A doctor may strongly suspect a pulmonary embolism based on a patient’s circumstances, such as suddenly struggling to breathe the day after hip replacement surgery, or sudden chest pain.
Even if the patient has other classic symptoms of a pulmonary embolus such as coughing up blood-tinged sputum, a doctor in good faith cannot just order administration of a clot busting drug unless the diagnosis is confirmed with imaging.
“The use of medication to bust up clots carries with it a risk of bleeding elsewhere in the body, as the medication stops blood from clotting,” says Darren Klass, MD, clinical instructor of interventional radiology at the University of British Columbia and the Vancouver Coastal Health Association.
“The physician responsible for administering the medication knows this and will ask specific questions to the patient to ensure it is safe.
“The patient must be closely monitored after this medication has been administered and therefore requires hospital admission.”
What leads to a pulmonary embolism?
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A pulmonary embolism is a blood clot in a lung (sometimes both; there can be multiple) that originally developed in a lower-extremity vein (lower leg to hip).
Such a blood clot is called a deep vein thrombosis (DVT) and are considered an emergency situation because it can dislodge at any time — and head straight for the lungs.
So to prevent a pulmonary embolus, one must take measures to lower their risk of a DVT.
Major Risk Factors for a DVT
- Obesity
- Smoking
- Birth control pills
- HRT therapy
- Sitting immobile in cramped quarters for hours without a break
- Recent joint replacement or abdominal surgery
- Excessive bed rest
- Pregnancy
- Older age
A DVT is easily diagnosed with an ultrasound. A pulmonary embolism is diagnosed with a CT scan.
PE symptoms in combination with a positive result of a specific blood test will raise strong suspicion of this blood clot, but are not enough for an official diagnosis.
“Aside from this, PE can only be confidently diagnosed using medical imaging such as a CT scan,” says Dr. Klass.
“The clinical signs of pulmonary embolus are non-specific and cannot be confidently made without imaging.”
Dr. Klass specializes in interventional oncology, aortic intervention, PVD, venous disease and venous access. He has been inducted into The Leading Physicians of the World, published by the International Association of HealthCare Professionals.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.
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