for other conditions. This makes it hard for doctors to recognize the condition right away. In fact, studies show that only about 1 in 5 people initially suspected of having a PTE actually turn out to have it.
Increased Death Rates From PTE?
A study in the Journal of the American Heart Association has found that after years of decline, deaths from PTE are once again on the rise. This increase has been most noticeable among people under 65 and within African American communities. Experts believe the resurgence may be linked to growing rates of obesity and other long-term health conditions.
The Covid-19 pandemic has made the situation even worse. Research from England showed a sharp increase in blood clot-related events, including PTE, during the pandemic. Many of these deaths occurred at home rather than in hospitals. Scientists point to several possible causes: the virus itself may have increased the risk of blood clots, lockdowns led to reduced physical activity, and fear of seeking medical help may have caused dangerous delays in treatment.
In the United States, data from the Centers for Disease Control and Prevention( CDC) showed a nearly 24 % jump in deaths caused by PTE in 2020 compared to previous years. Interestingly, many of these deaths occurred in people who did not have a confirmed Covid-19 diagnosis. This suggests that the pandemic’ s indirect effects- like disruptions in healthcare services and delays in seeking treatment- may have played a major role in the rise.
Although local data is currently unavailable, I have personally conducted autopsies on five individuals who have died from pulmonary thromboembolism( PTE) since January this year. Notably, four of these cases involved male victims- a striking shift, as PTE was previously more commonly observed in female patients.
What To Lookout For
As mentioned earlier, the symptoms of PTE can vary. However, if you experience sudden shortness of breath that progressively worsens and does not improve despite treatment( often initially mistaken for pneumonia), along with chest pain that ranges from mild discomfort to severe, excruciating pain- be cautious. In some cases, people wrongly attribute this chest pain to ulcers and self-medicate with antacids, delaying proper diagnosis.
Other warning signs include a persistent cough, which may be dry or produce blood-stained sputum, episodes of lightheadedness or fainting, a rapid heartbeat, and a strong sense of anxiety or impending doom. These symptoms should not be ignored, especially if you have a family history of blood clots( as some clotting disorders are inherited), a personal history of PTE or DVT, or pain and swelling in one leg, particularly in the calf region.
In some instances, it may be necessary to seek a second medical opinion, especially if symptoms are worsening and the possibility of a clot has not been thoroughly investigated.
Regarding symptoms of DVT, pay attention to: swelling in one leg; pain, especially in the calf area; red or discoloured skin; and warmth over the affected leg.
These signs may indicate a clot that could travel to the lungs and cause a pulmonary embolism, so early detection and treatment are critical.
Prevention Strategies
The risk factors for developing deep vein thrombosis, which can lead to pulmonary thromboembolism, include several important contributors. These include: injury to blood vessels; major surgeries, especially orthopaedic procedures; prolonged immobility, which causes blood to pool in the lower limbs and increases the risk of clot formation( this includes long-distance travel, particularly long-haul flights); inherited clotting disorders, such as Factor V Leiden mutation, Protein C deficiency, Protein S deficiency, Antithrombin III deficiency, and Prothrombin gene mutation.
Medical conditions such as cancer and heart disease are a contributor, as well as hormonal influences, including the use of birth control pills, hormone replacement therapy, and pregnancy. Lifestyle factors such as obesity and a sedentary way of life play a role too.
Given these risks, it is important to be aware of the contributing factors and take proactive steps to minimize them. Preventive measures include:
• Moving around regularly during longhaul flights and making frequent stops to walk when driving long distances.
• Staying well-hydrated all day.
• Wearing compression stockings after surgeries or during travel, as advised by a healthcare provider.
• Taking prescribed blood thinners( anticoagulants) as directed.
• Avoiding hormonal contraceptives if at risk.
Additionally, if there is a family history of inherited clotting disorders, it is advisable for close relatives to undergo screening for the conditions mentioned above. Early detection and proper management can greatly reduce the risk of serious complications.
Conclusion
Pulmonary embolism is a serious but often silent threat that can strike without warning. Because its symptoms can be vague or mistaken for other illnesses, it ' s easy to miss- sometimes until it ' s too late. That’ s why it’ s so important for the public to be aware of the signs, especially sudden shortness of breath, chest pain, or unexplained fatigue.
Staying active, knowing your personal risk factors, and seeking medical help quickly can save lives. As more cases are being seen- even among people who don’ t appear obviously at risk- it’ s time to take this condition seriously and push for more awareness and early diagnosis to prevent sudden, avoidable deaths.
I had previously written an article on pulmonary thromboembolism in this publication. However, due to the rising number of cases, it is now necessary to write another piece on the same topic as part of our efforts to raise public awareness.
Dr. Johansen Oduor, MBChB( UoN), MMed Path( UoN), LLB Hons( UoN), Dip for Med( College of Medicine South Africa), is a Forensic Pathologist / Medicolegal Specialist and President Emeritus, African Society Forensic Medicine. You can commune with him via mail at: Johansenoduor @ gmail. com.