Pulmonary thromboembolism, often referred to for short as pulmonary embolism, is a common, serious, and potentially fatal complication of a blood clot within the venous circulation. Pulmonary embolism is estimated to cause over 50,000 deaths in the U.S. each year, and is the third leading cause of death among hospitalized patients.

Many substances can cause small emboli (clots) into the circulation of the lungs, including air (from catheters), fat (from bone fractures), foreign bodies (as in IV drug use), sepsis (from infection) and tumor cells in some cases. The most common embolus is called a thrombus, and it arises from the circulatory system in the body. The deep veins in the major calf muscles are the commonest site, and these small clots which migrate upward in the circulation can break off and be carried to the lungs. Up to 70% of those who have pulmonary embolus diagnosed will have deep vein thrombosis as an underlying cause. Incompetent veins (varicose veins), where the valves directing blood flow are faulty, are very common causes of deep vein thrombosis primarily, and of pulmonary embolus secondarily.

An increase in the ability for blood to coagulate can also be caused by medication (birth control pills) or disease (malignancy, extensive surgery). Deficiency in body proteins can also cause hypercoagulable states, and these are usually inherited and not diagnosed until a blood clot occurs.

Diagnosing a pulmonary embolus can often prove difficult. Any clinical findings depend on the both the size of the embolus and the body's preexisting heart and lung status. Difficulty breathing and pain on taking a deep breath are probably the two most reliable symptoms.

Once diagnosed, treatment is immediately started with anticoagulants, also known as blood thinners. Heparin is the usual drug of choice given intervenously. Streptokinase is another drug commonly given, especially when the cardiac circulation may be compromised as well. After 3-5 days, an oral anticoagulant (usually Coumadin) is started and continued for a period of time of 3-6 months, after which it may be discontinued or continued indefinitely if the source for a blood clot or pulmonary embolism remains.

Applicants for insurance are usually postponed within the first few months post pulmonary embolus to insure recovery and watch for signs of recurrence. Most who are medically treated and in whom the cause is unlikely to return are then offered standard insurance. Those who have multiple episodes are postponed for longer periods, and of course those who have underlying conditions (like heart or lung compromise) are generally underwritten on the basis of that continuing condition.

The information contained on this page is not intended to provide medical advice, which should be obtained directly from your physician.