It may start with fatigue, a bit of breathlessness or an odd heaviness in the chest. Then suddenly, the lungs begin to fail. Doctors say pulmonary embolism is one of the most silent and deadly medical emergencies that people still fail to recognise on time.A blood clot in the lungs isn’t always accompanied by chaos.Sometimes it comes quietly. One climbs stairs and is unusually out of breath. And the heart beats for nothing. You have chest pain, you’re tired, you’re restless, maybe a little dip in your oxygen. Most people blame stress, anxiety, pollution, exhaustion or acidity.But pulmonologists warn that in some cases, these are the first whispers of a deadly condition called pulmonary thromboembolism, more commonly known as pulmonary embolism, where a blood clot suddenly blocks blood flow inside the lungs.And when that blockage gets massive, survival can be a race against minutes. The recent death of Prateek Yadav due to “cardiorespiratory collapse due to massive pulmonary thromboembolism” has once again highlighted the condition in the public domain. There were also reports of a history of deep vein thrombosis (DVT), breathlessness, hypertension and pulmonary complications in the weeks prior to his death. According to Dr Ruchita Sharma, Associate director in the department of medicine at Medanta Hospital Prateek had been admitted to the hospital a few days ago after being diagnosed with pulmonary embolism.The common perception of blood clots is that they occur in the legs or cause a stroke. “Very few people know that when the clot reaches the lungs, it can choke the oxygen circulation in the body suddenly,” says Dr Sourabh Pahuja, Senior Consultant, Pulmonary Medicine, Amrita Hospital, Faridabad. Most often the clot forms in the deep veins of the legs, a situation known as DVT, doctors say. If a part of the clot breaks off, it is swept along by the blood stream until it gets impacted in the pulmonary arteries.What comes next can be disastrous.“The heart suddenly gets a huge pressure load because the blood can’t get through the lungs correctly. Oxygen levels decrease rapidly. “In severe pulmonary embolism patients can drop in minutes,” Dr. Pahuja explains.Pulmonary embolism is referred to in the world medical literature as one of the leading preventable causes of sudden hospital deaths. The scary part, doctors say, is how normal the symptoms can appear at first.Some patients complain of sudden breathlessness only. Some have chest pain when breathing. Others get dizzy, sweat for no reason, cough, have racing heartbeats, pass out or see one leg swelling days before the emergency hits.“Typically these signs are ignored because they don’t appear dramatic initially. “Pulmonary embolism is dangerous because it hides behind common symptoms,” says Dr. Pahuja.Doctors say prolonged sitting, obesity, smoking, long-distance travel, recent surgery, cancer, hormonal medications, clotting disorders and a sedentary lifestyle can lead to the formation of dangerous clots in the body.Even younger adults are becoming concerned. Studies of cardiovascular and respiratory problems around the world show that late diagnosis is one of the main causes of mortality related to pulmonary embolism. Early detection by CT pulmonary angiography, D-dimer blood tests, oxygen assessment and Doppler scans can greatly improve survival.There’s one red flag that pulmonologists say should never be ignored: Sudden, unexplained shortness of breath, especially if it occurs with chest pain or low oxygen levels.“The body gives signals before a massive clot attacks the lungs,” said Dr Pahuja. “The tragedy is that people often don’t recognise the danger until the lungs are already failing.”Medical experts consulted This article includes expert inputs shared with TOI Health by:Dr Sourabh Pahuja, Senior Consultant, Pulmonary Medicine, Amrita Hospital, FaridabadInputs were used to explain pulmonary embolism and why the symptoms should not be ignored.
