Pulmonary Embolism Deaths Rising Among Younger Americans

Nearly 900,000 Americans develop a pulmonary embolism each year, a condition in which a blood clot travels through the veins and lodges in the lungs, blocking blood flow to vital tissue. The numbers are sobering: between 10 and 30 percent of those diagnosed die within a month. A third of the survivors will face another clot within the next decade. What makes this particularly urgent now is a shift in who is being affected. After death rates from PE declined steadily between 1999 and 2008, they have begun climbing again—rising roughly 0.06 percent annually since 2010—and the increase is concentrated among people under 65.

Understanding what happens inside the body helps explain why early detection matters so much. A pulmonary embolism typically begins as a deep vein thrombosis, a clot that forms in the legs or pelvis. When that clot breaks free and travels to the lungs, it wedges itself into a blood vessel and cuts off oxygen supply to the surrounding lung tissue. The heart, sensing the obstruction, works harder to push blood through. Blood pressure in the lungs rises. If the clot is not removed or dissolved, the heart continues to strain, eventually enlarging and potentially failing altogether. In some cases, multiple clots accumulate, a condition called pulmonary infarction, which can destroy entire sections of lung function.

The risk factors are numerous and often interconnected. Some are inherited—a family history of blood clots or a genetic clotting disorder puts a person at higher baseline risk. Others stem from medical events: surgery, trauma, fractures of the hip or leg, a previous heart attack or stroke. Pregnancy and hormonal birth control both increase clotting risk. Cancer and its treatments do as well. But many of the most common triggers are behavioral or circumstantial. Sitting or standing motionless for extended periods—during long car rides, airplane flights, or bed rest after surgery—allows blood to pool in the legs. Obesity and smoking both contribute. Even the simple act of maintaining a cramped position for hours can initiate clot formation.

Recognizing the symptoms is complicated because they overlap with many other conditions. A deep vein thrombosis may announce itself with pain, redness, swelling, or warmth at the site of the clot, usually in the leg. But a pulmonary embolism itself can feel like something else entirely: shortness of breath, chest pain that radiates to the jaw or shoulder, heart palpitations, rapid breathing, dizziness, or fainting. Some people experience low blood pressure, cough up blood, or sweat profusely. Anxiety and restlessness can occur. The symptom list is long enough that diagnosis requires imaging. Doctors use chest X-rays, electrocardiograms, blood tests, CT scans, ultrasound, and in some cases angiography—a procedure in which dye is injected into the veins to make them visible on X-ray.

Once diagnosed, treatment focuses on two goals: dissolving the existing clot and preventing new ones from forming. Anticoagulation medications thin the blood and stop clots from growing. Compression stockings reduce swelling and prevent blood from pooling in the veins. In more severe cases, doctors may use catheters to deliver clot-dissolving drugs directly to the site of the blockage. Prevention, though, remains the most accessible intervention. Moving regularly—standing or walking every one to two hours—keeps blood circulating. Staying hydrated helps. Avoiding medications that promote clotting is important for those at risk. For people facing surgery or prolonged immobility, a doctor may recommend compression stockings as a preventive measure.

The rising death rate among younger Americans suggests that awareness and early intervention are not reaching everyone who needs them. A person in their forties or fifties might not recognize the warning signs, or might attribute chest pain and shortness of breath to anxiety or a pulled muscle. By the time a diagnosis is made, the clot may have caused significant damage. The window for effective treatment is narrow. This is why Dr. Omar Haqqani, Chief of Vascular and Endovascular Surgery at Vascular Health Clinics in Midland, emphasizes that early diagnosis and treatment are not merely helpful—they are essential. The difference between catching a pulmonary embolism in its first hours and discovering it days later can be the difference between recovery and death.