Pulmonary Embolism: Blood Clot in Lungs

Pulmonary embolism is a blood clot in the lungs. This serious condition requires medical attention as the blockage can cause damage to the lungs and heart. Andrew Mihalek, MD, shares the causes, symptoms, and treatment for pulmonary embolism.

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A pulmonary embolism, or a PE, is simply just a blood clot that occurs in the lungs. A great majority of people that suffer blood clots will present with shortness of breath, maybe some racing heart, maybe a little bit of chest pain. They come into the hospital. They’re evaluated, usually put on blood thinners, and able to be discharged in a timely manner.

A small group of patients, though, will go on to develop heart strain as a result of that. And that heart strain can come in different flavors. At the more severe side, we talk about people having massive PEs, or PEs that cause hemodynamic instability. It’s a nice way of saying that your heart suffers the consequences of that blood clot, and as a result of it, can’t do its job, which is provide blood pressure to the rest of your body.

Patients that present with massive PEs present with very low blood pressures. It’s a medical emergency. We have designed this multi-disciplinary group where many doctors can come to the table with expertise in their field, to help come up with a treatment plan that works for a patient in the short term, when they come into the hospital, and then also into the long term, when they’re dealing with the consequences of this disease over the next days, weeks, months, or years.

Here at the University of Virginia, we have surgical interventions that can be offered, where the clots are taken out by a cardiothoracic surgeon. We have an ECMO system, which is, essentially, a life-sustaining system for the heart and lungs while the body treats itself. We have interventional radiologists that can offer clot-busting medicine, directly at the site of the clot. We have the facilities of our intensive care units that are able to take care of the patients as they’re going through this very important and very serious time in their life.