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 may become worse when breathing in that is so sharply felt you may think you are having a heart attack
  • Lightheadedness, dizziness or passing out due to a sudden loss in blood pressure 
  • Cough, which may contain blood
  • Leg pain or swelling
  • Pain in your back
  • Excessive sweating
  • Blueish lips or nails

How to Diagnose Pulmonary Embolism

Because pulmonary embolism can be difficult to diagnose, it is important to consult your healthcare provider immediately if you are experiencing symptoms. They will probably do a physical exam and ask about your personal 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—an area that's 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 are:

  • CTPA or a computed tomographic angiography 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
  • Pulmonary V/Q scan to show which parts of your lungs are getting airflow and blood flow 
  • D-Dimer blood tests to  detect clot formation in your blood
  • Chest X-ray of your heart and lungs to rule out other conditions with similar symptoms 
  • Pulmonary V/Q scan to show which parts of your lungs are getting airflow and blood flow
  • Ultrasound of the legs to measure blood flow and assess for clots in the veins
  • Pulmonary angiography to show the blood clots in the lungs
  • Electrocardiogram to record heart activity
  • Echocardiogram to measure heart function and assess for elevated pressure in the pulmonary arteries. 
  • MRI is usually reserved for pregnant people and individuals that may not be able to tolerate the contrast used in other imaging tests

Reviewed and approved by the American Lung Association Scientific and Medical Editorial Review Panel.

Page last updated: January 20, 2023

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