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Suspected pulmonary embolism: signs that cannot wait | CION Cancer Clinics
Sudden breathlessness, sharp chest pain that worsens when you breathe in, a racing heart, coughing up blood or fainting can all mean a pulmonary embolism, a blood clot in the lung. Call 108 or go to the nearest emergency department straight away. Risk is higher with cancer, recent surgery, pregnancy, long bed rest or a clotting disorder, but you do not need to be sure before you go. At CION Cancer Clinics, our haematology team supports patients and families through treatment, cost questions and life at home.
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Medically reviewed by Dr. Basudev PokhrelConsultant Haematologist · last reviewed September 2026, next review due September 2027
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On this page
- What are the emergency signs of a pulmonary embolism?
- Who is more likely to get a clot in the lung?
- What will the emergency team do?
- How is it different from a heart attack or a chest infection?
- What stops families acting quickly?
- What happens after a clot is found, and what can this page not tell you?
- Common questions about a suspected pulmonary embolism
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Sudden breathlessness or chest pain: call 108 now
Call 108 or go to the nearest emergency department straight away if someone suddenly becomes breathless, has sharp chest pain that is worse on breathing in, coughs up blood, faints or collapses. Say that a blood clot in the lung is possible, and mention any recent surgery, cancer treatment or long bed rest. Do not wait to see if it settles, and do not drive yourself.
The short answer
What are the emergency signs of a pulmonary embolism?
The main signs are sudden breathlessness, chest pain that is sharper when you breathe in, a fast heartbeat, coughing up blood, and fainting. Any of these, appearing without a clear reason, needs emergency care the same hour, because a clot in the lung can become life-threatening quickly.
What a pulmonary embolism actually is
A pulmonary embolism, often shortened to PE, is a blood clot that blocks a blood vessel in the lung. Most start as a clot in a deep vein of the leg, called a DVT or deep vein thrombosis. A piece breaks off, travels through the heart and lodges in the lung. Blood then cannot pick up oxygen properly, and the heart has to strain to push past the blockage.
Why it is easy to miss
The signs overlap with a heart attack, a chest infection, asthma and even a panic attack. Some people have only mild breathlessness climbing stairs, or a cough. That is why doctors would rather test and find nothing than send someone home with a clot. You do not need to be sure before you go.
A swollen, painful, warm calf on one side is a warning sign of a leg clot. It needs a doctor the same day, even without chest symptoms.Not sure whether this applies to you?
Ask an oncologistWho should be most alert
Who is more likely to get a clot in the lung?
Anyone can, but some situations raise the chance a great deal. If you or your parent fits one of these, take new breathlessness seriously.
People with cancer
Cancer itself makes the blood clot more easily. Some chemotherapy, hormone treatments and a central line, a thin tube in a large vein, add to that. Blood cancers such as myeloma and lymphoma carry this risk too.
After surgery or a hospital stay
Lying still for long periods slows blood in the legs. The risk stays raised for a while after going home, particularly after surgery on the hip, knee, abdomen or pelvis.
Pregnancy and after birth
The blood clots more easily during pregnancy and in the period after delivery, including after a caesarean section. Hormone pills and hormone replacement add a smaller risk.
A blood or clotting disorder
An inherited tendency to clot, antiphospholipid syndrome, a high red cell count or a previous clot all raise the chance of another.
Also adds to it
- Long bus, train or air journeys
- Being very overweight or a smoker
At the hospital
What will the emergency team do?
Check how stable you are
Oxygen level, pulse, blood pressure and an ECG, a heart tracing, come first. Oxygen is given if levels are low. If blood pressure is dropping, treatment may start before every test is done.
Blood tests
A D-dimer test looks for signs of clot breakdown in the blood. A normal result helps rule a clot out in lower-risk people. A raised one does not prove a clot, because infection, surgery and cancer raise it too.
A scan of the lungs
Usually a CT pulmonary angiogram, a CT scan with dye that shows the lung blood vessels. Where dye is unsafe, a lung scan called a V/Q scan may be used. A leg ultrasound checks for a clot in the leg.
Treatment
Most people are started on a blood thinner, which stops the clot growing while the body breaks it down. A large clot straining the heart may need a clot-dissolving medicine or a procedure.
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Telling them apart
How is it different from a heart attack or a chest infection?
Points more towards a clot in the lung
Can also happen with other causes
Breathlessness that starts suddenly, often at rest
A chest infection usually builds over days with fever and phlegm
Sharp pain on one side, worse on a deep breath
Heart attack pain is often a heavy pressure that may spread to the arm or jaw
A swollen, painful leg in the days before
Swelling of both legs is more often linked to the heart or kidneys
Recent surgery, cancer treatment or bed rest
Any of these conditions can still happen in the same person
Commonly believed
What stops families acting quickly?
"It is only gas or acidity. Let us wait till morning."
Chest pain with sudden breathlessness should never be put down to acidity at home. A clot in the lung can worsen within hours. Going to emergency and being told it was nothing is a good outcome, not a wasted trip.
"He is young and fit, so it cannot be a clot."
Clots are more common with age, but young adults get them too, especially after surgery, during pregnancy, on hormone pills, or with a clotting disorder or cancer. Fitness does not protect you.
"She is already on a blood thinner, so it cannot be a clot."
Clots can still form on blood thinners, particularly with cancer or if doses are missed. New breathlessness or chest pain on a blood thinner needs emergency care just the same. Tell the team the name of the medicine.
"Rub the swollen calf, it will ease the cramp."
Do not massage a leg that is swollen, warm and painful on one side. If it is a clot, the pressure does not help, and the leg needs to be checked by a doctor the same day.
Being straight with you
What happens after a clot is found, and what can this page not tell you?
Most people with a pulmonary embolism are treated with blood thinners and recover. How long treatment lasts, and whether you are cared for in hospital or at home, depends on the size of the clot, how your heart is coping and why the clot formed. The team treating you decides that.
Blood thinners need care
Blood thinners lower the chance of new clots but raise the chance of bleeding. They may not suit people who are actively bleeding or who have very low platelets, the cells that help blood clot. Never start, stop, skip or change a blood thinner on your own. If you are due for surgery, a tooth extraction or chemotherapy, tell every doctor you are on one.
What this page cannot tell you
A list of signs is not a diagnosis. It cannot tell you whether your symptoms are a clot, and it cannot tell you your own outlook. Only examination, blood tests and a scan can. If a clot happened alongside a cancer or a blood disorder, CION's haematology team can review your reports, discuss the plan at a tumour board and coordinate follow-up with your treating doctors.
Coming back to emergency is right if breathlessness returns, you cough up blood, or you notice black stools or unusual bleeding while on a blood thinner.Questions we are asked
Common questions about a suspected pulmonary embolism
Can a pulmonary embolism go away on its own?
The body can slowly break down small clots, but you cannot know at home whether a clot is small or whether another is forming. An untreated clot can grow or be followed by a larger one. That is why every suspected clot in the lung is checked and treated in hospital, rather than watched at home.
Should we call 108 or take a taxi to hospital?
Call 108 if the person is very breathless, confused, has fainted, has blue lips or has chest pain with sweating. An ambulance crew can give oxygen on the way. If symptoms are milder and the nearest emergency department is close, going by car with someone else driving is reasonable. Do not go to a clinic first.
My mother is on chemotherapy and suddenly breathless. Is it a clot?
It might be, and it might be infection, a low haemoglobin or fluid around the lung. All of these need the same thing: emergency assessment today. Tell the hospital she is on chemotherapy and whether she has a central line or port. Then inform her oncology team once she is being seen.
Does a normal chest X-ray rule out a clot?
No. A chest X-ray is often normal with a clot in the lung. It is useful for finding other causes such as pneumonia or a collapsed lung. A clot is usually confirmed or ruled out with a D-dimer blood test, a CT scan of the lung blood vessels, or both.
Is the CT scan dye safe with weak kidneys?
The dye can strain kidneys that are already weak, so tell the team about any kidney problem or diabetes. They will weigh that against the danger of missing a clot. Sometimes they choose a V/Q lung scan instead, or give fluids and check kidney tests afterwards.
Can I travel or fly after a pulmonary embolism?
Many people travel again once they are stable on treatment, but the timing is a decision for your treating doctor. On long journeys, walk about when you can, flex your ankles often and drink water. Ask your doctor before travelling rather than assuming it is fine.
Will I need blood thinners for life?
Not always. People whose clot had a clear, temporary cause, such as surgery, often stop after a set course. Those with ongoing cancer, a clotting disorder or repeated clots may be advised to continue for longer. This is decided with your doctor and reviewed over time. Never stop on your own.
Is emergency treatment covered by Aarogyasri or insurance?
Emergency admission for a clot is often covered under Aarogyasri, PM-JAY, CGHS, ECHS, EHS and most cashless insurance, though rules differ by scheme and hospital and change over time. In an emergency, go first and sort the paperwork after. Keep your card, ID and recent reports with you.
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Sources
- NHS — Pulmonary embolism
- NHLBI — Venous thromboembolism
- NICE — Venous thromboembolic diseases: diagnosis, management and thrombophilia testing (NG158)
- American Society of Hematology — Blood clots
This page is general information, not a prescription. Do not change or stop any treatment based on what you read here. If anything is worrying you, contact your own treating team — or call our helpline and we will help you reach the right specialist.
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Talk to us
Had a clot alongside a blood disorder or cancer?
In an emergency, call 108 first. Once you are stable, send us your reports and our haematology team will help you plan the follow-up with your treating doctors.