Glossary · Risk

Pulmonary embolism (PE)

Also called: PE.

Definition: Pulmonary embolism is a blood clot — typically a fragment from a deep vein thrombosis — that lodges in a pulmonary artery, blocking blood flow. Symptoms include sudden shortness of breath, chest pain (often pleuritic), tachycardia, and in severe cases hemodynamic collapse. PE is the most serious VTE complication.

Detailed definition

Pulmonary embolism (PE) most commonly arises from DVT fragments embolizing through the venous system to lodge in pulmonary arteries. Presentation ranges from asymptomatic (small distal clots) to massive (saddle embolus with hemodynamic instability). Classic symptoms include sudden dyspnea, pleuritic chest pain, tachycardia, hypoxia, and sometimes hemoptysis or syncope. Diagnosis is typically by CT pulmonary angiography. Treatment is anticoagulation; massive PE may require thrombolysis or mechanical thrombectomy. PE is one of the leading preventable causes of in-hospital death and a feared complication of any VTE risk factor including oral estrogen.

Why it matters in menopause

Sudden severe shortness of breath or pleuritic chest pain in a woman on oral estrogen is a medical emergency. The absolute risk of PE on transdermal estrogen in a healthy menopausal woman is very low; on oral estrogen with other risk factors it can be meaningfully elevated.

Sources

External references: Wikipedia.

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