Warning Signs of a Pulmonary Embolism

If you have a wearable device, you may also notice your heart rate go up unexpectedly even when you’re at rest. “Once the blood clot travels to the lungs, the symptoms can be really nonspecific,” Pugliese says. “The most common symptom that patients can have is they’re just going to feel short of breath.” A sharp pain on one side of your lungs when you breathe in could also suggest a blood clot.

Together, chest pain, shortness of breath and pain with deep breathing can point to PE. “That separates it from a heart attack,” which can also cause chest pain and shortness of breath, but typically not pain when you take deep breaths, explains Geno Merli, M.D., a professor of medicine and surgery at Sidney Kimmel Medical College and director of the Division of Vascular Medicine at Thomas Jefferson University Hospital in Philadelphia.

For about one-quarter of people with PE, sudden death is the first symptom, the CDC says. According to the Cleveland Clinic, about 33 percent of people with a pulmonary embolism die before they get a diagnosis and treatment.

How age plays a role in risk – and why you should be increasingly vigilant

As we age, the risk for pulmonary embolism increases, though young people aren’t immune. In fact, PE-related deaths increased for all individuals under the age of 70 between 1999 and 2019, according to a study published in 2022 in the American Heart Journal Plus: Cardiology Research and Practice.

Numerous factors raise a person’s risk for pulmonary embolism, and those tend to become more severe and cluster with age. For instance, cancer risk climbs steadily with age, and some cancer treatments increase the likelihood of blood clots, Merli says. Heart disease, diabetes and lung disease, which disproportionately affect older adults, are also risk factors for DVT and PE.

When a person moves less — whether it’s because they’re sitting on a plane for a long trip, they have a degenerative condition that renders them less mobile, or they’re less active — the chances they’ll develop pulmonary embolism rise. “As patients age, they tend to become more and more sedentary, which is a significant risk factor,” Merli stresses.

Undergoing surgery also puts a person at risk, Pugliese says. What’s more, research finds that postmenopausal women who take hormone replacement therapy face a higher risk of developing blood clots, including PE; however, that risk was most pronounced in the first year of therapy and seemed to lessen over time.  

Treating pulmonary embolism

Anticoagulants — blood thinners that dissolve clots and prevent future ones — are “the cornerstone of treatment” for PE, Bikdeli says.

For more severe PE, like a clot that’s completely blocking an artery in the lungs and is life-threatening, doctors may turn to a procedure that involves snaking a catheter into the artery to bust or suck out the clot immediately. In the most extreme cases, open surgery may be performed to remove the clot from the lungs. But with clot-busting and surgery, the potentially life-threatening risk of bleeds must be considered, Bikdeli says.

Afterward, patients are often instructed to continue taking a blood thinner orally to prevent future complications from PE. “It’s really not a condition that comes and goes away,” Bikdeli says.

If the blood clot can be traced back to a one-off event like surgery, doctors may determine a patient’s risk of a future blood clot is much lower. But especially in the minority of cases where the cause isn’t known or hasn’t been identified — what’s called “unprovoked” pulmonary embolism — patients are much more likely to develop blood clots again if they stop taking blood thinners, Pugliese says.

Preventing pulmonary embolism

There are some things you can do to lower your chances of having a PE. “I would say it’s one of the most common and highly preventable conditions in cardiovascular diseases,” Bikdeli says.

Regular physical activity can help you manage your weight, lowering your overall blood clot risk. But even simple movements help. For example, if you’re on a long plane ride or sitting for long hours at work, move your arms, legs and feet for a few minutes every hour, the Cleveland Clinic suggests.

“I think keeping mobile is most important,” Merli says.

Also, consider wearing compression stockings, which can encourage blood flow. Keeping hydrated, limiting alcohol and staying away from tobacco products can lower your risk of PE. And if you’ve had a blood clot in the past, keeping up with any prescribed medications and keeping in touch with your doctor is key to preventing future clots.

Left unaddressed, repeated PE can lead to chronic high blood pressure and can damage the lungs and heart and lead to other potentially fatal issues like heart failure.