Understanding This Deadly Blood Clot

A pulmonary embolism is a blood clot that obstructs blood flow in an artery in the lungs. In many cases, the clot traveled from a different body part, such as a deep vein in the leg. A saddle pulmonary embolism is a rare form an acute pulmonary embolism that is often life-threatening.

The article below provides more information on the causes, symptoms and treatments.

What is a Saddle Pulmonary Embolism?

A saddle pulmonary embolism is a large blood clot that is atop the main pulmonary artery. The clot lodges at the spot where the main pulmonary artery branches into the right and left lungs. A blockage at this location prevents proper blood flow.

The main pulmonary artery carries blood from the heart to the lungs, where it becomes oxygenated. When a clot obstructs normal blood flow, it can lead to inadequate blood supply to the entire blood. Not treated quickly can lead to heart failure and sudden death.


Symptoms of a saddle pulmonary embolism can develop suddenly and may depend on the size of the blood clot. Common symptoms include the following:

  • Sudden onset of trouble breathing.
  • Shortness of breath.
  • Chest pain.
  • Coughing up blood.
  • Lightheadedness.
  • Rapid heartbeat.
  • Bluish lips and nails.
  • Excessive sweating.

Saddle Pulmonary Embolism Causes

A saddle pulmonary embolism often occurs due to a venous thromboembolism, which means a blood clot in a vein. In many instances, the clot first develops in a large vein in the leg, which breaks off.

According to research in the journal Critical Care Explorations, an acute deep vein thrombosis was found in 65.8 percent of people with a saddle pulmonary embolism.

Certain factors increase a person’s risk of developing a saddle pulmonary embolism, such as:

Immobility: Not moving around for a long time reduces blood flow and may lead to clotting. Conditions that can cause immobility include surgery, wearing a cast and long plane and car rides.

Chronic medical conditions: Some conditions may promote blood clotting and increase the risk of an embolism. Those conditions include cancer and lung and heart disease.

Injury to a vein: If a vein becomes injured, it can affect normal blood flow and increase the risk of a blood clot.

Remember that not everyone developing a saddle pulmonary embolism has a deep vein thrombosis or other risk factor. In some cases, the exact cause is not known.

Treatment for a Saddle Pulmonary Embolism

Prompt treatment is vital for someone with a saddle pulmonary embolism. In general, pulmonary embolisms are life-threatening. According to the Centers for Disease Control and Prevention, about 25% of people with a pulmonary embolism experience sudden death due to the condition.

The goal of treatment is to break up the clot of allow normal blood flow to return. Treatment also aims to prevent future blood clots from developing.

Treatment options for a saddle pulmonary embolism include:


Medications may be given in a pill form or as an injection. Typically, medications recommended include anticoagulants. Anticoagulants prevent clots from becoming larger. They may also help prevent future clots from forming.

Thrombolytics are also often prescribed to break up or dissolve blood clots. This type of medication can increase the risk of bleeding. Because of the potential side effects, doctors often only prescribe thrombolytics in cases of a life-threatening pulmonary embolism.


If medications are not adequate to dissolve the blood clot, doctors may have to prescribe a procedure to remove the clot. One option is a percutaneous thrombectomy. This procedure involves the doctor inserting a thin catheter into the blood vessel to remove the blood clot. A suction device may pull the clot through the catheter to remove it. Another option is attaching a small tool to the catheter that breaks up the clot.


Since doctors do not always know why the clot forms, it may not be possible to prevent a saddle pulmonary embolism in every instance. But there are things a person can do to decrease their risk of a deep vein thrombosis and a possibly saddle pulmonary embolism, such as:

  • Remain at a healthy weight
  • Take a break from long car rides to move around
  • Stretch your legs and get up and walk during long flights
  • Avoid wearing clothes that are too tight
  • Wear compression stockings if at high risk of a blood clot


The prognosis for a saddle pulmonary embolism often depends on how fast doctors diagnose the condition and how a person receives treatment. Receiving treatment within the first few hours of having an embolism increases the likelihood of a full recovery. Doctors also often prescribe anticoagulant treatment for two to three months after having a saddle pulmonary embolism to prevent future clots.

Learn how you can improve your blood circulation.

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