Symptoms of Pulmonary Embolism

In This Article
Table of Contents

When someone is experiencing pulmonary embolus, doctors are often able to confirm a diagnosis based the person's description of their symptoms. This is because symptoms typically "classic" - meaning they are typical of the condition.  

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

So, while understanding and identifying the symptoms of pulmonary embolus 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 embolus complains of even mild symptoms.

A pulmonary embolus that does not produce impressive symptoms may soon be followed by another, potentially preventable pulmonary embolus. This could, unfortunately, be accompanied by severe complications.

pulmonary embolus symptoms
© Verywell, 2018 

Common Symptoms

The classic symptoms of a pulmonary embolus are:

  • sudden, unexplained dyspnea (shortness of breath)
  • dull chest pain that is often pleuritic in nature, meaning it gets worse when you try and take a deep breath
  • coughing

Other symptoms that people often have with a pulmonary embolus include:

People presenting with any of the above symptoms could be experiencing pulmonary embolus, 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 embolus. Doctors will often check for pulmonary embolus even if a patient is not presenting with any other classic symptoms or is presenting with just mild breathing issues - including 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 had a pulmonary embolus. 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 sacks
  • 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 embolus should happen right away if any of the above signs are presenting alongside the classic symptoms - even if everything seems mild. Early detection of pulmonary embolus is critical for improving overall outcomes.

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

Complications

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

The major complications of a pulmonary embolus are:

  • Recurrent pulmonary embolus. 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 a pulmonary embolus 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 emboli—if the clot or clots produce a permanent, partial obstruction of the pulmonary artery.
  • Death. The mortality rate for untreated pulmonary embolus is quite high and has been reported as high as 30 percent. 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 recurrent pulmonary emboli.

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.

Was this page helpful?
Article Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Huisman MV, Klok FA. How I diagnose acute pulmonary embolism. Blood. 2013;121(22):4443-8. doi:10.1182/blood-2013-03-453050


  2. U.S. National Library of Medicine. MedlinePlus. Pulmonary Embolism. Last reviewed August, 5 2020.

  3. National Heart, Lung, and Blood Institute. Venous Thromboembolism


  4. Cedars Sinai. Pulmonary Embolism.

  5. Bĕlohlávek J, Dytrych V, Linhart A. Pulmonary embolism, part I: Epidemiology, risk factors and risk stratification, pathophysiology, clinical presentation, diagnosis and nonthrombotic pulmonary embolism. Exp Clin Cardiol. 2013;18(2):129-38.


  6. Ortel TL, Neumann I, Ageno W, et al. American Society of Hematology 2020 guidelines for management of venous thromboembolism: treatment of deep vein thrombosis and pulmonary embolism. Blood Adv. 2020 Oct 13;4(19):4693-4738. doi: 10.1182/bloodadvances.2020001830.

Additional Reading
  • Keller K, Beule J, Balzer JO, Dippold W. Syncope and collapse in acute pulmonary embolism. Am J Emerg Med 2016; 34:1251. doi: 10.1016/j.ajem.2016.03.061.
  • Konstantinides SV, Torbicki A, Agnelli G, et al. 2014 ESC guidelines on the diagnosis and management of acute pulmonary embolism. Eur Heart J 2014; 35:3033. doi: 10.1093/eurheartj/ehu283.
  • Lucassen W, Geersing GJ, Erkens PM, et al. Clinical decision rules for excluding pulmonary embolism: a meta-analysis. Ann Intern Med 2011; 155:448. doi: 10.7326/0003-4819-155-7-201110040-00007.
  • Stein PD, Beemath A, Matta F, et al. Clinical characteristics of patients with acute pulmonary embolism: data from PIOPED II. Am J Med 2007; 120:871.