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I'm A Three-Time Pulmonary Embolism Survivor: Mallory's Story
Photo credit: National Blood Clot Alliance I am a three-time pulmonary embolism survivor! My first PE was in 2003 after childbirth complications (including a collapsed lung), which caused me to be hospitalized for one month. After I was released from the hospital, I returned one week later with shortness of breath while my lungs were still healing and stayed in the hospital for another week.
My second PE was two months after the first while on enoxaparin. I experienced severe shortness of breath and returned to the hospital. I had several clots and stayed for a week.
All of this happened when I was in my senior year of high school. I was attempting to rise above the idea that a teenager wouldn't be able to graduate high school with a baby — I graduated with honors!
My third PE was eight years later. This time, I had an annoying pain in my chest right below my collarbone that I thought was a cramp from working out. I went to the emergency room for something unrelated and decided to mention the pain, just to find out I had several more clots. I spent the week in the hospital again. Each time, leg pain never happened.
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I am supposed to be on blood thinners for life, but I have had several blood workups and doctors thought they weren't needed. Since then, I have had other blood issues, including severe iron deficiency, anemia and malabsorption of iron, which requires me to get regular iron infusions. None of what I have been through has been explained.
This experience has changed me in so many ways! It was traumatic and has caused me to walk day in and day out not knowing if I will have another one. I am grateful to be alive.
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Can Smoking Cause Pulmonary Embolism?
A pulmonary embolism occurs when part of a blood clot breaks off from a deep vein in the body, travels up to an artery or vein in your lungs, and causes a blockage. It is a type of venous thromboembolism (VTE).
Smoking is one of the most common risk factors for severe health conditions that can affect the lungs, heart, brain, esophagus, and bladder, among other organs.
Research on the direct link between cigarette smoking and pulmonary embolism is mixed.
However, it's widely considered a modifiable risk factor that could increase your risk of pulmonary embolism.
When to get immediate medical attention
Pulmonary embolism is a medical emergency that could be life threatening. If you experience any of the following symptoms, get immediate medical attention:
For many years, smoking was only considered a risk factor for chronic conditions that increased the risk of arterial thromboembolism, such as heart disease and stroke.
However, a 2016 study involving 244,865 participants found that cigarette smoking was a risk factor for provoked VTE, which is when there are identifiable risk factors for VTE.
However, smoking requires intervention if you have another identifiable risk factor, such as:
Smoking may also increase your risk of cancer, which is strongly associated with pulmonary embolism and VTE.
For instance, a 2021 study of 144,952 people found that people with cancer who smoked were 50% more likely to develop VTE than people who did not smoke.
Smoking increases inflammation in the body and increases the thickness of your blood, making it more likely to clot.
According to the American Lung Association, smoking can also damage and narrow the lining of your blood vessels, which increases the risk of blood clots forming.
Quitting smoking could greatly reduce your risk of VTE, especially if you're living with other health conditions. Consider speaking with a doctor about how to quit smoking.
Pulmonary Embolism Risk And Anticoagulation In End-Stage Kidney Disease
A RECENT study analysing data from the US Renal Data System (USRDS) has revealed a significant risk of pulmonary embolism (PE) in patients with end-stage kidney disease (ESKD) starting dialysis. The research, which tracked 288,073 patients from 2011 to 2019, found a 1-year PE incidence of 0.84%, with rates increasing over the study period. Patients on peritoneal dialysis (PD) had a lower incidence of PE compared to those on haemodialysis (HD).
The study also highlighted challenges in managing PE in ESKD patients, especially regarding anticoagulation (AC) therapy. Only 41% of patients prescribed AC filled their prescriptions, and no significant benefit was found in preventing PE recurrence between those who took AC and those who didn't. Mortality rates were high—13.7% in-hospital and 13.1% at 30 days post-discharge—indicating the severity of PE in this high-risk group.
This research highlights the complexities of managing PE in ESKD patients, stressing the need for further investigation into optimal treatment strategies and the underlying causes of increased thrombotic risk to improve outcomes in this population.
Helena Bradbury, EMJ
Reference
Patel KN et al. Pulmonary embolism in patients with end-stage kidney disease starting dialysis. JAMA Netw Open. 2025;8(3):e250848.
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