Several myPHteam members have reported that they’ve had pulmonary embolisms. These blockages in the pulmonary arteries, or blood vessels of the lungs, develop when a blood clot travels to the lungs.

Unfortunately, a pulmonary embolism can cause pulmonary hypertension (PH). In some cases, it may lead to chronic thromboembolic pulmonary hypertension (CTEPH), a rare but treatable type of PH.

This article will discuss common causes, symptoms, and diagnosis of a pulmonary embolism. We’ll also explain its connection to pulmonary hypertension and how you can work with your doctor to treat both conditions.

Causes of Pulmonary Embolism

A pulmonary embolism typically occurs when a piece of a blood clot breaks off from another part of the body — such as the deep veins — and travels to your lungs’ blood vessels. The drifting blood clot is called an emboli, and the obstruction it forms in the blood vessels is called an embolism.

The most common source of pulmonary embolism is deep vein thrombosis (DVT), in which a blood clot forms in the deep veins of your legs. This sort of blood clot typically results from being stationary for a long time, such as during a plane flight or after bed rest.

Anything that contributes to blood clot formation is also likely to increase your risk of having a pulmonary embolism. Common risk factors include:

• Cigarette smoking
• Family history of blood clots or clotting disorders
• Previous surgery or injury to the legs
• Some medications, such as birth control or cancer treatments
• Varicose veins, or having enlarged veins

Lungs Sounds and Other Symptoms of a Pulmonary Embolism

If you’re experiencing a pulmonary embolism, you may notice new lung sounds like crackles (called rales) or wheezing. This symptom comes from fluid in your small airways. You might also:

• Cough up blood
• Breathe with difficulty or have shortness of breath
• Feel light-headed
• Have an irregular heart rate, including palpitations (racing heartbeat)
• Experience chest pain that may worsen with breathing

These blood clots typically result from DVT, so you should watch out for symptoms including swelling, pain, or discoloration in your legs. A pulmonary embolism can be life-threatening. If you suspect you have one, don’t hesitate to seek help from your health care provider immediately.

Diagnosis of Pulmonary Embolism

A pulmonary embolism can be hard to diagnose because many of its symptoms also happen with other medical conditions. As a result, your health care provider may have to perform several medical exams to confirm your diagnosis.

The most common tests for a pulmonary embolism include blood tests that look for specific proteins made when your blood clots. Your health care provider will also check if you have any genetic disorders that suggest you’re more likely to experience blood clotting. Finally, measuring the amount of oxygen in your blood can help determine if an embolism is affecting oxygen levels throughout your body.

In addition, your health care provider will likely assess your heart and lung function and track your blood flow. These tests may include chest X-rays and other noninvasive techniques, such as:

• Computed tomography (CT) pulmonary angiography, which uses X-rays or CT scans to construct a 3D image of your lungs and pulmonary tract
• Doppler or duplex ultrasound, in which sound waves identify blood clots and examine blood flow through your veins
• Echocardiogram, which uses sound waves to create images of your heart’s structures and the surrounding vessels

Your doctor may also use more involved techniques to determine if you have a pulmonary embolism. For example, a pulmonary angiogram requires inserting a tube called a catheter into your veins to check how well blood flows through your pulmonary arteries. Additionally, a ventilation-perfusion scan injects and follows a tracer in your blood to see if you’re experiencing pulmonary hypertension.

Pulmonary Embolism and Pulmonary Hypertension

PH refers to high blood pressure in your lungs’ blood vessels. A pulmonary embolism can block blood flow in the lungs, causing the pressure to build behind it. This can become very dangerous because your heart has to work much harder to pump blood into your lungs.

High blood pressure in the lungs is serious and needs to be diagnosed and treated early. Over time, strain on your heart can lead to heart damage and even heart failure. The situation is something like a clogged sink, which eventually causes water to back up in the basin and the pipes to leak or burst.

Pulmonary Hypertension From Pulmonary Embolism vs. Other Types

Factors other than pulmonary embolism also can lead to PH. For example, narrowing or a blockage in your lungs’ blood vessels can cause blood pressure to build there, resulting in pulmonary arterial hypertension (PAH).

There are several types of PAH, and not all are related to blood clots. In fact, many people who live with idiopathic PAH have no clear cause of their symptoms. That said, if your doctor feels confident that your PH is caused by a pulmonary embolism or another underlying health condition, it can be referred to as secondary PH.

If blood clots remain in your lungs a long time or recur, scar tissue can form in your pulmonary arteries and lead to CTEPH. This is one of the few types of pulmonary hypertension that can be cured. One myPHteam member joked, “CTEPH is a curable variation of PH. Almost makes me wish my CTEPH test hadn’t been negative!”

If you have CTEPH, your doctor may recommend pulmonary thromboendarterectomy, a surgical procedure to remove the blood clot.

Treatment of Pulmonary Embolism

Several treatment options exist for a pulmonary embolism, depending on the severity and other complicating factors. If your pulmonary embolism is life-threatening, you may be given an IV medication to break down your clot.

However, you’re more likely to be prescribed an anticoagulant or blood thinner such as warfarin (Coumadin). This medication prevents your body from forming new clots, but it can cause excessive bleeding. Watch out for signs of this side effect, such as blood in vomit or mental confusion, if you’re taking this medication.

Your health care provider may use a more invasive treatment if you experience complications from anticoagulants or if they aren’t working to dissolve your clots. These procedures include:

• Percutaneous thrombectomy — A catheter is inserted into the site of the embolism and is then used to break the clots apart.
• Vena cava filter — A metal device inserted into your large blood vessel, called the vena cava, prevents clots from traveling to your lungs.
• Pulmonary embolectomy — This surgery to remove a pulmonary embolism is usually performed only in severe cases.

Ultimately, the best way to prevent a pulmonary embolism and associated PH is to stop blood clots from forming in the first place. Besides making certain healthy lifestyle changes, like not smoking or exercising more, you can also consider:

• Getting yourself moving after surgery or illness to stimulate blood circulation and prevent blood clots
• Putting on compression stockings or sleeves that press against the veins to prevent blood from moving backward
• Wearing pneumatic compression devices, which place alternating pressure on your body to help your blood flow

Several myPHteam members mentioned wearing compression stockings to help prevent blood clots. Since these tight-fitting garments can be uncomfortable, especially if you form sores, one member suggested, “If you have sores, you can use an Ace bandage instead of compression stockings.”

Talk With Others Who Understand

On myPHteam, the social network for people with heart disease and their loved ones, more than 51,000 members come together to ask questions, give advice, and share their stories with others who understand life with pulmonary hypertension.

Have you had a pulmonary embolism? Did it cause your PH? Share your knowledge in the comments below, or start a conversation by posting on your Activities page.