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Pulmonary embolism

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Respiratory System

Pulmonary embolism is a condition that occurs when an artery in your lung becomes blocked. In most cases, the blockage is caused by one or more blood clots that travel to your lungs from another part of your body.

Most blood clots originate in your legs, but they can also form in the veins of your arms, the right side of your heart or even at the tip of a catheter placed in a vein. In rare cases, other types of clots - such as globules of fat, air bubbles, tissue from a tumor or a clump of bacteria - also can lodge in your lungs' arteries.

Smaller clots prevent adequate blood flow to the lungs, sometimes causing damage to lung tissue (infarction). Large clots that completely block blood flow can be fatal.


Pulmonary embolism can be life-threatening. About one-third of people with undiagnosed and untreated pulmonary embolism don't survive. When the condition is diagnosed and treated promptly, however, that number drops dramatically. Once you've had one pulmonary embolism, you're at increased risk of another. Up to half of these recurrences may be fatal.

In addition to fatality, pulmonary embolism can lead to several serious complications, including:

  • High blood pressure in your lungs (pulmonary hypertension). A number of conditions can contribute to pulmonary hypertension. One occurs when a large number of clots obstruct blood flow in your lungs' blood vessels, making the right side of your heart work extra hard against great resistance. This condition is reversible if the embolism is treated appropriately. The most common symptoms of pulmonary embolism are breathlessness (dyspnea) when you exert yourself and general fatigue. Fainting, dizziness, swollen legs or ankles, and pressure or pain in your chest also are common.

  • Heart damage. In a condition called cor pulmonale, the lower right chamber of your heart (right ventricle) becomes enlarged and eventually fails as a result of problems in your lungs. Understanding the relationship between your heart and lungs can help explain why this occurs. Blood flows from the right side of your heart into your lungs where it releases carbon dioxide and picks up oxygen. Normally, it doesn't take much pressure to push blood into your lungs, so the walls of the right ventricle aren't as strong as those on the left side of your heart, which pumps blood to the rest of your body. But when clots obstruct blood flow in your lungs, your heart has to pump harder. Although your heart can compensate for a time, eventually the extra strain causes the right ventricle to fail. This failure can occur within hours or even minutes if the blood clots are very large. It may occur over months or years if the obstruction is smaller.


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