Pulmonary Embolism: Warning Signs When Every Minute Counts

I have been working with veins for many years, and, to be honest, pulmonary embolism is the diagnosis that keeps me in a constant state of professional alertness. Not because it occurs at every turn, but because it knows how to disguise itself. A person feels more or less fine — and then, within a matter of minutes, everything changes. That is why I am writing this article: not to frighten you, but so that you know what to watch for.

What Is Pulmonary Embolism and Where Does It Come From

Pulmonary embolism (PE) is a blockage of the pulmonary artery or its branches by a blood clot. The clot, as a rule, does not form in the lungs on its own. Most often it 「travels」 from the deep veins of the legs or pelvis — breaks free, enters the bloodstream, and is carried by the blood flow to the lungs.

That is precisely why deep vein thrombosis is not simply 「a leg that hurts.」 It is a potentially dangerous condition that, if underestimated, can lead to pulmonary embolism. According to international registries, approximately 30–50% of deep vein thrombosis cases are asymptomatic, and the person learns of the problem only at the stage of complications.

Who Is at Risk

I do not want every reader to start anxiously monitoring every breath after reading this article. However, there are situations in which vigilance is genuinely warranted:

• prolonged immobility: a flight lasting more than 4 hours, bed rest after surgery or injury
• recent surgical operation, especially on the joints or pelvic organs
• oncological diseases
• pregnancy and the postpartum period
• use of hormonal contraceptives, especially combined with smoking
• varicose vein disease and prior episodes of thrombosis
• hereditary blood-clotting disorders

If you have one or more of these risk factors and alarming symptoms have appeared — do not wait.

Warning Signs When Every Minute Counts

Please read this section carefully. Pulmonary embolism does not always 「announce itself.」 Sometimes it begins with mild discomfort. But there are symptoms that require an immediate response:

1. 1Sudden shortness of breath — appears abruptly, without an obvious cause, unrelated to physical exertion. The person cannot take a full breath.
2. 2Chest pain — typically sharp and stabbing, worsening with inhalation or coughing. Sometimes resembles the pain of a heart attack.
3. 3Rapid heartbeat — tachycardia above 100 beats per minute, a sensation that the heart is 「pounding out of the chest.」
4. 4Coughing up blood — the appearance of blood when coughing, even in small amounts.
5. 5Loss of consciousness or pre-syncopal state — brief loss of consciousness without an obvious cause.
6. 6Sudden pallor, bluish discoloration of the lips or fingertips — a sign of impaired oxygen saturation in the blood.

If any of these signs appear — especially sudden shortness of breath combined with chest pain — call an ambulance immediately. Do not wait; do not look for 「another explanation.」

Important note: if one leg was swollen, painful, or felt 「heavy」 in the days before these symptoms appeared — this is crucial context for the emergency physician. Report it right away.

Why Time Is So Critical

Pulmonary embolism is one of the leading causes of preventable death in hospitals worldwide. In massive PE without treatment, the mortality rate reaches 30% or higher. With timely anticoagulant therapy, this figure drops to 2–8%. The difference is enormous — and it depends directly on how quickly the person reaches a doctor.

That is exactly why I say: it is better to arrive at the emergency department and hear 「it is not PE, everything is fine」 than to hesitate.

How Pulmonary Embolism Is Diagnosed

In a hospital setting, the diagnosis is confirmed by means of:

• CT pulmonary angiography — the 「gold standard」 of diagnosis
• D-dimer — a laboratory marker whose normal values allow pulmonary embolism to be ruled out with high probability
• ECG and echocardiography — to assess the load on the right side of the heart
• Vein duplex ultrasound of the lower extremities — to locate the source of the clot

That last point is critically important. Vein duplex ultrasound makes it possible not only to locate a clot, but also to evaluate its character: how much it 「floats」 (moves) and how high the risk of detachment is. In our practice in Tashkent, we perform duplex vein scanning — the examination takes approximately 20–30 minutes and provides a clear picture of the venous system.

Prevention: What You Can Do Right Now

In most cases, pulmonary embolism is a preventable complication. Here are concrete steps that work:

• Do not ignore deep vein thrombosis. If a leg has become swollen and heavy, or a dull ache has appeared along the vein — see a phlebologist. Not in a week, but within the nearest few days. More on the management of thrombosis — in the section thrombosis treatment.
• Keep moving during long flights and journeys. Every hour, stand up, walk through the cabin, and do simple foot exercises.
• Use compression stockings during long flights and in the postoperative period — as directed by your doctor.
• Follow your prescribed anticoagulant therapy. If you have been prescribed blood-thinning medications — do not discontinue them on your own.
• Undergo scheduled check-ups if you have risk factors: cancer, thrombophilia, varicose veins with complications.

Prevention of pulmonary embolism begins with attention to the veins. Timely treatment of deep vein thrombosis is the primary protection against thromboembolism.

When to See Me Before Calling an Ambulance

If you do not have acute symptoms — no sudden shortness of breath, no chest pain, no loss of consciousness — but you do have concerns: a leg is swelling, heaviness or a hardening has appeared along a vein, varicose veins are troubling you — this is a reason for a scheduled phlebologist consultation.

I see patients at M-Clinic in Tashkent. During the appointment we perform duplex vein scanning, order tests as needed, and develop an individual management plan. If an in-person visit is difficult to arrange, a home visit is available.

You can book an appointment by phone +998 99 883-93-21. Do not put it off if something is worrying you — it is better to confirm that everything is fine than to regret lost time.

*The information in this article is educational in nature and does not replace an in-person consultation with a physician. For any alarming symptoms involving the heart or lungs — seek medical attention without delay.*

Not sure? Call and I'll tell you how urgent your situation is: +998 99 883-93-21

This article is for informational purposes only and does not replace a consultation with a qualified physician. If you are experiencing symptoms, please see a specialist.