What-Are-The-Symptoms-Of-Pulmonary-Embolism (1)

What Are The Symptoms Of Pulmonary Embolism?

A pulmonary embolism (PE) occurs when a blood clot gets stuck in one of the arteries leading from the heart to the lungs because the clot blocks the normal flow of blood.

Blood goes from the heart to the lungs through the pulmonary artery. The blood is oxygenated in the lungs and then returned to the heart, which pumps oxygen-rich blood to the rest of your body. However, in pulmonary embolism, this mechanism is disturbed.

This blockage can cause serious problems, such as lung damage and reduced blood oxygen levels. A lack of oxygen can also damage other parts of your body. A pulmonary embolism can be fatal if the clot is large or smaller clots block the artery.

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pulmonary embolism (PE)

Pulmonary emboli usually travel from the deep veins of the legs to the lungs. Doctors call this event deep vein thrombosis (DVT). These clots form when blood cannot flow freely through the legs. Because your body has been immobile for a long time, for example, during a flight or a long drive, this also happens if you are on bed rest after surgery or illness.

What factors can increase the possibility of pulmonary embolism?

Risk factors are the same as for DVT. Doctors refer to these cases as Virchow’s triad. They include the following:

  • Prolonged immobility or any change in normal blood flow

This complication occurs if you are in the hospital or on bed rest for a long time. Pulmonary embolism can also occur while flying or driving a vehicle for a long time.

  • Blood that is likely to clot

Doctors call this increased blood clotting, which can be caused by medications such as birth control pills. Smoking, cancer, recent surgery, or pregnancy can also put you at risk.

  • Damage to the walls of blood vessels

Injury to the leg can lead to this complication.

In rare cases, a pulmonary artery may be blocked by something other than a clot, such as an air bubble or part of a tumor. If a large bone is broken, bone marrow fat sometimes enters the bloodstream and blocks the vessel.

deep vein thrombosis (DVT)

How to prevent pulmonary embolism?

The best way to prevent PE or pulmonary embolism is to prevent blood clots from forming deep in your veins. This can be challenging if you have spent much time resting after surgery or illness or had a long flight.

If you are at risk, here are a few things that may help you reduce your chances of developing a dangerous blood clot:

  • Use of blood thinners

Doctors call them anticoagulants. These factors prevent the formation of clots in the blood. Your doctor may prescribe them while you are in the hospital for surgery. You may also be advised to take these medicines after being discharged home.

If you have been hospitalized after a stroke or heart attack, or if you are suffering from complications from cancer, your doctor may also prescribe blood thinners.

  • Compression socks

There are long socks that put pressure on your legs. This extra pressure helps move blood through the veins and muscles of the leg. Your doctor may recommend wearing these socks for a while after surgery.

blood thinners drugs
  • Sports

After an extended hospital stay or an illness that has kept you in bed for a long time, get out and take a walk. This will keep the blood flowing in your legs and not have a chance to pool.

  • Stretching during travel

If you have a long flight, try to walk every few hours. If you cannot stand, bend your toes by pulling your toes towards you. Here are a few more stretches you can do while sitting:

With one hand, pull your leg up to your chest.

Hold the lower part of one leg with the other hand.

Hold this position for 15 seconds, then try it with the other leg. Do this up to 10 times per hour.

If you are driving a long distance, stop every hour and stretch your legs.

Be sure to drink extra fluids to keep your body hydrated.

  • Change of lifestyle

Other actions you can take include:

  1. Have a good weight.
  2. Talk to your doctor about blood clots risk if you start hormonal medications, such as birth control pills or other treatments.
  3. If you have other health problems, such as diabetes or heart failure, take your medications on time. Be careful what you take, and talk to your doctor about any changes.
  4. Also, consult your doctor if you have a history of kidney disease, some autoimmune diseases, or a family history of blood clots.
  5. If you smoke, quit.
  6. In life-threatening cases of pulmonary embolism, your doctor may decide to give you drugs called thrombolytics to break up the clot. The clot may even need to be surgically removed or removed, although this is rare.

Symptoms of pulmonary embolism

When a blood clot blocks a blood vessel in your lung, you have a pulmonary embolism (PE). The symptoms of this condition may vary. The symptoms you experience depend on the size of the clot and the extent of your lung involvement. If you have lung or heart disease, this can also play an important role.

PE symptoms appear suddenly:

  • Shortness of breath
  • Chest pain
  • Cough (may be accompanied by blood and blood in your sputum)
  • Sudden pain in the back
  • Sweating much more than usual
  • Feeling distracted or confused
  • Blue lips or nails
  • Warning signs of deep vein thrombosis

When a clot forms in a deep vein of the legs, it is called a deep vein thrombosis (DVT). If the clot breaks off and travels to your lung, it becomes a PE.

See a doctor immediately if you notice symptoms of DVT. If detected early, doctors can prevent pulmonary embolism. Symptoms of DVT include:

  • Swelling of the leg or arm
  • Pain or discomfort in the leg when standing or walking
  • Swelling of a leg or arm and a feeling of excessive heat in it
  • Red skin or skin discoloration on the affected arm or leg
  • Veins in the arm or leg are more prominent than normal
  • Diagnosis of pulmonary embolism

The doctor will likely start with a physical exam. He will carefully look at your feet to see if he notices any symptoms such as swelling, tenderness, discoloration, or heat. These signs may indicate that one of your deep veins is clotted.

Next, your doctor may order several tests, such as a chest X-ray or ultrasound. A blood test may also be required. These tests can measure the amount of oxygen and carbon dioxide in the blood. They also help the doctor detect a substance called D-dimer, a small protein fragment that appears in the blood after the body breaks down the clot.

deep vein thrombosis (DVT) 01

Other tests your doctor may order include:

  • Computed tomography pulmonary angiography (CTPA)

This test is a particular type of X-ray test. It is also the primary test doctors use to see if you have PE. Your doctor will inject dye or contrast into the veins. The doctor will then be able to see the blood vessels in the lungs with an X-ray.

  • ventilation/perfusion (V/Q) scan

This test is used if CTPA is unavailable or unsuitable for you. This method uses radioactive material to show which parts of the lungs have airflow (ventilation) and blood flow (perfusion). A clot may be present if blood flow is low in a particular area, but airflow is normal.

  • Catheter-based pulmonary angiography

This is the most accurate test to diagnose PE. This test is used if other tests do not show precise results. The specialist inserts a thin tube (catheter) into the large vein in the groin and the veins inside the lung. Then he injects the dye through the catheter. X-ray images of the blood vessels inside the lungs appear. This test is rarely used due to the presence of CTPA.

  • MRI

If you are pregnant or your doctor is concerned that other tests that use contrast could harm you, this method can be a good option.

  • Echocardiogram

This is a heart ultrasound test. It cannot detect PE but shows whether the heart is strained.

blood vwssels

Treatment of pulmonary embolism

A blood clot in the lung is called a pulmonary embolism (PE). This complication is severe and can threaten a person’s life. However, the good news is that doctors can treat it if it is caught early.

Here we look at some of the most common ways to deal with this disease.

1) Blood thinners

These drugs, also called “anticoagulants,” are the most common method of treating lung blood clots. They play two leading roles:

  • First, As mentioned above, one of the functions of blood thinners is to prevent clots from getting more significant.
  • Second, they prevent the formation of new clots.


These drugs do not destroy blood clots. Instead, your body does this naturally and over time.

The most common blood thinners are warfarin and heparin. Warfarin is a pill that can treat and prevent clots. You can also receive these drugs by injection or IV. Many blood thinners are available in pill form, and your doctor will help you decide which one will work best for you. Heparin can reduce the chance of more clots forming. You can also get it by injection or IV.

Treatment may begin in the hospital or the ER, and you can be discharged the same day. The duration of hospitalization and treatment depends on your condition.

Blood thinners 02

Low molecular weight heparins are also widely used. These drugs can also be injected at home. They are:

  • Dalteparin (Fragmin)
  • Enoxaparin (Lovenox)
  • Tinzaparin (Innohep)

The main complication of blood thinners is internal bleeding. If the drug thins your blood too much, internal bleeding may occur. Your doctor may order a blood test to monitor this. However, even at therapeutic doses, internal bleeding is dangerous.

In life-threatening situations, doctors may use thrombolytic drugs. These drugs quickly break up the clots that cause severe symptoms. However, they can lead to sudden bleeding and should be used only after careful consideration.

2) Catheter

In cases that have been carefully investigated, this method is another emergency treatment that the doctor may use. He inserts a thin and flexible tube into a vein in the thigh or arm. This tube is inserted into your lung, where it removes the clot or uses medicine to remove it.

3) Other treatment methods

If you cannot take blood thinners, your doctor may use these options to treat your PE:

  • Inferior vena cava filter

The inferior vena cava is a large vein that carries blood from the lower parts of the body to the heart. The doctor can place a filter in this vein to stop the clots before they reach the lungs. This filter does not prevent the formation of clots but only prevents them from reaching the lungs.

  • Compression socks

Sometimes called “support tubes,” these stockings come up to your knees and apply pressure to your legs to prevent blood pooling or clotting. (Most clots that form in the lung start from the leg area).

  • surgery

Rarely, surgery may be needed to remove a pulmonary clot.

Inferior vena cava filter


Pulmonary embolism is the blockage of one or more arteries that cause blood to reach the lungs. Most often, the cause of blockages in the arteries is blood clots in other parts of the body and eventually reaching the lungs. Sometimes the cause of this blockage may be the presence of glands, air bubbles, or fat in other body parts.

If a blood clot forms or gets stuck in the artery, lung congestion occurs and prevents blood and oxygen from reaching other organs, which causes lung tissue damage and cell and organ death.

Also, the presence of blocked arteries causes shortness of breath and difficulty breathing and eventually causes death.

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Author and specialist

Dr. Majid Zahrabi,


  • Board Certified Neurosurgeon
  • DHA certificate holder
  • Plantation certificate holder, France
  • Certified holder of Discogol, France
  • A pioneer in the non-surgical treatment of disc herniation in the Middle East and CIS countries.
  • Under the training and coaching of Professor Jacques Theron (founder of Discogel Therapy) since 2008
  • More than 400 successful cervical and 1300 lumbar discogel injections
  • Trained and certified several neurosurgeons and spine surgeons in the Middle East and CIS countries for the treatment of Discogel
  • Strong belief in patient-centered care planning and participation
  • Neurosurgeon and spine surgeon at Imam Khomeini and Amir Mazandarani Hospital, Sari, Iran, with more than 430 surgeries annually, 2000-2011
  • Neurosurgeon and spine surgeon at Farmaniyeh, Nikan and Yas Sepid Hospital, Tehran, Iran, with more than 400 surgeries annually, 2011-2012
  • Neurosurgeon at Iranian Hospital, Dubai, 2022-2023
  • Since 2015, he has been working as a reference doctor for the treatment of intervertebral disc herniation with Discogel and has trained many doctors of spine-related specialties in various countries of the Middle East and CIS in person/practically and online.



  • Individual training sessions under the direct supervision of Professor Jacques Theron in Discogel treatment, 2008-2020
  • Training sessions under the supervision of Professor Thierry Boye on spinal implants, 2007
  • Participation and presentation in several national and international medical and neuro-spinal conferences
  • Board certificate by Iran Neurosurgery Board, 2001
  • Neurosurgery assistant training course, Isfahan University of Medical Sciences, Isfahan, Iran, 1996-2001 (In 2001, he graduated from Isfahan University of Medical Sciences with the first rank in the country.
  • His thesis the titled:The Application of human amniotic membrane in repair of dura matter in dogs.” ( It was happening for the first time in the world. )
  • General medical education, Tabriz University of Medical Sciences, Tabriz, Iran, 1984-1993


Published books:

  • CT scan of the brain for doctors
  • Etiology and treatment of painful spine disorders
  • Atlas of diagnosis, prevention, and treatment of spine disorders
  • The most common mistakes in the treatment of spinal disorders
  • Reading brain CT scan in simple language (3rd place in the book of the year)
  • Treatment of head and spine injuries

Publications and articles:

  • Bacteriostatic and bactericidal effects of DISCOGEL® (https://www.researchgate.net/)
  • Muscle recovery, reduction of pain, and improvement of movement strategies in patients with lumbar discopathy after injection of Discogel.
  • The article on the initial results of the treatment of intervertebral disc herniation with discogel injection, which won the second-best poster rank at the Pan Arab International Congress of Interventional Radiology (March 14-16, 2015) and was accepted for presentation at the Chicago Pain Congress.
  • The use of human amniotic membrane in dura mater repair in dogs, a study for the first time in the world.



  • Annual Congress of Physiotherapists of Iran, 2019
  • Chicago International Pain Congress, 2019
  • Iran International Pain Management Congress, 2018
  • Annual Congress of Physiotherapists of Iran, 2018
  • Presentation of Discogel as an innovative solution for the treatment of spinal disc herniation in Armenia for orthopedic specialists and neurosurgeons, 2017
  • First Live Workshop and Seminar on Minimally Invasive Disc Therapy (DISCON), 2017
  • Presentation of Discogel as an innovative solution for the treatment of spinal disc herniation in Azerbaijan for orthopedic specialists and neurosurgeons, 2016
  • Seminar of Iranian official managers, 2016
  • Presentation of Discogel as an innovative solution for the treatment of spinal disc herniation in Tajikistan for orthopedic specialists and neurosurgeons, 2016
  • International Neurological Intervention Congress in Iran, 2014
  • Educational seminar for nurses on treatment approaches for head and spine trauma, 2014
  • Educational seminar for general practitioners on treatment approaches for head and spine trauma, 2014
  • Speech at the Retraining Seminar for General Practitioners and Specialists in Dubai (Discon) in 2017
  • Speech in the internal retraining courses of Irani Hospital, Dubai
  • Holding lecture sessions and practical workshops on the treatment of intervertebral disc herniation with discogel injection in Azerbaijan, Tajikistan, Ukraine, Oman, and Armenia during the years 2015 to 2021.
  • Giving a lecture and holding a practical workshop for neurosurgeons in Vietnam at Ho Chi Minh City University in 2023

Dr. Majid Zohrabi started treating his patients in Dubai in 2022 and continues his activities in private medical centers in the UAE.