Understanding Pulmonary Embolism (PE)
A pulmonary embolism (PE) is a sudden blockage in one of the pulmonary arteries in the lungs, usually caused by blood clots that travel from the legs or other parts of the body (deep vein thrombosis, or DVT). These clots interrupt blood flow, which can severely damage lung tissue, cause oxygen levels to drop, and strain the right side of the heart. In severe cases, PE can lead to cardiac arrest or even death.
At Northern Heart Hospital, our team is trained to act quickly when diagnosing and treating PE. We understand that time is crucial, and we are equipped with round-the-clock emergency capabilities to ensure that patients receive immediate, life-saving care.
We recognise that PE can mimic other conditions such as:
- Heart attack
- Pneumonia
- Panic attacks or anxiety
- Heart failure
Our specialists use advanced clinical assessments to differentiate PE from other potential causes of chest pain or breathlessness, ensuring patients receive the correct treatment as quickly as possible.
Symptoms and Risk Factors
PE symptoms can range from mild to severe, and in some cases, there may be no obvious warning signs. Recognising both the symptoms and the risk factors of PE is vital for early detection.
Common symptoms include:
- Sudden, unexplained shortness of breath
- Sharp chest pain that worsens when breathing in
- Rapid or irregular heartbeat
- Dizziness or fainting
- Coughing, sometimes with blood
- Swelling or pain in the calf (a sign of DVT)
Risk factors include:
- Prolonged immobility (e.g. long flights, bed rest)
- Recent major surgery, especially orthopaedic or abdominal
- Personal or family history of blood clots
- Hormonal therapies or birth control pills
- Obesity or smoking
- Cancer or chemotherapy
- Pregnancy or post-partum period
- Certain genetic clotting disorders
At Northern Heart Hospital, our clinical team conducts a comprehensive risk assessment when patients present with suspected PE. We also offer screening for inherited clotting disorders, especially for patients with recurrent PEs or strong family histories. By identifying at-risk individuals early, we can intervene to prevent future events and ensure timely care.
How PE is Diagnosed
PE can be life-threatening, making fast and accurate diagnosis critical. At Northern Heart Hospital, we have developed a rapid diagnostic pathway that combines cutting-edge technology with clinical efficiency.
Our PE diagnostic tools include:
- D-dimer blood test – This test detects clot breakdown products in the blood, helping us determine whether a clot is present.
- CT Pulmonary Angiography (CTPA) – The gold standard for visualising clots in the lungs. CTPA is fast, reliable, and non-invasive.
- Echocardiography – This technique is used to assess the strain on the heart if further assessment is needed.
- Lower limb Doppler ultrasound – This test is used to detect deep vein thrombosis (DVT), which is often the source of PE.
- Arterial blood gas testing – This assesses oxygen and carbon dioxide levels, providing further insight into the severity of the PE and the function of the lungs.
Our radiologists，cardiologists， vascular surgeon and cardiothoracic surgeons collaborate in real-time, ensuring results are interpreted quickly and accurately. This collaboration ensures that treatment decisions are made promptly, which is essential when dealing with a life-threatening condition like PE.
Treatment and Immediate Management
Once a diagnosis of PE is confirmed, treatment begins immediately. The specific approach depends on the severity of the PE and the patient’s overall health.
At Northern Heart Hospital, treatment options include:
- Anticoagulation therapy: Heparin followed by oral blood thinners (e.g. warfarin, rivaroxaban, apixaban) to prevent the clot from growing and to reduce the risk of new clots forming.
- Thrombolytic therapy: This involves using clot-busting drugs in more severe cases to dissolve the clot quickly and restore blood flow.
- Catheter-directed thrombolysis: A minimally-invasive procedure where a catheter is inserted into the lung’s artery to directly dissolve the clot at the site.
- Minimally invasive thrombosis: Direct removal of the blood clot by sucking or pulling out the clot.
- Inferior vena cava (IVC) filter insertion: This is a treatment for patients who are unable to tolerate anticoagulants. An IVC filter is inserted to catch any clots before they can reach the lungs.
- Oxygen therapy and cardiac monitoring: For stabilisation and supportive care, oxygen is provided, and the patient is continuously monitored for any signs of deterioration.
These treatments are provided under the care of a dedicated pulmonary embolism response team. Patients who are critically ill are managed in our high-dependency cardiac and respiratory units, with access to ventilatory support and continuous cardiac monitoring. Our expert team works tirelessly to ensure that patients receive the best care possible, all tailored to their specific condition and needs.
Recovery and Ongoing Care
Recovery from a PE doesn’t end with treatment. Long-term management is key to preventing recurrence, addressing complications, and supporting overall health. At Northern Heart Hospital, we offer comprehensive post-PE care, which includes:
- Medication management: We provide guidance on the use of anticoagulants, explaining potential side effects and the duration of therapy to ensure effective treatment.
- Regular follow-up imaging and blood tests: These tests are crucial for monitoring the resolution of the clot and assessing the risk of bleeding complications.
- Pulmonary rehabilitation: This programme includes breathing exercises and light activity, which are supervised by our team of physiotherapists.
- Screening for chronic thromboembolic pulmonary hypertension (CTEPH): This rare but serious complication can occur following a PE, and our screening helps detect it early.
- Patient education and support: We educate patients on medication adherence, recognising warning signs, and managing anxiety related to the recovery process.
Our multidisciplinary team, consisting of haematologists, cardiologists, respiratory specialists, pharmacists, and physiotherapists, works together to develop a personalised care plan tailored to each patient’s specific needs.ion. Visit our website or contact our patient care team to learn more about how we can support your cardiac health needs.
Mental Health and Lifestyle
Experiencing a PE can be frightening and may lead to psychological effects such as health anxiety, PTSD, or depression. We believe in addressing the emotional and psychological aspects of recovery, not just the physical. We offer support in building healthier lifestyle habits through:
Safe return-to-activity programmes for those previously sedentary, enabling patients to gradually regain their strength and confidence
Dietary advice from our expert cardiac nutritionists
Smoking cessation clinics to help patients quit smoking
Weight management support to help patients reach and maintain a healthy weight
Essential Questions Answered
Q: Is the echocardiogram procedure painful?
- A: The procedure is painless and non-invasive.
Q: How long will it take to receive the results?
- A: Results are available within immediately.
Q: Are echocardiograms covered under the Advanced Heart Wellness packages?
- A: Yes, they are included as part of our comprehensive approach to cardiac health.
Why Timely, Specialist Care Matters
A pulmonary embolism can develop quickly, but outcomes improve dramatically with prompt diagnosis and expert treatment. At Northern Heart Hospital, our strengths include:
- 24/7 emergency response: Our team is available around the clock for urgent chest pain or breathlessness.
- Integrated team of specialists: Our cardiologists, respiratory physicians, and interventional specialists collaborate to ensure comprehensive care.
- State-of-the-art imaging and diagnostic tools: Our advanced technologies support precise and quick diagnoses.
- Patient-centred rehabilitation and long-term care: We ensure that all aspects of recovery—physical, emotional, and lifestyle—are managed with expert care.
By combining rapid diagnosis, advanced treatment options, and thoughtful follow-up care, Northern Heart Hospital is committed to not only treating PE but also reducing the chance of it recurring. Our holistic approach ensures that every patient receives personalised, compassionate care throughout their recovery journey.