https://kingstonhospital.nhs.uk/information/pulmonary-embolism-pe
This leaflet is for patients who have been diagnosed with a Pulmonary Embolism (PE). It explains how a PE might affect you including the symptoms and treatments to expect.
A PE happens when a blood vessel in your lungs becomes blocked. Most of the time this blockage is caused by a blood clot in the body that has broken off and travelled to the arteries in the lung. It is a serious condition because it can prevent blood from reaching your lungs. Prompt medical treatment can be lifesaving.
The symptoms of a PE are one or more of the following:
However, sometimes PEs occur for no obvious reason. Some people have an inherited or acquired tendency for their blood to clot. This is called Thrombophilia and can mean a PE is more likely to happen. It can also affect other members of the family. If this applies to you, you will be given advice about this and referred to the haematology clinic for support (haematology clinic is where we see patients who have a confirmed diagnosis of PE).
Blood thinners are the most common form of treatment. These reduce the body’s ability to form clots.
In clinic, we will explain blood thinning medication to you including how important it is to take this medication as prescribed to prevent the clot from getting any bigger and stop new clots forming.
Medication may be either injections or tablets. The most common choices are low molecular weight heparin (LMWH) injections, a direct oral anticoagulant (DOAC) (such as Apixaban, Rivaroxaban, or Edoxaban), or Dabigatran and Warfarin. Your doctor will discuss these options with you to decide which the medicine is most suitable for you, taking account of any other health conditions that you have.
You will be given an anticoagulation alert card to carry at all times.
unexpected or uncontrollable bleeding
a fall or injury to your head
coughing or vomiting blood
blood in your urine
black stools or blood in your stools
severe unexplained bruising
a severe headache that will not go away and/or dizziness or weakness
As part of your diagnosis of PE, you will have an assessment to check the risk of coming to harm from the PE. If you are thought to be at intermediate or high risk, you will be admitted to hospital and treated as an inpatient. If you are at lower risk, you will be treated as an outpatient.
If we decide to treat you as an outpatient, you should be reviewed by a senior clinician before you go home, but please contact your GP or return to the Emergency Department (A&E) if you develop any new symptoms.
You will be given a 1 month supply of medication and referred to the anticoagulation clinic for review. Within one month, they will contact you with an appointment date and time. The anticoagulation clinic will issue you a further 2 month’s supply of medication and, if it is agreed in clinic that you would benefit from further prescriptions, these will be provided by your GP. We will issue a DOAC (Direct Oral Anticoagulant) initiation form to your GP to inform them about the tablets they need to prescribe.
You may also be referred to the respiratory team or for further hospital investigations if the doctor at the anticoagulation clinic feels this is required. This will be discussed with you in clinic.
Yes, keep as active as you can and lead as healthy a lifestyle as you can.
Keep yourself well hydrated and do not exceed the recommended limits for alcohol consumption.
Move your lower limbs if you are not mobile for a long period of time (a general guideline is that you the less time you are immobile the better, but to move lower limbs at least every 4 hours. However, this will vary depending on individual risk factors). This can prevent blood from pooling in your legs and developing into a DVT (Deep Vein Thrombosis) or blood clot, especially during a long journey or after surgery.
These can all increase your risk of bleeding.
If you are going to take any other medication, including herbal medicines, please make sure that the person providing is knows that you are taking anticoagulant medication. Multivitamins are generally safe.
If you need to take painkillers for any reason, you may take paracetamol, codeine, co-dydramol, or co-codamol, but seek further medical advice if you have a chest pain that worsens despite taking these pain killers (this group of pain killers is known as analgesia).
Depending on the severity of your symptoms and the nature of your work you may feel able to return to work within a few weeks. You can discuss this with your GP or healthcare professional.
Most patients will not have a repeat scan as the results do not usually change the way we manage your condition.
However, if your PE was large or caused a strain to your heart, you may be asked to have a repeat scan. This will be explained to you before you go home or when you are seen in clinic.
Air travel should be delayed for a minimum of 2 weeks or longer if you are not feeling well. If you need to fly, we advise you to speak to your GP about this. They may provide compression stockings to wear during a flight.
Everyone’s risk is different. Taking anti-coagulants as they are prescribed should prevent you from having a further PE.
If we decide to stop your anti-coagulation medication, we will review you in the haematology clinic. We will look at your case in detail and give you further advice to reduce the risk of recurrent PE. This may include continuing anticoagulation medication if you are at high risk of having another PE or using anticoagulant medication in certain situations.
Be guided by your body – if normal activity makes you feel short of breath or unwell, you will need to rest until you feel recovered. Once your symptoms have settled you can start slowly increasing your activity.
If you have any questions, please contact the Anticoagulation Helpline using the contact details below.
If you wish to speak to someone urgently, please contact the Same Day Emergency Care Unit (SDEC) using the contact details below.
 Pulmonary Embolismhttps://cks.nice.org.uk/topics/pulmonary-embolism/ |  |
| NHS.UK Blood Clots https://cks.nice.org.uk/topics/pulmonary-embolism/ |  |
| Anticoagulation Helpline | 020 8934 2030 |
| Same Day Emergency Care Unit | 020 8934 3651 or 3883 |
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Please contact the Patient Experience Team on 020 893 3850 if you need this information in a different format.
