7 warning signs of a pulmonary embolism most people mistake for anxiety or chest pain

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A pulmonary embolism is a medical emergency, and the first symptoms are easy to write off.

A pulmonary embolism, or PE, is what happens when a blood clot travels to the lungs and blocks blood flow. In most cases the clot starts as a deep vein thrombosis in a leg vein, breaks loose, and lodges in a pulmonary artery, according to the Cleveland Clinic.

The condition is common and dangerous. Around 900,000 U.S. adults experience a PE each year, and blood clots are blamed for about 100,000 deaths annually in the U.S., according to CDC figures cited by AARP. Cleveland Clinic notes that about 1 in 3 people with a PE die within a few hours of when symptoms begin, often before they can get a diagnosis or treatment.

Symptoms are the reason so many cases are caught too late. Sudden breathlessness, chest pain, and a racing heart can look like a panic attack. Sharp pain on inhalation can suggest pneumonia or pleurisy. The American Lung Association calls PE a medical emergency that can lead to death if untreated.

The 7 warning signs to know

1. Sudden shortness of breath. This is the single most common symptom. Steve Pugliese, M.D., a pulmonary and critical care doctor at the Hospital of the University of Pennsylvania, told AARP that "the most common symptom that patients can have is they're just going to feel short of breath." Breathlessness that appears out of nowhere, especially at rest, deserves urgent attention.

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2. Sharp chest pain that worsens when you breathe in. Cleveland Clinic lists sharp chest pain among the core signs of a PE. Geno Merli, M.D., a professor of medicine and surgery at Sidney Kimmel Medical College, told AARP that pain during deep breathing "separates it from a heart attack."

3. Rapid or irregular heartbeat. The heart works harder to push blood past the blockage, and a fast heartbeat often accompanies the breathlessness. Cleveland Clinic lists fast heartbeat and fast breathing among the typical PE symptoms.

4. Cough, sometimes with blood-tinged mucus. Cleveland Clinic notes that a PE cough may bring up blood. A new, unexplained cough alongside breathlessness or chest pain should never be dismissed as a cold.

5. Dizziness, lightheadedness, or fainting. When blood flow to the lungs is blocked, oxygen delivery to the brain drops. Cleveland Clinic lists dizziness and fainting as classic PE signs, and both are easy to mistake for dehydration or low blood sugar.

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6. Leg pain or swelling. This is often the earliest clue, because the clot usually begins in a leg vein. Pugliese told AARP that DVT symptoms "will typically happen a few days before" the clot travels to the lungs. Warm, swollen, or painful calves warrant a call to the doctor even without lung symptoms.

7. Clammy or bluish skin. Cleveland Clinic notes that pale, clammy, or bluish skin can appear as oxygen levels fall. Bluish lips or nail beds are a late and serious sign.

Why the misdiagnosis is so common

Once the clot reaches the lungs, the picture blurs fast. Pugliese told AARP that "once the blood clot travels to the lungs, the symptoms can be really nonspecific." That overlap is dangerous. AARP reports that for roughly one-quarter of people with a PE, sudden death is the first symptom, according to the CDC.

Risk climbs with age, recent surgery, long periods of immobility such as a long flight or bed rest, cancer, pregnancy, and hormone therapy, according to AARP. A personal or family history of blood clots is another red flag worth discussing with a doctor.

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When to act

Anyone who suspects a pulmonary embolism should not drive themselves to the hospital or wait to see if the symptoms pass. Cleveland Clinic is explicit. "Call 911 or your local emergency number if you have these symptoms." Clot-dissolving drugs and other treatments work best when they start within hours of the first symptom.

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This article is made and published by Jesper Bengtson, who may have used AI in the preparation.

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