Acute Pulmonary Embolism: Understanding the Triggers and Risk Factors

Acute pulmonary embolism (PE) can be triggered by a variety of factors, primarily those that contribute to hypercoagulability of the blood, vascular wall injury, or impaired blood flow. These triggers can be broadly categorized into two groups: inherited and acquired conditions.

Inherited Risk Factors for Pulmonary Embolism

Some individuals have a genetic predisposition that increases their likelihood of developing blood clots. These inherited conditions can lead to abnormal clotting and may cause unexpected episodes of pulmonary embolism. For example, a patient may experience a sudden PE event despite having no apparent risk factors. Upon investigation, it may be discovered that a close relative, such as a sibling, had a similar experience. One case involved a woman who suffered a pulmonary embolism after temporarily discontinuing her anticoagulant medication for a dental procedure. Despite resuming treatment, she continued to experience recurrent deep vein thrombosis (DVT) and pulmonary embolism. This pattern often suggests an underlying genetic condition. Individuals under the age of 50 who experience unexplained clotting events or have a family history of venous thromboembolism should be evaluated for inherited thrombophilia.

Acquired Conditions Linked to Pulmonary Embolism

In addition to genetic factors, several acquired conditions can significantly increase the risk of acute pulmonary embolism. These include deficiencies in natural anticoagulant proteins such as protein C, protein S, and antithrombin III. Another notable acquired condition is antiphospholipid syndrome, which is associated with abnormal blood clotting and recurrent thrombotic events. Moreover, chronic illnesses such as nephrotic syndrome or other forms of chronic kidney disease can alter blood composition and promote clot formation. These acquired risk factors are particularly concerning in patients with multiple comorbidities or those undergoing surgical procedures, prolonged immobilization, or hormone therapy.

Conclusion

Understanding the underlying triggers of acute pulmonary embolism is essential for both prevention and treatment. Whether the cause is inherited or acquired, identifying these risk factors early can help guide appropriate anticoagulation therapy and reduce the likelihood of recurrent events. Patients with a personal or family history of unexplained blood clots should undergo thorough evaluation to determine the most effective long-term management strategy.