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Preventing pulmonary embolism (PE) begins with preventing deep vein thrombosis (DVT). Knowing whether you're at risk for DVT and taking steps to lower your risk are important.
                
Exercise your lower leg muscles if you're sitting for a long time while traveling.
                
Get out of bed and move around as soon as you're able after having surgery or being ill. The sooner you move around, the better your chance is of avoiding a blood clot.
                
Take medicines to prevent clots after some types of surgery (as your doctor prescribes).
                
Follow up with your doctor.
                
If you've already had DVT or PE, you can take more steps to prevent new blood clots from forming. Visit your doctor for regular checkups. Also, use compression stockings to prevent chronic (ongoing) swelling in your legs from DVT (as your doctor advises).
                
Contact your doctor right away if you have any signs or symptoms of DVT or PE.
An aneurysm (AN-u-rism) is a balloon-like bulge in an artery. Arteries are blood vessels that carry oxygen-rich blood to your body.
                
Arteries have thick walls to withstand normal blood pressure. However, certain medical problems, genetic conditions, and trauma can damage or injure artery walls. The force of blood pushing against the weakened or injured walls can cause an aneurysm.
                
An aneurysm can grow large and rupture (burst) or dissect. A rupture causes dangerous bleeding inside the body. A dissection is a split in one or more layers of the artery wall. The split causes bleeding into and along the layers of the artery wall.
                
Both rupture and dissection often are fatal.
                
Overview
                
Most aneurysms occur in the aorta, the main artery that carries oxygen-rich blood from the heart to the body. The aorta goes through the chest and abdomen.
                
An aneurysm that occurs in the chest portion of the aorta is called a thoracic (tho-RAS-ik) aortic aneurysm. An aneurysm that occurs in the abdominal portion of the aorta is called an abdominal aortic aneurysm.
                
Aneurysms also can occur in other arteries, but these types of aneurysm are less common. This article focuses on aortic aneurysms.
                
About 13,000 Americans die each year from aortic aneurysms. Most of the deaths result from rupture or dissection.
                
Early diagnosis and treatment can help prevent rupture and dissection. However, aneurysms can develop and grow large before causing any symptoms. Thus, people who are at high risk for aneurysms can benefit from early, routine screening.
                
Outlook
                
Doctors often can successfully treat aortic aneurysms with medicines or surgery if theyre found in time. Medicines may be given to lower blood pressure, relax blood vessels, and reduce the risk of rupture.
                
Large aortic aneurysms often can be repaired with surgery. During surgery, the weak or damaged portion of the aorta is replaced or reinforced.
The force of blood pushing against the walls of an artery combined with damage or injury to the arterys walls can cause an aneurysm.
                
Many conditions and factors can damage and weaken the walls of the aorta and cause aortic aneurysms. Examples include aging, smoking, high blood pressure, and atherosclerosis (ath-er-o-skler-O-sis). Atherosclerosis is the hardening and narrowing of the arteries due to the buildup of a waxy substance called plaque (plak).
                
Rarely, infectionssuch as untreated syphilis (a sexually transmitted infection)can cause aortic aneurysms. Aortic aneurysms also can occur as a result of diseases that inflame the blood vessels, such as vasculitis (vas-kyu-LI-tis).
                
A family history of aneurysms also may play a role in causing aortic aneurysms.
                
In addition to the factors above, certain genetic conditions may cause thoracic aortic aneurysms (TAAs). Examples of these conditions include Marfan syndrome, Loeys-Dietz syndrome, Ehlers-Danlos syndrome (the vascular type), and Turner syndrome.
                
These genetic conditions can weaken the bodys connective tissues and damage the aorta. People who have these conditions tend to develop aneurysms at a younger age than other people. Theyre also at higher risk for rupture and dissection.
                
Trauma, such as a car accident, also can damage the walls of the aorta and lead to TAAs.
                
Researchers continue to look for other causes of aortic aneurysms. For example, theyre looking for genetic mutations (changes in the genes) that may contribute to or cause aneurysms.
Certain factors put you at higher risk for an aortic aneurysm. These factors include:
                
Male gender. Men are more likely than women to have aortic aneurysms.
                
Age. The risk for abdominal aortic aneurysms increases as you get older. These aneurysms are more likely to occur in people who are aged 65 or older.
                
Smoking. Smoking can damage and weaken the walls of the aorta.
                
A family history of aortic aneurysms. People who have family histories of aortic aneurysms are at higher risk for the condition, and they may have aneurysms before the age of 65.
                
A history of aneurysms in the arteries of the legs.
                
Certain diseases and conditions that weaken the walls of the aorta. Examples include high blood pressure and atherosclerosis.
                
Having a bicuspid aortic valve can raise the risk of having a thoracic aortic aneurysm. A bicuspid aortic valve has two leaflets instead of the typical three.
                
Car accidents or trauma also can injure the arteries and increase the risk for aneurysms.
                
If you have any of these risk factors, talk with your doctor about whether you need screening for aneurysms.
The signs and symptoms of an aortic aneurysm depend on the type and location of the aneurysm. Signs and symptoms also depend on whether the aneurysm has ruptured (burst) or is affecting other parts of the body.
                
Aneurysms can develop and grow for years without causing any signs or symptoms. They often don't cause signs or symptoms until they rupture, grow large enough to press on nearby body parts, or block blood flow.
                
Abdominal Aortic Aneurysms
                
Most abdominal aortic aneurysms (AAAs) develop slowly over years. They often don't cause signs or symptoms unless they rupture. If you have an AAA, your doctor may feel a throbbing mass while checking your abdomen.
                
When symptoms are present, they can include:
                
A throbbing feeling in the abdomen
                
Deep pain in your back or the side of your abdomen
                
Steady, gnawing pain in your abdomen that lasts for hours or days
                
If an AAA ruptures, symptoms may include sudden, severe pain in your lower abdomen and back; nausea (feeling sick to your stomach) and vomiting; constipation and problems with urination; clammy, sweaty skin; light-headedness; and a rapid heart rate when standing up.
                
Internal bleeding from a ruptured AAA can send you into shock. Shock is a life-threatening condition in which blood pressure drops so low that the brain, kidneys, and other vital organs can't get enough blood to work well. Shock can be fatal if its not treated right away.
                
Thoracic Aortic Aneurysms
                
A thoracic aortic aneurysm (TAA) may not cause symptoms until it dissects or grows large. If you have symptoms, they may include:
                
Pain in your jaw, neck, back, or chest
                
Coughing and/or hoarseness
                
Shortness of breath and/or trouble breathing or swallowing
                
A dissection is a split in one or more layers of the artery wall. The split causes bleeding into and along the layers of the artery wall.
                
If a TAA ruptures or dissects, you may feel sudden, severe, sharp or stabbing pain starting in your upper back and moving down into your abdomen. You may have pain in your chest and arms, and you can quickly go into shock.
                
If you have any symptoms of TAA or aortic dissection, call 911. If left untreated, these conditions may lead to organ damage or death.
If you have an aortic aneurysm but no symptoms, your doctor may find it by chance during a routine physical exam. More often, doctors find aneurysms during tests done for other reasons, such as chest or abdominal pain.
                
If you have an abdominal aortic aneurysm (AAA), your doctor may feel a throbbing mass in your abdomen. A rapidly growing aneurysm about to rupture (burst) can be tender and very painful when pressed. If you're overweight or obese, it may be hard for your doctor to feel even a large AAA.
                
If you have an AAA, your doctor may hear rushing blood flow instead of the normal whooshing sound when listening to your abdomen with a stethoscope.
                
Specialists Involved
                
Your primary care doctor may refer you to a cardiothoracic or vascular surgeon for diagnosis and treatment of an aortic aneurysm.
                
A cardiothoracic surgeon does surgery on the heart, lungs, and other organs and structures in the chest, including the aorta. A vascular surgeon does surgery on the aorta and other blood vessels, except those of the heart and brain.
                
Diagnostic Tests and Procedures
                
To diagnose and study an aneurysm, your doctor may recommend one or more of the following tests.
                
Ultrasound and Echocardiography
                
Ultrasound and echocardiography (echo) are simple, painless tests that use sound waves to create pictures of the structures inside your body. These tests can show the size of an aortic aneurysm, if one is found.
                
Computed Tomography Scan
                
A computed tomography scan, or CT scan, is a painless test that uses x rays to take clear, detailed pictures of your organs.
                
During the test, your doctor will inject dye into a vein in your arm. The dye makes your arteries, including your aorta, visible on the CT scan pictures.
                
Your doctor may recommend this test if he or she thinks you have an AAA or a thoracic aortic aneurysm (TAA). A CT scan can show the size and shape of an aneurysm. This test provides more detailed pictures than an ultrasound or echo.
                
Magnetic Resonance Imaging
                
Magnetic resonance imaging (MRI) uses magnets and radio waves to create pictures of the organs and structures in your body. This test works well for detecting aneurysms and pinpointing their size and exact location.
                
Angiography
                
Angiography (an-jee-OG-ra-fee) is a test that uses dye and special x rays to show the insides of your arteries. This test shows the amount of damage and blockage in blood vessels.
                
Aortic angiography shows the inside of your aorta. The test may show the location and size of an aortic aneurysm.
The best way to prevent an aortic aneurysm is to avoid the factors that put you at higher risk for one. You cant control all aortic aneurysm risk factors, but lifestyle changes can help you lower some risks.
                
For example, if you smoke, try to quit. Talk with your doctor about programs and products that can help you quit smoking. Also, try to avoid secondhand smoke. For more information about how to quit smoking, go to the Diseases and Conditions Index (DCI) Smoking and Your Heart article.
                
Another important lifestyle change is following a healthy diet. A healthy diet includes a variety of fruits, vegetables, and whole grains. It also includes lean meats, poultry, fish, beans, and fat-free or low-fat milk or milk products. A healthy diet is low in saturated fat, trans fat, cholesterol, sodium (salt), and added sugar.
                
For more information about following a healthy diet, go to the National Heart, Lung, and Blood Institutes (NHLBIs) Aim for a Healthy Weight Web site, "Your Guide to a Healthy Heart," and "Your Guide to Lowering Your Blood Pressure With DASH." All of these resources include general information about healthy eating.
                
Be as physically active as you can. Talk with your doctor about the amounts and types of physical activity that are safe for you. For more information about physical activity, go to the DCI Physical Activity and Your Heart article and the NHLBIs "Your Guide to Physical Activity and Your Heart."
                
Work with your doctor to control medical conditions such as high blood pressure and high blood cholesterol. Follow your treatment plans and take all of your medicines as your doctor prescribes.
                
Screening for Aneurysms
                
Although you may not be able to prevent an aneurysm, early diagnosis and treatment can help prevent rupture and dissection.
                
Aneurysms can develop and grow large before causing any signs or symptoms. Thus, people who are at high risk for aneurysms may benefit from early, routine screening.
                
Your doctor may recommend routine screening if youre:
                
A man between the ages of 65 and 75 who has ever smoked
                
A man or woman between the ages of 65 and 75 who has a family history of aneurysms
                
If youre at risk, but not in one of these high-risk groups, ask your doctor whether screening will benefit you.
Pulmonary hypertension (PH) begins with inflammation and changes in the cells that line your pulmonary arteries. Other factors also can affect the pulmonary arteries and cause PH. For example, the condition may develop if:
                
The walls of the arteries tighten.
                
The walls of the arteries are stiff at birth or become stiff from an overgrowth of cells.
                
Blood clots form in the arteries.
                
These changes make it hard for your heart to push blood through your pulmonary arteries and into your lungs. Thus, the pressure in the arteries rises, causing PH.
                
Many factors can contribute to the process that leads to the different types of PH.
                
Group 1 pulmonary arterial hypertension (PAH) may have no known cause, or the condition may be inherited. ("Inherited" means the condition is passed from parents to children through genes.)
                
Some diseases and conditions also can cause group 1 PAH. Examples include HIV infection, congenital heart disease, and sickle cell disease. Also, the use of street drugs (such as cocaine) and certain diet medicines can lead to PAH.
                
Many diseases and conditions can cause groups 2 through 5 PH (often called secondary PH), including:
                
Mitral valve disease
                
Lung diseases, such as COPD (chronic obstructive pulmonary disease)
                
Sleep apnea
                
Sarcoidosis
                
For more information about the types of PH and the diseases, conditions, and factors that can cause them, go to "Types of Pulmonary Hypertension."
The exact number of people who have pulmonary hypertension (PH) isn't known.
                
Group 1 pulmonary arterial hypertension (PAH) without a known cause is rare. It affects women more often than men. People who have group 1 PAH tend to be overweight.
                
PH that occurs with another disease or condition is more common.
                
PH usually develops between the ages of 20 and 60, but it can occur at any age. People who are at increased risk for PH include:
                
Those who have a family history of the condition.
                
Those who have certain diseases or conditions, such as heart and lung diseases, liver disease, HIV infection, or blood clots in the pulmonary arteries. (For more information about the diseases, conditions, and factors that cause PH, go to "Types of Pulmonary Hypertension.")
                
Those who use street drugs (such as cocaine) or certain diet medicines.
                
Those who live at high altitudes.
Signs and symptoms of pulmonary hypertension (PH) may include:
                
Shortness of breath during routine activity, such as climbing two flights of stairs
                
Tiredness
                
Chest pain
                
A racing heartbeat
                
Pain on the upper right side of the abdomen
                
Decreased appetite
                
As PH worsens, you may find it hard to do any physical activities. At this point, other signs and symptoms may include:
                
Feeling light-headed, especially during physical activity
                
Fainting at times
                
Swelling in your legs and ankles
                
A bluish color on your lips and skin
Espaol
                
Deep vein thrombosis (throm-BO-sis), or DVT, is a blood clot that forms in a vein deep in the body. Blood clots occur when blood thickens and clumps together.
                
Most deep vein blood clots occur in the lower leg or thigh. They also can occur in other parts of the body.
                
A blood clot in a deep vein can break off and travel through the bloodstream. The loose clot is called an embolus (EM-bo-lus). It can travel to an artery in the lungs and block blood flow. This condition is called pulmonary embolism (PULL-mun-ary EM-bo-lizm), or PE.
                
PE is a very serious condition. It can damage the lungs and other organs in the body and cause death.
                
Blood clots in the thighs are more likely to break off and cause PE than blood clots in the lower legs or other parts of the body. Blood clots also can form in veins closer to the skin's surface. However, these clots won't break off and cause PE.
                
The animation below shows a deep vein blood clot. Click the "start" button to play the animation. Written and spoken explanations are provided with each frame. Use the buttons in the lower right corner to pause, restart, or replay the animation, or use the scroll bar below the buttons to move through the frames.
                

                

                
The animation shows how a blood clot in a deep vein of the leg can break off, travel to the lungs, and block blood flow.
Blood clots can form in your body's deep veins if:
                
A vein's inner lining is damaged. Injuries caused by physical, chemical, or biological factors can damage the veins. Such factors include surgery, serious injuries, inflammation, and immune responses.
                
Blood flow is sluggish or slow. Lack of motion can cause sluggish or slow blood flow. This may occur after surgery, if you're ill and in bed for a long time, or if you're traveling for a long time.
                
Your blood is thicker or more likely to clot than normal. Some inherited conditions (such as factor V Leiden) increase the risk of blood clotting. Hormone therapy or birth control pills also can increase the risk of clotting.
The risk factors for deep vein thrombosis (DVT) include:
                
A history of DVT.
                
Conditions or factors that make your blood thicker or more likely to clot than normal. Some inherited blood disorders (such as factor V Leiden) will do this. Hormone therapy or birth control pills also increase the risk of clotting.
                
Injury to a deep vein from surgery, a broken bone, or other trauma.
                
Slow blood flow in a deep vein due to lack of movement. This may occur after surgery, if you're ill and in bed for a long time, or if you're traveling for a long time.
                
Pregnancy and the first 6 weeks after giving birth.
                
Recent or ongoing treatment for cancer.
                
A central venous catheter. This is a tube placed in a vein to allow easy access to the bloodstream for medical treatment.
                
Older age. Being older than 60 is a risk factor for DVT, although DVT can occur at any age.
                
Overweight or obesity.
                
Smoking.
                
Your risk for DVT increases if you have more than one of the risk factors listed above.
The signs and symptoms of deep vein thrombosis (DVT) might be related to DVT itself or pulmonary embolism (PE). See your doctor right away if you have signs or symptoms of either condition. Both DVT and PE can cause serious, possibly life-threatening problems if not treated.
                
Deep Vein Thrombosis
                
Only about half of the people who have DVT have signs and symptoms. These signs and symptoms occur in the leg affected by the deep vein clot. They include:
                
Swelling of the leg or along a vein in the leg
                
Pain or tenderness in the leg, which you may feel only when standing or walking
                
Increased warmth in the area of the leg that's swollen or painful
                
Red or discolored skin on the leg
                
Pulmonary Embolism
                
Some people aren't aware of a deep vein clot until they have signs and symptoms of PE. Signs and symptoms of PE include:
                
Unexplained shortness of breath
                
Pain with deep breathing
                
Coughing up blood
                
Rapid breathing and a fast heart rate also may be signs of PE.
Your doctor will diagnose deep vein thrombosis (DVT) based on your medical history, a physical exam, and test results. He or she will identify your risk factors and rule out other causes of your symptoms.
                
For some people, DVT might not be diagnosed until after they receive emergency treatment for pulmonary embolism (PE).
                
Medical History
                
To learn about your medical history, your doctor may ask about:
                
Your overall health
                
Any prescription medicines you're taking
                
Any recent surgeries or injuries you've had
                
Whether you've been treated for cancer
                
Physical Exam
                
Your doctor will check your legs for signs of DVT, such as swelling or redness. He or she also will check your blood pressure and your heart and lungs.
                
Diagnostic Tests
                
Your doctor may recommend tests to find out whether you have DVT.
                
Common Tests
                
The most common test for diagnosing deep vein blood clots is ultrasound. This test uses sound waves to create pictures of blood flowing through the arteries and veins in the affected leg.
                
Your doctor also may recommend a D-dimer test or venography (ve-NOG-rah-fee).
                
A D-dimer test measures a substance in the blood that's released when a blood clot dissolves. If the test shows high levels of the substance, you may have a deep vein blood clot. If your test results are normal and you have few risk factors, DVT isn't likely.
                
Your doctor may suggest venography if an ultrasound doesn't provide a clear diagnosis. For venography, dye is injected into a vein in the affected leg. The dye makes the vein visible on an x-ray image. The x ray will show whether blood flow is slow in the vein, which may suggest a blood clot.
                
Other Tests
                
Other tests used to diagnose DVT include magnetic resonance imaging (MRI) and computed tomography (to-MOG-rah-fee), or CT, scanning. These tests create pictures of your organs and tissues.
                
You may need blood tests to check whether you have an inherited blood clotting disorder that can cause DVT. This may be the case if you have repeated blood clots that are not related to another cause. Blood clots in an unusual location (such as the liver, kidney, or brain) also may suggest an inherited clotting disorder.
                
If your doctor thinks that you have PE, he or she may recommend more tests, such as a lung ventilation perfusion scan (VQ scan). A lung VQ scan shows how well oxygen and blood are flowing to all areas of the lungs.
                
For more information about diagnosing PE, go to the Health Topics Pulmonary Embolism article.