Pulmonary Embolism:

Another major cause of chest pain is a pulmonary embolism. An embolism is a mobile blood clot that usually occurs after a surgical procedure, particularly if the patient has been lying immobile in bed for several days. Immobility and the stress of surgery are associated with stasis of blood in the lower extremities and pelvis. This encourages the formation of blood clots in these areas. An injury to the lower extremities also may result in the formation of a clot, days or even weeks later. Whatever the origin, portions of the clot may break off and migrate to the lungs. This is most likely to occur when attempts are made to ambulate a patient in the post-operative period. Usually such a clot lodges in the small blood vessels in the lung. If the clot is a large one, it may be associated with coughing up of blood, shortness of breath, pain intensified by deep breathing, and even sudden death. The pain associated with a pulmonary embolism may be indistinguishable from both cardiac ischemia and the pain of an acute heart attack. Chest pain may be the first clue that a clot is present in the legs or thighs. In general, prolonged bed rest for any reason encourages the formation of blood clots in the lower half of the body followed by a pulmonary embolus. Usually the diagnosis of an embolism can be made by chest x-ray, however, special tests and procedures may be required in more obscure cases.