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What are the signs and symptoms of pulmonary embolism?

The most common symptoms of a pulmonary embolus are:

  • Chest pain: The pain is classically described as pleurtic, a sharp pain that worsens when taking a deep breath.
  • A cough that may produce bloody sputum (hemoptysis)
  • Shortness of breath: The person may have difficulty catching their breath at rest, and the shortness of breath often worsens with activity.

The patient may have stable vital signs (blood pressure, heart rate, respiratory rate, and oxygen saturation), but depending upon the amount of blood clot in the lung and how much lung tissue is affected, the vital signs may be abnormal.

Classic signs of a pulmonary embolus are associated with abnormal vital signs. Depending on the amount of blood clot (clot burden or clot load), the following may occur:

  • Elevated heart rate: tachycardia (tachy=fast + cardia=heart)
  • Elevated respiratory (breathing) rate: tachypnea (tachy=fast + pnea= breathing)
  • Bluish discoloration of skin and mucous membranes (cyanosis), due to decreased oxygen saturation (red blood cells that do not have oxygen molecules attached to them)
  • Decreased blood pressure: hypotension (hypo=low + tension=pressure)

The condition progresses as follows:

  • The heart rate and respiratory rate may elevate as the body tries to compensate for less oxygen transfer in the lung. Breathing and heart rate increase to help circulate the blood throughout the body more quickly, so that the available oxygen can be distributed as best as possible to the body's organs and tissues.
  • This may lead to weakness and lightheadedness as the body's organs are deprived of the necessary oxygen to function.
  • If the blood clot is large enough, it can block blood from exiting the right side of the heart, thus preventing blood from entering the lungs.
  • No blood enters the left side of the heart to pump blood throughout the rest of the body. This can result in shock (circulatory collapse) and sudden death.

Up to 25% of patients with pulmonary embolus may experience sudden death, in which the patient collapses, stops breathing, and their heart stops beating (cardiac arrest) without prior symptoms. Pulmonary embolus is the second leading cause of sudden death, behind coronary artery disease.

Return to Pulmonary Embolism (Blood Clot in the Lung)

See what others are saying

Comment from: Richard, 55-64 Male (Patient) Published: March 01

I had surgery to remove my cancerous prostate and adjacent lymph nodes. The second day after the surgery I felt a slight pain in my left calf. Still catheterized from the surgery I did manage to walk a bit and the pain subsided. A few days later I was awakened by severe back pain and shortness of breath. My wife got me up and we walked around until I belched, which we both thought it was just gas and I went back to bed. After a restless night I awoke with the pain and a feeling that something was not right. I was having a gout attack in my hand and foot, my back was aching, I could not breathe and I was still recovering from surgery. By noon the pain was so severe that I was rushed to the emergency room. There, after much testing, the doctors concurred that I had multiple emboli in my lungs. The pain and shortness of breath lasted for a day and one half and no medication could stop the pain. Finally one last ditch effort of a different drug and an anxiety medicine did allow me to relax and rest. The next morning I was pain free and remained in the hospital 3 more days. Two of the doctors that handled my case told me that I should not have survived such a massive amount of embolisms. I am on blood thinners now and trying to walk as much as I am able but most of all I am just glad to be alive.

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Comment from: sokhermom13, 55-64 Female (Patient) Published: December 30

My presenting symptoms of pulmonary embolism were atypical which caused an incorrect diagnosis of bronchitis for seven weeks. The only symptom I showed was a sudden onset of coughing that I could not stop. I tried Proventil inhaler without success. After three hours, I went to the emergency room (ER), and was given another Proventil treatment, steroids and a codeine cough syrup which worked. I went to a follow-up appointment, had an x-ray done and was told to anticipate that the cough may last up to seven weeks. It was at the seven-week point at which I went to my allergist who provided three Proventil treatments back to back with no improvement in oxygen saturations or coughing and was then transported to the ER. After several hours of treatment and being prepared for discharge, the ER doctor went with her gut feeling at the last minute and ordered a CT which showed bilateral pulmonary embolisms. Again, the only symptom was non-stop coughing. No chest pain at all.

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Comment from: Hollywood, 35-44 Female (Patient) Published: September 11

The first time I had a pulmonary embolism my symptoms was shortness of breath, coughing and back aches back in 2013 and now it came with a pop in my back followed by sharp pain and coughing.

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