When someone is experiencing pulmonary embolism, doctors are often able to confirm a diagnosis based the person’s description of their symptoms. This is because the symptoms are typically “classic,” meaning they’re typical of the condition and recognizable.  

In some cases, however, people do not experience these classic symptoms. They instead have mild versions of those symptoms or no symptoms at all, making the condition tough to identify. Still others have severe symptoms, which can even result in cardiac arrest and sudden death.

A pulmonary embolus that does not cause impressive symptoms may soon be followed by a more serious and potentially preventable pulmonary embolus. This could, unfortunately, be accompanied by severe complications.

So, while understanding and identifying the symptoms of pulmonary embolism is critically important, it is also crucial for doctors to have a high index of suspicion whenever a person who has an increased risk of pulmonary embolism complains of even mild symptoms.

Common Symptoms

The classic symptoms of pulmonary embolism are:

  • Sudden, unexplained dyspnea (shortness of breath)
  • Dull chest pain that is often pleuritic in nature, meaning it gets worse when you try to take a deep breath
  • Coughing

Other symptoms that people often have with pulmonary embolism include:

  • Pain in the calf or thigh (suggestive of deep vein thrombosis, DVT)
  • Wheezing
  • Hemoptysis (coughing up blood)
  • Syncope (loss of consciousness)

People presenting with any of the above symptoms could be experiencing pulmonary embolism, and doctors will consider this when evaluating the potential medical causes.

People experiencing sudden, severe dyspnea are quick to seek medical attention, and doctors know any cause of this symptom could be a medical emergency—including pulmonary embolism. Doctors will often check for pulmonary embolism even if a patient is not presenting with any other classic symptoms or is presenting with just mild breathing issues. The examination will include a review of their medical history and risk factors for pulmonary embolism.

Signs

Doctors will often see objective findings (referred to as “signs”), in people who have a pulmonary embolism. These signs include:

  • Tachycardia (rapid heart beat)
  • Tachypnea (rapid breathing)
  • Hypotension (low blood pressure)
  • Decreased breath sounds over a portion of a lung, indicating that air is not flowing to that area
  • Rales (crackles over the lungs), indicating fluid in the air sacs
  • Elevated pressure in the neck veins, suggesting an obstruction in the pulmonary artery
  • Swelling or tenderness over the thigh or calf, indicating a DVT

Diagnostic testing for pulmonary embolism should be done right away if any of the above signs are presenting alongside the classic symptoms, even if everything seems mild. Early detection of pulmonary embolism is critical for improving overall outcomes.

Complications

Pulmonary embolism can have dire consequences, especially if the diagnosis is delayed or missed. To avoid these consequences, doctors should always be suspicious of pulmonary embolism if there is any reason to think one might have occurred. 

Due to the dangers of pulmonary embolism, doctors may begin treatment for the condition before the diagnosis is even confirmed.

The major complications of pulmonary embolism are:

  • Recurrent pulmonary embolism: Unless the diagnosis is made and effective treatment is given, people who have a pulmonary embolus have a greatly elevated risk of having another one.
  • Pulmonary infarction: A pulmonary infarction is the death of a portion of lung tissue, which can be caused by pulmonary embolism if an artery supplying lung tissue is completely blocked by the embolus. If large enough, a pulmonary infarction may be life-threatening.
  • Pulmonary hypertension: Pulmonary hypertension is a very serious medical disorder that can result over weeks or months from a large pulmonary embolus—or from recurrent pulmonary embolism—if the clot or clots produce a permanent, partial obstruction of the pulmonary artery.
  • Death: The mortality rate for untreated pulmonary embolism has been reported to be as high as 30%. A large, acute pulmonary embolus can cause sudden death, but more commonly death occurs within a few days of the diagnosis if treatment is insufficient to stop pulmonary embolism.

Not all cases of pulmonary embolism require hospital treatment, especially if symptoms are mild. Guidelines published by the American Society of Hematology in 2020 conditionally recommend home treatment over hospitalization for people with uncomplicated pulmonary embolism.

Frequently Asked Questions

  • Are there signs that you’re at risk for a pulmonary embolism?
  • There are some common signs, but you also may have no symptoms beforehand. Pain, tenderness, swelling, and redness in the area where a blood clot is blocking circulation might precede a pulmonary embolism. These symptoms of deep vein thrombosis should be discussed immediately with your doctor.
  • What does pain from a pulmonary embolism feel like?
  • Chest pain located under the breastbone or on one side is very common with a pulmonary embolism. You might experience a sharp, stabbing, or burning sensation. The pain may become worse with deep breathing and may cause you bend over for relief.

There are some common signs, but you also may have no symptoms beforehand. Pain, tenderness, swelling, and redness in the area where a blood clot is blocking circulation might precede a pulmonary embolism. These symptoms of deep vein thrombosis should be discussed immediately with your doctor.

Chest pain located under the breastbone or on one side is very common with a pulmonary embolism. You might experience a sharp, stabbing, or burning sensation. The pain may become worse with deep breathing and may cause you bend over for relief.