What is a pulmonary embolism?
Pulmonary embolism occurs when a fragment of clot — nearly always from a deep vein in the leg or pelvis — breaks off, travels through the heart and blocks an artery in the lung. The blocked segment of lung can no longer take up oxygen, and if the blockage is large the strain on the right side of the heart becomes dangerous within hours.
Because pulmonary embolism and deep vein thrombosis are two ends of the same disease, treatment is never only about the lung. Finding and treating the source clot, and identifying why it formed, is what stops a second event.
Symptoms to watch for
- Sudden breathlessness, at rest or on minimal exertion
- Sharp chest pain that is worse when breathing in
- Rapid heartbeat or palpitations
- Coughing, sometimes with blood-streaked sputum
- Light-headedness, collapse or fainting
- Swelling or pain in one leg, pointing to the source clot
When to seek urgent care
Suspected pulmonary embolism is an emergency. Call for emergency help or go directly to the nearest emergency department — do not wait for an outpatient appointment.
How it is diagnosed
Investigation is chosen to answer a specific question rather than as a blanket screen. For pulmonary embolism that usually means:
- Immediate clinical risk scoring, oxygen saturation and ECG
- CT pulmonary angiography — the definitive imaging test
- D-dimer testing to exclude the diagnosis where probability is low
- Echocardiography to assess strain on the right side of the heart
- Leg venous duplex ultrasound to identify the source thrombus
- Investigation for an underlying cause in unprovoked events
Treatment options at Siva Sakthi
Which of these applies to you depends on what the assessment shows. The options are discussed with you, including what each involves and what recovery looks like.
- Emergency stabilisationOxygen, monitoring and haemodynamic support are the first priority in a large embolism, in a hospital setting.
- AnticoagulationPrompt blood-thinning treatment prevents further embolism and allows the body to clear the existing clot; it is the mainstay for most patients.
- Systemic or catheter-directed thrombolysisClot-dissolving therapy is reserved for high-risk embolism with circulatory compromise, or selected intermediate-risk cases.
- Catheter or surgical embolectomyPhysical clot removal is considered where thrombolysis has failed or is contraindicated.
- Treating the sourceThe deep vein thrombosis that caused the embolism is assessed and managed, including stenting an obstructed iliac vein where that is the underlying reason.
- Secondary preventionDuration of anticoagulation, thrombophilia assessment and risk-factor management are planned to prevent recurrence.
Common questions
Most patients recover with prompt anticoagulation, and the body clears the clot over subsequent weeks. Outcome depends on the size of the embolism and how quickly treatment started, which is why speed matters so much.
Because the clot almost always came from a leg or pelvic vein. Treating that source, and any vein narrowing behind it, is how recurrence is prevented.
Not necessarily. A clot with a clear temporary cause is often treated for a defined period; unprovoked or recurrent events more often warrant long-term treatment. It is reviewed with you against your bleeding risk.
Book a consultation in Guntur
Pulmonary Embolism is assessed and treated by Dr. Vijay Kumar Vishnumolakala, MS, MCh, at our Kothapeta clinic. Request an appointment or call +91 00000 00000.