Pulmonary Embolism

What it is and who described it

A clot, usually from a deep vein thrombosis in the leg, travels through the heart and lodges in the lung arteries. European guidelines rank venous thromboembolism as the third most common acute cardiovascular syndrome after heart attack and stroke (Konstantinides et al., 2020). Rudolf Virchow described the process and coined 'embolism' in the 1850s; Friedrich Trendelenburg attempted surgical removal in 1908; and in 1960 Barritt and Jordan's controlled trial showed untreated patients fared far worse, making anticoagulation standard (Barritt & Jordan, 1960).

Wow~ How I won 1st place in an investing contest... take a look.Get $100 free when you open an account - GoldStudyNet#Tesla#Nvidia#Gold#Nasdaq#TradeTodayAfterSignupCollege Trading CommunityGo to GoldStudyNet ›Sponsored

Warning signs

• Sudden shortness of breath, even at rest
• Chest pain that worsens on breathing in
• Racing heart, dizziness or fainting
• Coughing, sometimes with blood
• A swollen, painful leg beforehand

It mimics pneumonia, heart failure or panic attacks. Suspect it after surgery, hospitalization, long flights, during cancer treatment, pregnancy or estrogen use.

Diagnosis

Doctors estimate probability with the Wells score (Wells et al., 2000); low-probability patients can be ruled out with the PERC rule (Kline et al., 2004) or a D-dimer blood test. CT pulmonary angiography confirms the clot; a ventilation/perfusion scan suits those who cannot receive contrast (PIOPED Investigators, 1990); echocardiography checks strain on the right heart.

Treatment

Anticoagulants stop clots growing while the body dissolves them. Guidelines now favor direct oral anticoagulants such as rivaroxaban, apixaban, edoxaban or dabigatran over warfarin, usually for at least three months (Kearon et al., 2016; Stevens et al., 2021). High-risk patients in shock may receive clot-dissolving drugs or catheter or surgical removal; low-risk patients may be treated at home.

Prevention

• On long flights, walk or flex your calves every hour or two and stay hydrated.
• After surgery, move early and follow advice on stockings or preventive medication.
• Smoking, obesity and immobility raise risk; discuss it if you have atrial fibrillation or lung cancer.

This article is general health information and is not a substitute for diagnosis or treatment. If symptoms persist, see a doctor.

FAQ

Can it be cured?

Most people recover with anticoagulation, but some have recurrences or lasting pulmonary hypertension and need follow-up.

Do long flights always cause it?

No, but they raise the risk; move often and talk to a doctor if you have other risk factors.

Sources reviewed: 2026-11-02

References

1. Konstantinides, S. V., Meyer, G., Becattini, C., Bueno, H., Geersing, G.-J., Harjola, V.-P., Huisman, M. V., Humbert, M., Jennings, C. S., Jiménez, D., Kucher, N., Lang, I. M., Lankeit, M., Lorusso, R., Mazzolai, L., Meneveau, N., Ní Áinle, F., Prandoni, P., Pruszczyk, P., ... Zamorano, J. L. (2020). 2019 ESC Guidelines for the diagnosis and management of acute pulmonary embolism developed in collaboration with the European Respiratory Society (ERS). European Heart Journal, 41(4), 543–603. European guideline on diagnosis, risk stratification and treatment.
2. Wells, P. S., Anderson, D. R., Rodger, M., Ginsberg, J. S., Kearon, C., Gent, M., Turpie, A. G., Bormanis, J., Weitz, J., Chamberlain, M., Bowie, D., Barnes, D., & Hirsh, J. (2000). Derivation of a simple clinical model to categorize patients probability of pulmonary embolism: Increasing the models utility with the SimpliRED D-dimer. Thrombosis and Haemostasis, 83(3), 416–420. Origin of the Wells score for pulmonary embolism.
3. Kline, J. A., Mitchell, A. M., Kabrhel, C., Richman, P. B., & Courtney, D. M. (2004). Clinical criteria to prevent unnecessary diagnostic testing in emergency department patients with suspected pulmonary embolism. Journal of Thrombosis and Haemostasis, 2(8), 1247–1255. Derivation of the PERC rule to avoid unnecessary tests.
4. The PIOPED Investigators. (1990). Value of the ventilation/perfusion scan in acute pulmonary embolism: Results of the prospective investigation of pulmonary embolism diagnosis (PIOPED). JAMA, 263(20), 2753–2759. Landmark study of the ventilation/perfusion scan.
5. Barritt, D. W., & Jordan, S. C. (1960). Anticoagulant drugs in the treatment of pulmonary embolism: A controlled trial. The Lancet, 275(7138), 1309–1312. First controlled trial of anticoagulants for pulmonary embolism.
6. Kearon, C., Akl, E. A., Ornelas, J., Blaivas, A., Jimenez, D., Bounameaux, H., Huisman, M., King, C. S., Morris, T. A., Sood, N., Stevens, S. M., Vintch, J. R. E., Wells, P., Woller, S. C., & Moores, L. (2016). Antithrombotic therapy for VTE disease: CHEST guideline and expert panel report. Chest, 149(2), 315–352. CHEST guideline favoring direct oral anticoagulants.
7. Stevens, S. M., Woller, S. C., Kreuziger, L. B., Bounameaux, H., Doerschug, K., Geersing, G.-J., Huisman, M. V., Kearon, C., King, C. S., Knighton, A. J., Lake, E., Murin, S., Vintch, J. R. E., Wells, P. S., & Moores, L. K. (2021). Antithrombotic therapy for VTE disease: Second update of the CHEST guideline and expert panel report. Chest, 160(6), e545–e608. 2021 update of the CHEST VTE guideline.