A pulmonary embolism can feel like a sudden sharp chest pain combined with unexplained shortness of breath. Many people describe it as a stabbing sensation that gets worse when they breathe in deeply. Others report a feeling of intense anxiety or a sense of doom that seems to come out of nowhere. The symptoms often hit fast, and they are not subtle — your body is telling you something is very wrong.
What Does a Pulmonary Embolism Actually Feel Like in the Chest?
The chest pain from a pulmonary embolism is often sharp and sudden. People describe it as a knife-like stab that makes them stop breathing for a moment. This pain usually worsens with deep breaths, coughing, or even laughing.
Some people feel a dull, heavy ache instead of sharp pain. It can mimic a heart attack, which is why many people rush to the ER thinking they are having one. The key difference is that pulmonary embolism pain is typically pleuritic — meaning it hurts more when you inhale deeply. The American Heart Association notes that this type of chest pain is a hallmark sign.
Research published in the journal Chest found that about 50% of people with a confirmed pulmonary embolism reported pleuritic chest pain. The other half felt either dull pain or no chest pain at all. This is why doctors do not rely solely on the type of pain to make a diagnosis.
How Does Shortness of Breath Feel With a Pulmonary Embolism?
Shortness of breath from a pulmonary embolism is not like being winded after exercise. It feels like you cannot get enough air no matter how hard you try. People often say it feels like someone is sitting on their chest or like they are breathing through a straw.
This symptom usually comes on suddenly. You might be sitting still and feel like you just ran a sprint. The CDC reports that sudden shortness of breath is the most common symptom of a pulmonary embolism, occurring in about 75% of cases.
Some people experience rapid breathing as their body tries to compensate for low oxygen levels. You might notice your heart racing too. This combination of fast breathing and a pounding heart can feel terrifying, which triggers the sense of panic many patients describe.
What Other Body Sensations Come With a Pulmonary Embolism?
Beyond chest pain and breathing trouble, a pulmonary embolism can affect other parts of your body. Many people feel lightheaded or dizzy, sometimes to the point of fainting. This happens because the clot is blocking blood flow to your lungs, which reduces oxygen reaching your brain.
Coughing is another common symptom. The cough may be dry at first, but some people cough up blood-tinged mucus. The blood can be pink, red, or rust-colored. If you cough up any amount of blood, that is a medical emergency.
Some people also feel pain in their back or shoulder. This can be confusing because it does not always point to the lungs. The pain radiates because the clot irritates the diaphragm, which shares nerve pathways with the shoulder area. This is called referred pain.
Leg swelling or pain in one leg often precedes the lung symptoms. This is a sign of deep vein thrombosis — the clot that started in your leg and traveled to your lungs. The leg might feel warm, look red, or be noticeably larger than the other leg.
How Does a Pulmonary Embolism Differ From a Heart Attack or Panic Attack?
Many people confuse a pulmonary embolism with a heart attack because the symptoms overlap. Both can cause chest pain, shortness of breath, and a sense of doom. But there are differences. Heart attack pain often feels like pressure or squeezing in the center of the chest, and it may radiate to the arm or jaw. Pulmonary embolism pain is more likely to be sharp and on one side, and it gets worse with breathing.
Panic attacks can also mimic a pulmonary embolism. Both cause rapid breathing, a racing heart, and intense fear. The difference is that panic attacks usually have a trigger, like a stressful event, and they tend to peak within 10 minutes. Pulmonary embolism symptoms do not improve with reassurance or calming techniques — they persist or worsen.
Doctors use a simple test called a d-dimer blood test to help tell them apart. A normal result makes a pulmonary embolism very unlikely. An elevated result means more testing is needed. The Wells criteria, a scoring system used in emergency rooms, also helps doctors estimate risk based on symptoms and medical history.
| Symptom | Pulmonary Embolism | Heart Attack | Panic Attack |
|---|---|---|---|
| Chest pain type | Sharp, stabbing, worsens with breathing | Pressure, squeezing, tightness | Sharp but often fleeting |
| Shortness of breath | Sudden, severe, persistent | May be gradual or sudden | Rapid breathing, peaks quickly |
| Cough | Common, may have blood | Rare | Rare |
| Leg symptoms | Swelling or pain in one leg | Not present | Not present |
| Response to rest | Does not improve | May improve slightly | Improves with calming |
When Do Symptoms of a Pulmonary Embolism Usually Start?
Symptoms of a pulmonary embolism can start within minutes or develop over hours. For most people, the onset is sudden. You might be doing something routine like watching TV or walking to the kitchen when the chest pain and breathing trouble hit.
Some people experience symptoms that come and go at first. This can trick them into thinking it is something minor like indigestion or muscle strain. But the symptoms always return and often get worse. The clot is not going away on its own — it needs medical treatment.
If you have a deep vein thrombosis in your leg, the leg symptoms may appear days before the lung symptoms. The leg pain or swelling might be mild, and you might ignore it. But that clot can break loose and travel to your lungs at any time. The CDC estimates that up to 50% of people with a deep vein thrombosis will develop a pulmonary embolism if left untreated.
Certain situations raise your risk. Long flights, surgery, pregnancy, cancer, and being immobile for long periods all increase the chance of a clot forming. If you have any of these risk factors and develop sudden chest pain or shortness of breath, do not wait to see if it passes.
What Should You Do If You Think You Have a Pulmonary Embolism?
If you suspect a pulmonary embolism, call 911 or go to the nearest emergency room immediately. Do not drive yourself. Do not wait to see if symptoms go away. This condition can be fatal within hours if not treated.
While waiting for help, try to stay as calm as possible. Sit upright if you can, as this helps with breathing. Do not take any blood thinners like aspirin unless a doctor tells you to, because the wrong dose or type could make things worse.
At the hospital, doctors will run tests quickly. A CT scan of the chest with contrast dye is the most reliable way to confirm a pulmonary embolism. They may also do a d-dimer blood test, an EKG, and an ultrasound of your legs. Treatment usually starts with blood thinners to prevent the clot from growing and to help your body dissolve it.
The good news is that with prompt treatment, most people recover fully. The mortality rate for a diagnosed and treated pulmonary embolism is about 8%, according to the National Institutes of Health. Without treatment, that number jumps to 30%. Early action saves lives.
Frequently Asked Questions
Can a pulmonary embolism feel like a pulled muscle?
Yes, some people mistake the chest pain for a muscle strain, especially if the pain is dull rather than sharp. But muscle pain usually does not come with shortness of breath or a racing heart.
How long can you have a pulmonary embolism without knowing?
Small clots can cause mild symptoms that people ignore for days or even weeks. But most pulmonary embolisms cause noticeable symptoms within hours of the clot reaching the lungs.
Does a pulmonary embolism hurt all the time?
No, the pain can come and go, especially with small clots. It often hurts more with deep breathing and eases with shallow breathing, but the underlying problem does not go away on its own.
Can a pulmonary embolism cause back pain?
Yes, pain can radiate to the back or shoulder because the clot irritates nerves near the diaphragm. This is called referred pain and can be confusing for both patients and doctors.
