What is Pulmonary Embolism?

Pulmonary Embolism is a condition in which a blood clot (thrombus) lodges itself in a blood vessel in the lung. A PE usually starts as a clot in the deep veins (also known as deep vein thrombosis or DVT) in the leg that has broken away and flowed to the lungs. This can be a life-threatening condition if not treated quickly.
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What are the signs and symptoms of Pulmonary Embolism?

The signs and symptoms of PE include the following:

• Pain in the chest or upper back
• Difficulty in breathing
• Coughing up blood
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What causes Pulmonary Embolism?

While it is not always possible to identify a reason, several factors may increase the risk of having PE:

• Previous episodes of PE or other blood clot conditions
• Surgery in the last 3 months
• Reduced mobility due to surgery, illness, injury or long-distance travel (lasting for more than 4 hours)
• Increasing age
• Obesity
• Pregnancy
• Use of oral contraceptives (birth control pills)
• Genetic factors – there are several genetic mutations that have been known to increase one’s risk of blood clots.
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How is Pulmonary Embolism treated?

The recommended treatment is an anticoagulant which is a medication which will thin the blood and prevent the clot from getting bigger. The blood clot will naturally dissolve in your body over time.
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In life-threatening cases, a treatment to dissolve the blood clot (called thrombolysis) may be used before the anticoagulant is started.
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What are the risks and side-effects of Anticoagulant medication?

While anticoagulant medication is effective for treating PE, it is associated with increased bleeding risks and side effects. You should seek medical attention if you develop:

• Prolonged or excessive bleeding
• Blood in your urine/stool
• Bleeding gums
• Prolonged nose-bleeds
• Coughing out blood
• Heavy periods for women
• Exceptional weakness, tiredness, paleness, dizziness, headache, unexplained swelling, breathlessness, chest pain or angina.
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What do I need to do after I go home?

• Avoid prolonged exercises – Your physical activity may be limited due to your symptoms. Avoid prolonged periods of exercise in the first few weeks, and have enough rest.
• Check with your doctor before taking other medication – Some medication like aspirin and ibuprofen may interfere with your treatment. Always check with your doctor before taking any other medication, including herbal and alternative treatments.
• Eat a healthy and balanced diet – Try to eat a healthy, balanced diet, and to avoid excessive changes in your weight during your treatment. 
• Avoid drinking alcohol – Alcohol can interfere with your medication. It is recommended to avoid drinking alcohol or limit your intake to no more than two units of alcohol each day.
• Refrain from long-distance travel – It is advisable to avoid long-distance travelling for the first six weeks after a PE.
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Frequently Asked Questions

How long will my symptoms last? 

Recovery from PE varies; it can take several months to return to your previous level of fitness. You may still experience symptoms such as chest pain, breathlessness and fatigue for weeks or months after a PE. If your symptoms do not improve over time, further tests may be required to determine the cause. In rare cases, pulmonary hypertension (a type of high blood pressure) may develop in the lungs and will require a specialist’s input to manage this.
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How long will I be on anticoagulants? 

The duration varies from person to person, ranging from three months to a lifetime. This depends on several factors which our doctor will discuss with you during your appointment.
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When should I be concerned about my symptoms? 

Visit your nearest hospital emergency department if you experience worsening chest pain or breathlessness.
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When should I return to work? 

You may be able to return to work within weeks, depending on the severity of your symptoms and the nature of your work. Our doctor will advise you on when it is suitable to return to work.
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What is the likelihood of developing another PE? 

The likelihood of developing another PE differs between patients. Our doctor will inform you if any additional tests are required and provide further advice to reduce your risk of recurrent PE. This may include a plan to continue anticoagulation if there is a high risk of recurrence.
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How much activity should I do? 

It is advisable to avoid vigorous exercise after a PE or any activities that will increase your risk of bleeding while you are on an anticoagulant. If you feel well enough, you should resume daily activities, such as walking. Bed rest may not be necessary. If you feel breathless or unwell during an activity, get ample rest until you feel recovered. You can start to increase your activities when your symptoms have settled..
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How do I find out more?

You can contact us at Clinic For Clinical Haematology (CFCH) to find out more about PE or our Anticoagulant treatment.

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Disclaimer:
The information on the Centre For Clinical Haematology website is intended for educational use.  It should not be considered or used as a substitute for medical advice, diagnosis or treatment from a qualified health professional.