The reason a pulmonary embolism (an embolism is a clot that is traveling through the blood stream) develops is well known.  A clot forms in the calf of the leg (or any other part of the body), breaks off and travels through the venous system through the heart to the lungs causing a sudden increase in pulmonary resistance, or cor pulmonale, also known as right sided heart failure.  When this condition is severe enough, the pressure in the pulmonary artery becomes so extremely high that the heart can no longer push blood through the lungs into the left ventricle resulting in a catastrophic low blood pressure that can lead to death.  Signs of a pulmonary embolism are chest pain, coughing up blood (hemoptysis), extreme shortness of breath, wheezing, fever, abdominal pain, sweating, a rapid heart beat, a blue tinge to the skin and lips and cardiac arrhythmia.  Ten per cent of patients who present with a pulmonary embolism in the ER die within an hour. However, some people experience multiple PEs before a diagnosis is made because their symptoms are so subtle.  Approximately 70% of patients who survive an acute PE develop chronic cor pulmonale which requires vigilant medical attention.

 The root cause of pulmonary emboli is clot formation in part of the body.  An injury to the extremities, surgery to any part of the body, pregnancy and the post-partum period, remaining immobile for long periods of time (such as occurs on a long plane or car ride or during hospitalization), estrogen replacement therapy, chemotherapy, clotting disorders and varicose veins are some of the causes of clot formation.

  By far, one of the most common causes of pulmonary embolism is a deep vein thrombosis in the calves of the legs.  This condition is frequently ignored because the victim may believe that the pain they are experiencing is due to an injured muscle.  The consequence of such inattention can be catastrophic.  If the victim’s leg becomes swollen, very painful, red and warm to the touch then the symptoms are often hard to ignore and the individual may become alarmed enough to seek out their physician’s advice.  Immediate hospitalization usually follows where anticoagulant therapy can be implemented as quickly as possible. 

 Often, the patient must remain on anticoagulant therapy for long periods of time following the thrombosis, if not for the rest of their lives. Frequent blood tests are required during anticoagulant therapy to insure that bleeding does not occur due to too much medication.  There is a very fine line between therapeutic anticoagulation levels and being over medicated.  Many patients have discovered that ignoring weekly blood tests have resulted in hemorrhaging in their joints, abdomen or extremities resulting in re- hospitalization.   Anticoagulation therapy requires strict adherence to a physician’s orders.

 Pain in the calf of the leg, arm, thigh, groin or at an old IV site should never be ignored.  Sharp chest pain resulting in shortness of breath, bloody sputum and a rapid heart rate requires emergency services.   A pulmonary embolism is easily preventable if the symptoms of clot formation are brought to the attention of a physician.  Pay attention to the language of your body and do not ignore pain.