So, how does a pulmonary embolism happen, and what can you do to protect yourself? These 13 questions can get the conversation going between you and your doctor.

1. What Causes a Pulmonary Embolism?

A pulmonary embolism is a blockage in an artery in your lungs, usually caused by a blood clot. Occasionally, tumor cells, parasites, air bubbles, amniotic fluid, or fat may be the culprit in a blockage, according to the National Institutes of Health (NIH).

Deep vein thrombosis (DVT) is a blood clot inside one of your body’s deep veins, often in your pelvis, lower leg, or thigh, and sometimes in your arm, according to the Centers for Disease Control and Prevention (CDC). If a blood clot breaks off and travels to your lungs, it becomes a pulmonary embolism, the most serious complication of DVT.

3. How Common Are Pulmonary Embolisms?

Blood clots are surprisingly common, and about 900,000 people in the United States develop DVT or a pulmonary embolism yearly, estimates the CDC. Additionally, the CDC says that as many as 100,000 people die of a blood clot each year, and 1 in 4 people with a pulmonary embolism die without warning.

4. How Has COVID-19 Changed the Likelihood of Getting a Pulmonary Embolism?

There’s a pretty convincing link, says Victor Tapson, MD, a pulmonologist at Cedars-Sinai in California. “We saw during the pandemic early on, and then with the delta surge, many more blood clots,” he says. “A number of hospital systems saw an increase of deep vein thrombosis and pulmonary embolism during COVID-19.” A study published in April 2022 in The BMJ found that getting COVID-19 was linked to an increased risk of developing deep vein thrombosis for three months after the COVID-19 diagnosis, and an increased risk of pulmonary embolism for six months after the COVID-19 diagnosis. However, Dr. Tapson says that what is not known is how each variant of COVID-19 is related to the increased risk of pulmonary embolism, which makes treatment from strain to strain difficult.

5. Am I at Risk of a Pulmonary Embolism?

Because a pulmonary embolism can be fatal, it’s essential to discuss your risk with your doctor, says Jason S. Fritz, MD, a pulmonologist at Penn Presbyterian Medical Center in Philadelphia. “There are preventive measures that can be taken to help mitigate that risk in appropriate circumstances,” he says. Though anyone can develop a pulmonary embolism, the CDC lists several factors that increase your risk, including your medical history, activities, and medications. Those factors are:

Older age (increasing risk after age 40)A previous DVT, pulmonary embolism, or strokeObesityHeart failureHigh blood pressureLong periods of sitting or lying still, such as on a long plane, train, or car rideRecent trauma or surgeryA current cancer diagnosisPregnancy, current or recentTaking oral contraceptives (especially if you smoke)

6. How Can I Prevent a Pulmonary Embolism?

If you are at an increased risk of a pulmonary embolism, your doctor may recommend steps to potentially lower it, such as taking blood thinners, getting back on your feet as soon as possible after surgery, or wearing special compression stockings to reduce your risk of blood clots. If you are on a long trip, take frequent breaks to walk around and stretch your legs, to improve circulation and avoid blood clots. Also, if you have been diagnosed and treated for a pulmonary embolism, make sure to follow up with your medical team to monitor your risk and get treatment for any conditions that may be increasing your risk.

7. How Do I Know if I Have a Pulmonary Embolism?

This condition is often misdiagnosed because the symptoms often aren’t particularly specific, says Shanon Makekau, MD, a pulmonologist with Kaiser Permanente in Hawaii. Usually, a pulmonary embolism causes shortness of breath and chest pain. Sometimes, people develop a fever and cough up blood, or experience dizziness, lightheadedness, and heart palpitations. But sometimes people won’t have symptoms, or the symptoms will be mild, so it can be hard to recognize and diagnose.

8. How Expensive Are Blood Clots to Treat?

Blood clots cost the United States up to $10 billion each year, according to the CDC. For an individual, treatment can cost as much as $20,000. If a blood clot turns into a pulmonary embolism, the average total per incident medical cost is around $30,000, according to Cost Helper.

9. Can a Pulmonary Embolism Be Cured?

A pulmonary embolism can be fatal if the blood clot completely blocks blood flow to the lungs, according to the CDC, and 10 to 30 percent of those who have an embolism die within the month. But if you spot the symptoms early and seek prompt medical care, a pulmonary embolism is treatable. Anticoagulant (blood-thinning) medications can help prevent further blood clots, and a treatment called thrombolytic therapy can help dissolve an existing clot. Treatment may require hospitalization, depending on the severity of the clot, notes the NIH.

10. How Long Does Blood-Thinner Treatment Last?

“This is a very important question to discuss with your physician,” says Dr. Fritz, and the answer depends on your risk of a future clot. If the pulmonary embolism was caused by a trauma or surgery, the blood thinner treatment could last a year or less. But if it was not caused by a temporary or reversible condition, or if you’ve had several DVTs or pulmonary embolisms, you might need to continue treatment indefinitely, because these types of blood clots are more likely to reoccur, he explains. It’s also important to discuss with your doctor the risks associated with a blood thinner treatment, such as an increased likelihood of bleeding.

11. Have There Been Any Advancements in Treatments?

Yes, on multiple fronts, according to Tapson. For blood thinners, new medications like rivaroxaban don’t require particular blood levels, nor do they negatively interact with other drugs or food, a problem that persisted with past blood thinners, like warfarin. For more aggressive treatments, there are new technologies that weren’t available even a decade ago. “We have devices that we can use to go in and remove the clot from the lungs,” says Tapson, referring to updated thrombectomy procedures.

12. Will a Pulmonary Embolism Come Back?

It might. About 33 percent of people who have had a DVT or pulmonary embolism will have another one within 10 years, according to the CDC.

13. If I Have Already Been Treated but Don’t Feel as Good as Before, Should I Be Concerned?

Maybe, Fritz says. It can take several months to recover, especially if you have a heart or lung problem. But in some cases, the clot doesn’t fully dissolve, which can lead to pulmonary hypertension and a form of heart failure. Those conditions may cause shortness of breath, swelling, fatigue, dizziness, fainting, and chest pain when you exert yourself. Follow up with your pulmonary team if you continue to have concerning symptoms after a pulmonary embolism or DVT. Additional reporting by Zachary Smith.