About one in three people with a pulmonary embolism (PE) die within hours of their symptoms starting, often before they can be diagnosed or treated, according to Cleveland Clinic. The condition is estimated to cause at least 100,000 deaths a year in the US.

The risk is in the spotlight after Philadelphia Eagles quarterback Jalen Hurts was diagnosed with deep vein thrombosis and bilateral pulmonary emboli, meaning clots in both lungs. The team said on 19 October that he is expected to make a full recovery.

Doctors first found a superficial clot in his left calf, but further testing revealed the full extent. Dr Rushad Patell of Beth Israel Deaconess Medical Center, who does not treat Hurts, said such clots can extend into the deep venous system.

How Clots Reach the Lungs

Most clots begin as deep vein thrombosis (DVT) in a deep vein of the leg or pelvis. The clot can then break free, travel through the bloodstream and lodge in a lung artery, where it obstructs blood flow.

Blood is more likely to clot abnormally when it pools, which is why long spells of inactivity are a concern. About half of DVT and PE episodes follow surgery or a hospital stay, when days without movement let blood pool.

Superficial clots are generally less dangerous than DVT but are not harmless. Dr Jordan Schaefer, a haematologist at the University of Michigan, said 10 per cent of patients see it reach deep veins, and clots over five centimetres need more aggressive treatment.

A blocked lung artery can leave tissue without blood and cause it to die, according to Mayo Clinic. This condition, called pulmonary infarction, makes it harder for the lungs to supply oxygen. Cardiac arrest and obstructive shock are also possible.

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Warning Signs to Know

Symptoms usually come on suddenly and range from mild to severe. They include sharp chest pain that worsens with movement or deep breaths, sudden shortness of breath, fast breathing and a rapid heartbeat.

The chest pain can feel like a heart attack and may prevent a deep breath. Fainting can occur if heart rate or blood pressure drops suddenly, and symptoms vary with the clot size and the lung area involved.

Other signs include a cough that may produce blood, wheezing, dizziness and pale, clammy or bluish skin. Excessive sweating and fever can also occur.

Leg pain, swelling and warmth may signal a clot that is waiting to dislodge, and these signs deserve just as much seriousness. The pain or swelling is usually felt in the back of the lower leg.

Anyone experiencing these symptoms should call 911 or the local emergency number straight away. Urgent attention is needed for unexplained shortness of breath, chest pain or fainting, as prompt treatment greatly reduces the risk of death.

Who Faces Higher Risk

Major surgery, especially on the hips or legs, and hospital stays longer than three days raise the danger. Prolonged sitting during long car or plane journeys can contribute to blood pooling and increase the risk of clots, particularly when other risk factors are present.

Inherited clotting disorders, pregnancy, hormone-based medications, cancer, kidney disease, heart failure and severe COVID-19 raise the risk. Smoking, excess weight (especially alongside other risk factors) and a family history of clots also add to it.

Diagnosis, Treatment and Recovery

Doctors review symptoms and medical history, then start with a D-dimer blood test. A CT pulmonary angiogram can show blockages, and blood thinners, given as pills or through an IV, are the first line of treatment.

In severe cases, thrombolysis dissolves the clot, while an embolectomy removes it. Most people recover well, though improvement can take weeks to months, and symptoms such as shortness of breath, fatigue and anxiety may linger.

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Frequently Asked Questions

  • What is a pulmonary embolism?
    A pulmonary embolism is a blockage in one of the pulmonary arteries in the lungs, usually caused by blood clots that travel to the lungs from the legs or other parts of the body.
  • What are the symptoms of a pulmonary embolism?
    Symptoms include sharp chest pain, sudden shortness of breath, fast breathing, rapid heartbeat, cough with blood, wheezing, dizziness, pale or bluish skin, excessive sweating, fever, leg pain, swelling, and warmth.
  • Who is at higher risk for pulmonary embolism?
    Higher risk groups include those who have undergone major surgery, have long hospital stays, experience long periods of inactivity, have inherited clotting disorders, are pregnant, take hormone-based medications, have cancer, kidney disease, heart failure, severe COVID-19, smoke, are overweight, or have a family history of clots.
  • How is a pulmonary embolism diagnosed?
    Diagnosis typically involves reviewing symptoms and medical history, and may include a D-dimer blood test or a CT pulmonary angiogram.
  • What treatments are available for pulmonary embolism?
    Treatments include blood thinners, thrombolysis to dissolve the clot, or an embolectomy to remove it, depending on the severity of the condition.