Structural & Vascular
Pulmonary Embolism / Pulmonary Hypertension
Pulmonary embolism (PE) occurs when a blood clot travels to the lungs and blocks blood flow — a potentially life-threatening emergency. Pulmonary arterial hypertension (PAH) is a rare condition where the blood pressure in the lung arteries is persistently elevated, straining the heart. Both require expert, specialist management.
Symptoms to Watch
- Sudden onset breathlessness — appearing within minutes or hours
- Sharp chest pain, often worse when breathing in
- Coughing up blood (in pulmonary embolism)
- Rapid heartbeat or palpitations
- Dizziness, light-headedness, or fainting
- Swollen, painful leg — if a blood clot in the leg is also present
- Progressive breathlessness on exertion (more typical of PAH)
- Fatigue and reduced exercise tolerance (more typical of PAH)
How We Diagnose
- 1CT Pulmonary Angiography (CTPA) — the definitive imaging test for pulmonary embolism
- 2D-dimer blood test as an initial rapid screening tool
- 3Echocardiogram to assess heart function and estimate pulmonary artery pressure
- 4Ventilation-perfusion (V/Q) scan as an alternative to CTPA in selected patients
- 5Doppler ultrasound of the legs to detect a source deep vein thrombosis
- 6Right heart catheterisation — the gold standard diagnostic test for PAH
- 7Blood clotting tests to identify an underlying thrombophilia (clotting tendency)
Your Treatment Plan
- Anticoagulation therapy — blood thinners — to treat PE and prevent further clots
- Thrombolysis (clot-dissolving drugs) for massive PE causing haemodynamic instability
- IVC filter for patients in whom anticoagulation is not safe
- PAH-targeted therapies — endothelin receptor antagonists, PDE-5 inhibitors, prostacyclins
- Diuretics and supplemental oxygen to manage symptoms of right heart strain in PAH
- Long-term follow-up with dose optimisation of anticoagulation and PAH medications
When to See a Doctor
If you experience sudden breathlessness, chest pain, or cough up blood — go to an emergency department immediately. For gradually worsening breathlessness on exertion, book an urgent appointment with Dr. Shah.