to experience slow-moving blood. It's important to take breaks from sitting too long to keep your blood moving.
- Trauma to veins: Injury to your blood vessels can lead to a blood clot. For example, patients who have leg surgery might have a higher likelihood of blood clots. Most patients who stay in the hospital to recover from major surgery receive anticoagulant medications (blood-thinners) to prevent them.
- Medical conditions: Some individuals with certain medical conditions may be at risk of forming clots. These conditions, such as atrial fibrillation, or Afib (an irregular heart rhythm), require lifelong anticoagulant medication. Other conditions and their treatments, including cancer and pregnancy, can also increase the likelihood of PE.
- Inherited blood disorders: Some conditions, such as thrombophilia, make the blood thick, which contributes to PE.
- Autoimmune diseases: Several autoimmune conditions can cause blood clots. People with diseases including lupus and inflammatory bowel disease (IBD) have higher risk of PE.
How do doctors identify pulmonary embolism?
PE can be life-threatening. The most common symptoms are chest pain and shortness of breath. You might mistake these symptoms for a possible heart attack. If you experience them, you should seek emergency treatment. Other symptoms may include a cough, fever and lightheadedness.
Doctors use several tests to diagnose PE. These include:
- Combination imaging studies: A computed tomography (CT) scan 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: Doctors usually order a chest X-ray. This test shows a picture of your chest and lungs. It helps doctors rule out other reasons for your symptoms.
- Electrocardiogram (ECG): An ECG can help distinguish a PE from a heart attack.
Thrombolytic (clot-busting) therapy
For a patient with a life-threatening PE, we may break up the clot using medication called a lytic. Henry Ford has extensive experience using this treatment, called thrombolytic therapy.
Because thrombolytics may have serious side effects, we evaluate patients very carefully before selecting this option. We monitor patients closely throughout treatment in one of two ways:
- Intravenous: We use an IV to deliver clot-busting medication into a vein. The medicine moves through your blood vessels to break up clots anywhere in your body. We provide this treatment in our ICU, while we monitor your heart and lungs.
- Catheter-directed: We use a catheter (a thin plastic tube that we can slip into a blood vessel) to deliver clot-busting medication directly into the clot. You’ll have this treatment in our catheterization lab, while you are awake. During the same procedure, we can also perform angioplasty (a treatment to widen the vein) or place a stent, a small mesh tube, to hold the vein open.
After thrombolytic treatment, you may stay in the hospital for one to three days. Most patients spend 48 hours in our ICU, where we can watch you very closely and quickly respond to any complications.
Pulmonary embolism treatment at Henry Ford
We also provide ongoing care after an embolism. Our comprehensive team may treat a PE with:
- Follow-up care: If you received care from our PERT team, we provide coordinated follow-up care in our pulmonary clinic. We’ll see you regularly, on an outpatient basis. Our goal is to catch additional blood clots and prevent your condition from progressing to pulmonary hypertension (PH).
- Anticoagulant medications: Treating PE and VTE often involves thinning your blood on an ongoing basis. We may give anticoagulant (blood-thinning) medications intravenously (as an infusion through an IV, into the vein) or orally (by mouth). These medicines help your body break down formed blood clots. They also prevent new blood clots from forming. Most patients receive at least three months of anticoagulation therapy after a PE. Some patients require lifelong anticoagulation medicines.
- Pulmonary rehabilitation: Our pulmonary rehabilitation program helps you regain your strength and endurance after PE. You’ll work out safely with other patients, supervised by respiratory therapists. Learn more about pulmonary rehabilitation.
- Surgery: For some patients with PE, the clot never goes away. Instead, it turns into a hard, almost plastic substance in the lung. This outcome isn’t common -- it happens in about 4 percent of people with PE . When it does happen, we can remove the hardened clot surgically. We’ll also follow you over time and assist in your recovery.