Varicose Veins and Pulmonary Embolism Risk

What is a pulmonary embolism?

A pulmonary embolism (PE) is a sudden blockage in one of the pulmonary arteries, the vessels that carry blood from the heart to the lungs. In most cases the blockage is a blood clot that formed somewhere else, most often in a deep vein of the leg or pelvis, then broke loose and travelled with the bloodstream.

When part of the lung loses its blood supply, less oxygen reaches the body and the right side of the heart has to work much harder. A small PE may cause mild breathlessness. A large one can cause collapse or sudden death. This is why PE is treated as a medical emergency everywhere in the world.

Can varicose veins cause a pulmonary embolism?

This is one of the most common worries we hear from patients, so it deserves a clear answer.

• Simple varicose veins rarely cause PE directly. The bulging veins you can see sit close to the skin. Clots in them are usually small and tend to stay put.
• The real link is through DVT. In untreated chronic venous disease, faulty valves let blood pool in the legs. Slow blood is more likely to clot. If a clot forms in, or spreads into, a deep vein, it can travel to the lungs.
• A clot near a junction matters. When a surface vein clot forms close to where the great or small saphenous vein joins the deep veins, it can extend inward. These clots need prompt ultrasound assessment.

In other words, varicose veins are rarely an emergency, but they are a sign that your venous circulation is not working normally. Leaving progressive disease untreated for years removes a safety margin.

What are the warning signs of PE?

Call emergency services immediately (119 in Korea, or your local number) if you notice:

• Sudden shortness of breath, at rest or with light activity
• Sharp chest pain that is worse when you breathe in or cough
• A fast or irregular heartbeat
• Coughing up blood
• Light-headedness, fainting or bluish lips

These symptoms are more alarming if you also have a swollen, painful leg, recently had surgery, or recently took a long flight. Do not wait to see if they pass, and do not book a clinic appointment instead. LEDAS is an outpatient vein clinic; acute PE needs a hospital emergency department.

Who is at higher risk?

1. People with a current or past DVT
2. People who have been immobile: bed rest, long hospital stays, long-haul travel
3. Recent surgery, especially of the hip, knee or abdomen
4. Pregnancy and the weeks after childbirth
5. Hormone treatment, including some oral contraceptives
6. Inherited clotting tendencies, cancer, older age and obesity
7. Advanced chronic venous disease with swelling and skin changes

How do vein specialists reduce the risk?

The most practical way to reduce PE risk linked to vein disease is to find and deal with problems before a clot forms . At LEDAS, a duplex ultrasound checks the deep veins as well as the varicose veins. If a clot or signs of an old clot are found, Dr. Kim Byoung Joon will explain what it means and whether you need referral before any vein treatment.

When treatment is suitable, LEDAS closes refluxing veins with EVLT and duplex-guided sclerotherapy . Local anesthesia only means you can walk right after the procedure, which supports healthy blood flow. Walking practice, compression stocking training and monitoring are part of every treatment day before same-day discharge.

Everyday prevention

• Break up long sitting with short walks every hour or so
• Do ankle pumps on flights and in cars; read flying after vein treatment if you are travelling home after care
• Stay hydrated and limit alcohol when travelling
• Wear prescribed compression stockings

Which symptoms need what kind of help?

Pulmonary embolism and vein disease – frequently asked questions