Pulmonary embolism

What is a pulmonary embolism?

A pulmonary embolism is also known as a blood clot on the lung.

How does this happen?

Most commonly, people develop blood clots in the veins of the legs or the abdomen. This is known as deep vein thrombosis (DVT). These clots can break off and travel up the veins to your heart and then from your heart to your lungs, where they have become lodged.

What symptoms would I have had due to my pulmonary embolism?

The most common symptom of a pulmonary embolism is breathlessness. Other symptoms can be chest pain (which is worse on breathing or coughing), cough, fever and coughing up blood.  It may also make your heart beat very fast or irregularly and give you a feeling of palpitations.

Larger pulmonary emboli may make you feel light headed or can cause you to faint or lose consciousness.

How are my pulmonary emboli diagnosed?

You will have undergone a lung scan. The most common lung scan to be used is an X-ray test called a CT scan. The particular type of CT scan is called a pulmonary angiogram.

This involves injecting dye into a drip in your arm or hand which then travels to your heart and is pumped through your lungs. This dye helps to show which blood vessels within the lung the blood clots are in.

If you are pregnant or have other reasons for you not to have a CT scan, you may have undergone a slightly different type of lung scan. This is also a type of X-ray scan called a ventilation / perfusion scan (VQ scan). The medical team will have picked the most appropriate test for you.

You may also have had a number of other tests as part of your investigations. These may have included a chest X-ray, blood tests and heart tracing (also known as an ECG). These tests would have helped to diagnose the blood clot. They would have also given the team an understanding of how much stress or strain the blood clot was placing on your body.

What treatment am I having?

The most common treatment for blood clots in the lungs are blood thinning drugs. There are a number of different drugs that can be used. These include tablets (Warfarin, Rivaroxaban, Apixaban) and injections (Tinzaparin, Enoxaparin).

The purpose of these medicines is to thin your blood to cut down your risk of having another blood clot. The treatment does not actually dissolve the blood clot itself. The body removes the blood clot with the same process that it uses to heal bruises.

If you had a very large pulmonary embolism which was interfering with your heart’s ability to pump blood through your lungs, you may have also received a clot busting drug to help break down the blood clot. This treatment is only used in the most serious of cases.

You may also have had other medicines during your admission including oxygen, fluids through a cannula (a thin tube inserted into a vein, through which medicines and other fluids can be passed) and painkillers.

How long will I need treatment for?

The length of time that a patient requires treatment with blood thinning drugs can vary from just 3 months to being required for the rest of the patient’s life.

The duration of treatment will depend on a number of different factors including:

• What may have caused the blood clot to form
• How unwell you were
• How likely you are to have another blood clot in the future.

The team looking after you take this all into consideration before they make a recommendation on how long they would wish you to stay on treatment.

Will I need any other investigations?

This will depend if the reason for you having developed a blood clot is clear. A number of patients who do not have a reason for the blood clot undergo further investigations. The purpose of these investigations are to make sure there has been no underlying or serious cause for the blood clot to have developed.

Further tests you may be asked to have include CT scans of your abdomen and pelvis, a mammogram in female patients and some further blood tests.

The team looking after you will explain if and why they think that you require further investigations.

What follow up will I need?

You may need to be followed up in the chest clinic to make sure that you have recovered from this blood clot and also to go through the results of any further investigations you may be having.

You may also be referred to a haematology or blood clinic to check if you have any underlying blood clotting problem that may have made you more likely to develop blood clots.

You may be asked to have a heart ultrasound, known as an echocardiogram, at certain points during your recovery to make sure that your heart is functioning normally and that the blood pressure flowing through your lungs has returned to normal.

How will I feel when I am recovering from my pulmonary embolism?

The most common symptoms are breathlessness and fatigue.  These get better gradually but can take several weeks to months for you to return to normal. The best aid to recovery is to live as normal a life as possible and to exercise to gradually build up your fitness.

What can I do to help me get better from this?

The important thing is to make sure that you take your blood thinning medicine every day and not to forget to take this.

We encourage you to exercise as much as you are comfortable with to gradually build up your strength over time. Ideally you would avoid contact sports or activities which put you at risk of bleeding.

If you smoke, we really want to encourage you to cut down or stop. Smoking slows down the recovery of your lungs from any illness.

Can I fly?

We ask you to wait at least 4 weeks after the blood clot has been treated before you consider flying to ensure that you are fully recovered. If there is any reason that you shouldn’t fly, then the team looking after you will explain this to you. We also ask you to make sure that you inform your health insurance company if you are flying as well as your flight carrier to make sure that they have no objections to this and to ensure that your insurance covers you adequately.

Where can I get more information on blood clots?

British Lung Foundation

https://www.blf.org.uk/support-for-you/pulmonary-embolism/symptoms

Contact numbers

University Hospital of North Tees

Lung health
Telephone: 01642 624270

Department of Respiratory Medicine
Monday to Friday 09:00am-05:00pm
Telephone: 01642 624936

Emergency Department
24 hours a day, 7 days a week
Telephone: 01642 382899

Comments, concerns, compliments or complaints

Patient Experience Team (PET)

We are continually trying to improve the services we provide. We want to know what we’re doing well or if there’s anything which we can improve, that’s why the Patient Experience Team (PET) is here to help. Our Patient Experience Team is here to try to resolve your concerns as quickly as possible. The office is based on the ground floor at the University Hospital of North Tees if you wish to discuss concerns in person. If you would like to contact or request a copy of our PET leaflet, please contact:

Telephone: 01642 624719

Freephone: 0800 092 0084

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Telephone: 01642 383551

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Leaflet feedback

This leaflet has been produced in partnership with patients and carers. All patient leaflets are regularly reviewed, and any suggestions you have as to how it may be improved are extremely valuable. Please write to the Clinical Governance team, North Tees and Hartlepool NHS Foundation Trust, University Hospital of North Tees, TS19 8PE or:

Email: [email protected]

Leaflet Reference: PIL1218
Date for Review: 28/08/2023