Health Column: Warning signs of a pulmonary embolism

Most people recognize tightness in the chest, shortness of breath and dizziness as telltale signs of a heart attack — But these symptoms can also signal a pulmonary embolism — which has proven to be just as grave. 

Dr. Norman Edelman, a professor in Stony Brook University’s preventive and internal medicine program, said the condition is relatively common and that it can be difficult for a patient to distinguish between an embolism and a heart attack. Either way, when the symptoms present themselves, patients need to act quickly.

“We as lung doctors see patients frequently who either have a pulmonary embolism or are suspected of having one,” he said. “Every day in the ER, you will see patients like that.

“What happens is a clot forms in a vein in the body — usually a large vein in the leg. Sometimes that clot dislodges and goes through the heart into the lungs, blocking off circulation in portions of the lung.”

With little or no blood circulating, he explained, cells in the lung muscle start to die, much as they would during a heart attack, which is why time is of the essence.

For most people, clots form when blood flow slows — an example being when one is sits for a long period of time, such as during a flight or car ride.

Because muscles are not moving, they are not contracting to help increase blood flow in the veins. When that flow slows, it can allow blood cells to “sludge” or gel, becoming sticky and potentially forming a clot, Dr. Edelman said.

“Anybody who is sitting still that for a long time — such as driving — ought to take breaks every 20 minutes or half-hour to keep the blood flowing,” he said. “Stand up and flex your calf muscles. That will help keep down the formation of clots.”

He said pregnant women, those on the mend from surgery, as well as those with certain conditions, including cancer and obesity, are most at risk for developing a clot.

Knowing one’s family history is also important, as many patients have an underlying predisposition to clotting.

According to the Centers for Disease Control and Prevention, it’s estimated that one or two out of every 1,000 people will develop a pulmonary embolism annually — and that the condition will prove fatal for 60,000 to 100,000 people each year.

In addition, the agency reports, one-third of those who suffer an embolism will experience a recurrence within the next decade.

Dr. Edelman said pharmaceutical advancements in anticoagulants — more commonly known as “blood thinners,” which cause the blood to take longer to form a clot — are making it easier and safer for patients during recovery.

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