Pulmonary Embolism Symptoms and Diagnosis

What are the Symptoms of Pulmonary Embolism?

The signs and symptoms of pulmonary embolism vary greatly depending on the size of the clot, how much of the lung is involved and whether you have an underlying medical condition. The most common symptoms are:

• Shortness of breath that appears suddenly
• Chest pain that becomes worse when breathing in. The pain can feel sharp and is often mistaken for a heart attack.
• Lightheadedness, dizziness or passing out due to a sudden loss in blood pressure
• Cough, with or without bloody mucus
• Leg pain or swelling
• Pain in your back, neck, shoulder or jaw
• Excessive sweating
• Clammy or discolored skin
• Fever
• Blueish lips or nails

How to Diagnose Pulmonary Embolism

Pulmonary embolism symptoms often mimic other conditions, which can make early diagnosis more challenging. It is important to seek immediate medical care if you are experiencing symptoms. Your healthcare provider will probably conduct a physical exam and ask about your personal health history, including any potential risk factors. Your healthcare provider may also do blood tests and imaging studies to determine the most likely diagnosis to fit with your symptoms. During the physical exam, your doctor might inspect your legs for evidence of a deep vein clot—it can make the legs appear swollen, tender, red and warm. They will also listen to your heart and lungs and check your blood pressure.

Common tests that may be ordered include:

• CT PA, or a computed tomographic angiography (CT or CAT scan) is a special type of X-ray that is the most common test used to diagnose PE because it uses contrast to analyze blood vessels
• D-Dimer is a blood test used to detect clot formation in your blood
• Electrocardiogram is a simple test that records heart activity, can detect sign of heart strain related to the blood clot and rules out the possibility of a heart attack
• Chest X-ray is a common imaging test that will show images of your heart and lungs to rule out other conditions with similar symptoms of pulmonary embolism
• Pulmonary V/Q scan is a two-part test that uses imaging and a radioactive tracer to show which parts of your lungs are getting airflow and blood flow
• Ultrasound is a noninvasive test that uses sound waves to scan the legs and sometimes arms to measure blood flow and assess for clots in the veins
• Pulmonary angiography uses a catheter to spread dye to the pulmonary arteries and heart to show a clear picture of blood flow in the pulmonary arteries
• Echocardiograms are an ultrasound of the heart used to measure heart function and assess elevated pressure in the pulmonary arteries and other measures of heart strain.
• Medical imaging test (MRI) uses a magnetic field and radio waves to create detailed images of organs and tissue in the body. An MRI is a better imaging test for pregnant people and individuals that may not be able to tolerate the contrast used in other imaging tests.