One month ago, My experienced swelling in her right leg. She was diagnosed with chronic lower limb venous insufficiency and began treatment with medication, compression stockings, and lifestyle changes. Three weeks later, she suddenly developed shortness of breath, shallow breathing, and pain in her right side, leading her to seek emergency care at Tam Anh General Hospital, Ho Chi Minh City.

Dr. Do Anh Tuan, a specialist in cardiology 1 at the Cardiovascular Center, reported that My was admitted with sudden dyspnea and pain in her right hypochondrium. Test results showed incomplete deep vein thrombosis in her lower limb (meaning blood flow was only partially obstructed) and acute pulmonary embolism.

Pulmonary embolism occurs when a blood clot forms in the lower limbs, travels through the venous system to the heart, and is then pumped into the pulmonary artery. This blocks blood flow to the lungs, reduces blood oxygen levels, and increases pulmonary artery pressure, which can be fatal if not treated promptly.

My stated that she had been taking combined birth control pills containing estrogen for nearly one year. According to Dr. Huynh Thanh Kieu, head of cardiology 1 at the Cardiovascular Center, Tam Anh General Hospital, Ho Chi Minh City, estrogen in birth control pills increases the production of clotting factors and reduces the activity of natural anticoagulants like protein C and protein S. This elevates the risk of thrombosis, especially in women with pre-existing blood stasis in their legs. The combination of blood stasis in deep veins and estrogen use makes patients prone to clot formation. When a portion of the clot detaches and travels to the lungs, a pulmonary embolism occurs.

My was fortunate to receive early emergency care. Doctors treated her with anticoagulants to prevent further clot growth and recurrence of embolism. After 48 hours, My's shortness of breath decreased, leg swelling subsided, and her hemodynamics stabilized. She was discharged after 5 days, continuing anticoagulant treatment at home, and scheduled for regular follow-up appointments. Doctors also advised her to switch to a different type of birth control pill or another contraceptive method.

Dr. Tuan checks on the patient before discharge. Photo: Ha Vu

Pulmonary embolism is a serious complication of deep vein thrombosis. Its symptoms vary depending on the extent of lung involvement, the size of the clot, and any underlying lung or heart conditions. Common symptoms include sudden shortness of breath, chest pain when breathing or coughing, coughing up blood, rapid heartbeat, fainting or dizziness, and swelling, pain, or redness.

Individuals at high risk for pulmonary embolism include those with a personal or family history of blood clots, and people with cardiovascular disease, cancer, or clotting disorders. Other risk factors are smoking, overweight or obesity, birth control pills, hormone replacement therapy with estrogen, and pregnancy. If symptoms suggestive of pulmonary embolism appear, patients should seek immediate medical attention for timely diagnosis and treatment.

Thu Ha