When we think of chest pain, we usually think about heart attacks.

According to the American Heart Association (AHA), a heart attack occurs when the blood flow that brings oxygen to the heart muscle is severely reduced or cut off completely, which can be fatal. Heart attack pain can last for hours if untreated.

A heart attack is the most serious symptom of coronary artery disease (CAD), the most common type of heart disease. CAD can produce a type of chest pain called angina.

Angina may feel like pressure or squeezing in your chest and typically happens when you are physically exerting yourself. The discomfort can also be felt in your:

  • Shoulders
  • Arms
  • Neck
  • Jaw
  • Abdomen
  • Back

Angina pain may even feel like heartburn, but it is short lived and typically doesn't last longer than 10 minutes.

If you're experiencing chest pain, it's important to get it checked out, ASAP. Don't hesitate to call 911, especially if it's a new symptom that you've never had before, the pain comes and goes, or the pain gets worse.

All chest pain should be checked out by a healthcare professional. They can determine if it's angina, heart attack pain, or something else.

Chest pain isn't always caused by a heart attach. Some causes can be mild, like heartburn, others can be dangerous, like pancreatitis.

You might be wondering how someone could mistake the symptoms of acid reflux for a heart attack, but there's a reason why it's called heartburn, after all.

Gastroesophageal reflux occurs when a person's stomach contents—including the gastric acids that help break down food—back up into the esophagus, the tube that connects the throat and stomach.

Stomach acid is highly acidic, hence, the burning sensation behind your breastbone; on the pH scale, it scores about a 1 according to the Environmental Protection Agency (EPA) falling somewhere between battery acid and vinegar.

Our stomachs are lined with protective membranes that shield it from the corrosive effects of acid, while our esophagus is not.

The occasional reflux is fairly common and probably nothing to worry about, but if you're experiencing it twice a week or more, you may have gastroesophageal reflux disease (GERD).

Left untreated over time, GERD can cause asthma, chest congestion, and a condition called Barrett's esophagus, which may increase your chances of developing a rare type of cancer, according to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).

It's possible for someone to mistake a strained chest muscle for something more serious, like a heart attack, said Christine Jellis, MD, PhD, a Cardiology Specialist at Cleveland Clinic.

"I had a patient who came in with chest pain, and he was worried he was having a heart attack," said Dr. Jellis. "After taking his history, I learned he had moved [to a new house] and hadn't lifted heavy furniture in years. But he did the right thing, coming in."

Healthcare providers don't expect people to be able to tell the difference between a heart attack and a pulled chest muscle, said Dr. Jellis, but a good way to check is that if you can press on the wall of the chest and it feels even more painful, it's more likely to be a musculoskeletal injury than a problem with your heart.

Costochondritis is an inflammation of the tissue (cartilage) connecting your ribs to your breastbone, according to MedlinePlus.

It's a common and benign (or non-threatening) cause of chest wall pain. But if it's new to you, it's a good idea to get it checked out by a medical professional anyway.

Although healthcare providers can't always pinpoint what triggered the condition, the causes can range from viral infections to chest injuries.

Typically, people feel a type of pressure on their chest wall and—similar to a strained muscle—a tenderness when they press on the area.

In this case, a healthcare provider will probably start by taking your medical history and doing a physical exam. "A physician is going to want to rule out cardiac and other serious issues first," said Dr. Jellis. "It'll most likely be a diagnosis by exclusion."

If you do have costochondritis, the pain typically goes away in a few days or weeks; taking over-the-counter painkillers can help.

The virus that causes chickenpox lingers in your body long after the spots have faded. In fact, the varicella-zoster virus can reactivate in adulthood (usually in people older than 50) as a disease called shingles.

The first symptoms include itching and burning skin. If the area over the chest is affected, someone might mistake this new pain for a heart attack or other cardiac issue, said Salman Arain, MD, an interventional cardiologist at Houston and the Memorial Hermann Heart & Vascular Institute-Texas Medical Center.

A few days later, however, the telltale rash can appear, followed by blisters.

If you think you have shingles, call a healthcare provider ASAP. Antiviral medications can lessen the pain and shorten the duration of the symptoms, but only if you take them within 72 hours of the rash appearing.

If it's too late to take antivirals, a healthcare provider can prescribe a prescription painkiller.

Pericarditis is a condition where there is inflammation in the layers of tissue that surround the heart (called the pericardium).

In 80%–85% of cases, pericarditis is caused by a viral infection, as reported in a 2022 review published in Current Cardiology Reports.

Other causes include bacterial infections, which are less common, and fungal infections, which are rare, according to MedlinePlus. Although there can be other causes as well.

Pain is present in most cases and is described as sharp or stabbing. The pain is located on the left side or front part of the chest, but it can also occur in the neck, shoulder, back, or abdomen.

It's more intense with lying down, breathing deeply, coughing, or swallowing, and it improves with sitting up and leaning forward, which is unique to this condition.

Although pericarditis is usually harmless, according to Dr. Arain, it can really impact your quality of life.

A healthcare provider may diagnose your condition after ordering a CT scan, EKG, or chest X-ray.

Chances are, however, your pericarditis will clear up in a few days or weeks simply through resting or taking over-the-counter pain medicine like ibuprofen, which also helps quell inflammation.

Just because a person's chest pain isn't related to a heart attack doesn't mean that it isn't dangerous. One example: acute pancreatitis—the sudden inflammation of the pancreas, which is located just behind the stomach, says NIDDK.

"Intense abdominal pain can radiate up to the chest," said Dr. Arain. "And the pain from pancreatitis is usually a deep-seated, intense pain."

Oftentimes, pancreatitis occurs when gallstones (hard, pebble-like pieces of material usually made of hardened cholesterol, according to NIDDK) trigger inflammation in the pancreas—something that's more likely to occur in women than men.

If you think you have pancreatitis, get medical attention right away; you'll probably have to stay in the hospital for a few days to get antibiotics, IV fluids, and pain medication.

A healthcare provider will also want to do blood work and order other tests, like a CT scan or abdominal ultrasound.

Chest pain can have a number of pulmonary (lung) causes. Because the lungs and heart are both located in the chest, it can be easy to confuse the origin of the pain.

Pleuritic chest pain occurs when the lining of your lungs (the pleura) becomes inflamed. This can cause "sudden and intense sharp, stabbing, or burning pain in the chest when inhaling and exhaling," according to a 2017 article published in the American Family Physician.

While not related to a heart attack, this type of chest pain can also be serious and is another reason you'll want to get your symptoms checked out by a medical professional.

Pulmonary embolism is the most common serious cause of pleuritic chest pain and is life threatening.

Pulmonary embolism occurs when there is a blockage in a lung artery. This blockage can damage the lungs and cause low oxygen levels in your blood, which can damage other organs as well, according to MedlinePlus.

Pneumonia can also cause pleuritic chest pain. Pneumonia is an infection of the lungs and can range from mild to severe, depending on the cause, according to MedlinePlus. Chest pain from pneumonia will occur when you breathe or cough.

If you've had some type of injury or trauma to your chest, a broken or bruised rib can also cause chest pain. Breathing, coughing, and moving your upper body can be very painful if you've injured your rib.

Having a panic attack can certainly feel like a heart attack; people often believe they're dying when they are having one.

In addition to chest pain, symptoms can include a pounding heart, sweating, shaking, nausea, dizziness, and a feeling of going crazy. It's your body's fight-or-flight response kicking in, according to the American Psychological Association.

Panic attacks tend to crop up suddenly with no warning. People can experience them for a variety of reasons, including:

  • Having a family history of panic attacks
  • A history of childhood trauma
  • Dealing with major life changes and ongoing stress (such as a serious illness of a loved one)
  • Experiencing a traumatic event (such as a robbery or car accident)

If you think you've experienced a panic attack, it can be helpful to visit a healthcare provider. They can rule out any physical issues with your heart, which can help put you at ease.

A provider may also refer you to a mental health professional who can help you treat and manage your symptoms.

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Dyspnea, commonly known as shortness of breath, is one of the common problems faced during pregnancy. Shortness of breath can also be considered as an early symptoms of pregnancy. Generally, dyspnea doesn’t cause any harm to the mother and the growing baby. But still, in some severe complicated conditions, it can lead to difficulty in breathing.

Reasons of breathlessness during pregnancy

An increase in levels of progesterone is the main cause of increase in shortness of breath during the first trimester of pregnancy, explains Dr. Anjali Chaudhary (PT), senior executive physiotherapist, Cloudnine Group of Hospitals, Noida.

it is basically due to increased capacity of lungs. The body adjusts itself to the new hormonal changes. However, other medical conditions such as asthma, anemia and pulmonary embolism, too can contribute to the same. Suitable precautions should be taken for the treatment of asthma and other underlying conditions.

shortness of breath
Keep a check on breathing patterns. Image courtesy: Shutterstock

As the size of the baby grows, other organs get compressed and start changing their position. At around 31st week to 34th week, the growing size of the belly exerts pressure on the diaphragm (the main muscle for breathing). This increase in the size restricts the lungs to expand fully and take in air.

Towards the end of pregnancy, the foetus head settles into the pelvis and eventually exerts less pressure on the diaphragm muscle. Therefore, the shortness of breath eases during the last few days of pregnancy.

How to handle the shortness of breath during pregnancy

You can try various breathing techniques and tips to manage and cope up with the situation of dyspnea or shortness of breath. By following these simple tips you can ease down the breathlessness.

1. Maintain a good posture:

Posture during pregnancy is important. Slouching while sitting will affect your lungs as lungs will not get enough space for expansion while breathing in. This may result in less oxygen intake. Sitting on a chair with your chest slightly bent forward can help relaxing the body and in creating extra space for breathing.

Standing with your back well-supported by a wall and body slightly leaned forward can also help relieve shortness of breath.

2. Sleep in a relaxed position

Dyspnea often leads to inability to sleep at night, leading to waking up several times and creating disturbance in sleep. To avoid this, sleep on the back with head elevated using extra pillows and knees bent with pillows below the feet. The right sleeping posture during pregnancy helps in keeping the airway relaxed and making breathing better.

sleeping posture during pregnancy
The right sleeping posture during pregnancy is important. Image courtesy: Shutterstock

3. Pursed lip breathing:

A very easy and a simple breathing technique that makes each breath deeper by helping release trapped air in the lungs, can help to manage shortness of breath during pregnancy.

Follow the simple steps to perform pursed lip breathing:
* Sit with shoulders relaxed.
* Slowly take in air through nose and keep the mouth closed while inhaling.
* Gently exhale or blow out air with pursed lips as if about to blow a candle.
* Practice for 5-10 minutes for about three to four times a day.

4. Diaphragmatic breathing:

Diaphragmatic breathing is basically deep breathing exercise which is also known as abdominal breathing or belly breathing.

To do diaphragmatic breathing or belly/abdominal breathing, follow these steps:

* Sit on a chair or simply lie down comfortably with knees bent and upper body relaxed.
* Place one hand on the chest and other below the rib cage (over the abdomen/belly) so that you can feel your diaphragm movement while breathing in and breathing out.
* Breathe in slowly and steadily so that the abdomen rises fully while doing so, making the hand to rise. Make sure the hand on the chest stays still.
* Then slowly exhale through pursed lips but make sure the abdomen lowers down while doing so and the hand on the chest remains still.
* Start practicing this exercise for 5-10 minutes for about three to four times a day. Gradually increase the number of times and even place a book over the abdomen to increase the efforts.

deep breathing
Deep breathing is good for lungs. Image courtesy: Shutterstock

5. Deep breathing with arm raise:

Deep breathing exercise with raised arms raises the diaphragm to open up the lungs. This helps to increase the capacity of the lungs and results in more oxygen uptake. It is similar to deep breathing, but along with breathing, hand movement is added.

* Stand and take a deep breath while raising arms slowly over your head. Exhale as you lower your arms. Repeat several times a days or whenever you feel breathlessness.
* Seeking Medical Help for Shortness of Breath during Pregnancy

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Acute respiratory distress syndrome (ARDS) is a noncardiogenic pulmonary edema secondary to inflammation-related lung injury from a variety of causes. It is diagnosed clinically as it is characterized by acute onset bilateral pulmonary infiltrates associated with worsening dyspnea once cardiogenic pulmonary edema and alternate causes of acute hypoxic respiratory failure are ruled out. Pulmonary infiltrates in ARDS are caused by diffuse inflammatory lung injury from a variety of insults including sepsis, pneumonia, aspiration, toxin inhalation, blood transfusion reaction, pancreatitis, amniotic fluid embolism, and many other causes [1]. Amniotic fluid embolism (AFE) is a rare cause of ARDS in the immediate post-partum period and is one of the most severe complications of pregnancy. It is seen in about one out of 40,000 deliveries, and mortality ranges between 20% and 60% [2]. We present a patient who developed hypoxic respiratory failure six hours after delivery and required endotracheal intubation and mechanical ventilation within four hours of symptom onset. Narrowing down the differential diagnosis, atypical AFE remained the most likely explanation for her symptoms. The purpose of this case presentation is to share an unusual and rare case of ARDS secondary to atypical AFE where many of the clinical features of AFE were missing.

A 25-year-old gravida 3 para 2 Hispanic female with anemia of pregnancy and no other medical problems was admitted to the labor and delivery unit at 38 weeks gestation while she was in labor. She followed up with her obstetrician regularly throughout her pregnancy, and her pregnancy course had been uncomplicated. She did not have any history of complicated pregnancy or delivery in the past, no history of surgeries in the past, did not smoke cigarettes or drink alcohol, and did not use any illegal drugs. Her home medications included ferrous sulfate 325 mg daily and prenatal vitamins. The vital signs at presentation were pulse of 89 bpm, blood pressure of 130/85 mmHg, respiratory rate of 18/min, temperature of 98.6°F, and oxygen saturation of 97% on room air. The physical examination was normal, including normal respiratory and cardiovascular examination. The pelvic examination done by the obstetrician was normal for gestational age, and the fetal heart rate was also normal with moderate variability and no decelerations. Her only symptoms were related to her labor, and she denied any recent fever or any respiratory or cardiovascular symptoms. Laboratory workup showed white blood cell (WBC) count of 15.9/mcL (4-10.6/mcL) with 90% neutrophils and hemoglobin (Hb) of 8.8 mg/dL (12-16 mg/dL) with a low mean corpuscular volume (MCV) and mean corpuscular hemoglobin concentration (MCHC) indicative of microcytic and hypochromic anemia, consistent with her previously diagnosed anemia of pregnancy. A healthy male infant was delivered vaginally within one hour of admission, without requiring any instrumentation or surgical procedure, a complete placenta was removed, and a second-degree laceration was successfully repaired. No postdelivery bleeding or any other complications were noted. The patient started complaining of dyspnea six hours after vaginal delivery and developed tachycardia and tachypnea. There was no chest pain, loss of consciousness, nausea, or vomiting, and she was not given any new medicines/food or blood transfusion before/during her symptoms started. Vital signs were as follows: pulse 142 bpm, blood pressure 140/78 mmHg, and temperature 97°F. CT pulmonary angiography (CTA) was performed to rule out pulmonary embolism (PE), which was negative for PE but showed dense bilateral opacities (Figure 1).

CT scan of the abdomen and pelvis with contrast only showed an enlarged uterus, and no other abnormalities were observed. Bedside transthoracic echocardiogram (TTE) showed left ventricular ejection fraction (EF) > 75%, without diastolic dysfunction or hemodynamically significant valvular abnormalities, and there were no vegetations. The patient was transferred to ICU as her oxygen saturation started dropping. She was started on oxygen, initially, a Venturi mask, which was later switched to a nonrebreather mask. However, hypoxia was not corrected, and tachypnea and tachycardia kept getting worse, ultimately requiring endotracheal intubation and mechanical ventilation within four hours of symptom onset. Arterial blood gases (ABGs) showed hypoxic respiratory failure, and the initial PaO2/FiO2 ratio was 95 (PaO2 38 mmHg while on Venturi mask with 40% oxygen saturation). The patient remained hemodynamically stable, no pressor support was required, and no cardiac arrhythmias were observed. Her physical examination at this point revealed bilateral crackles; however, the rest of the physical exam including the gynecological exam remained unremarkable, without any evidence of bleeding or infection. Repeat laboratory workup showed worsening leukocytosis with neutrophilic predominance and lymphopenia (Table 1). Blood and sputum cultures were sent, and broad-spectrum antibiotics including piperacillin-tazobactam 4-0.5 g every eight hours and linezolid 600 mg every 12 hours were started while awaiting culture results. The patient was on high ventilator support at this time and was transferred to a higher level of facility for extracorporeal membrane oxygenation (ECMO).

Laboratory workup 0 hours 10 hours 24 hours Reference range
White blood cells (WBC) 15.9 21.7 26.9 5.9-16.9/mcL
Absolute neutrophil count (ANC) 14.3 19.9 24.6 3.9-13.1/mcL
Absolute lymphocyte count 0.8 0.8 0.7 1-3.6/mcL
Hemoglobin (Hb) 8.8 7.4 7.7 9.5-15.0 g/dL
Platelets 156 207 209 146-429/mcL
Prothrombin time (PT)   10.4 10.3 9.6-12.9 seconds
International normalization ratio (INR)   1 0.99 0.8-1.09
Partial thromboplastin time (PTT)   24.5 55 22.6-35 seconds
Sodium   138 139 130-148 mmol/L
Potassium   3.5 3.6 3.3-5.1 mmol/L
Chloride   108 107 97-109 mmol/L
Bicarbonate   22 25 12-22 mmol/L
Creatinine   0.5 0.6 12-22 mmol/L
Blood urea nitrogen (BUN)   10 10 3-11 mg/dL
Calcium   7.1 7.8 8.2-9.7 mg/dL
Total bilirubin   0.35 0.29 0.1-1.1 mg/dL
Alkaline phosphatase (ALP)   180 168 38-229 units/L
Aspartate transaminase (AST)   32 39 4-32 units/L
Alanine aminotransferase (ALT)   15 18 2-25 units/L
Lactic acid     2.2 0.4-2.0 mmol/L

ARDS was first recognized in the 1960s and described as acute onset hypoxia, dyspnea, and loss of lung compliance after a variety of stimuli, which did not respond to usual respiratory therapy. It was later called adult respiratory distress syndrome due to its similarity to infant respiratory distress syndrome and was finally named ARDS [3]. Normal healthy lungs performed gas exchange as ventilation (V) matches perfusion (Q). At rest, the normal V/Q ratio is approximately equal to 1. This ratio is disturbed in many cardiorespiratory pathologies including ARDS. A normal alveolar-capillary unit consists of capillary endothelium, capillary basement membrane, interstitial space, alveolar epithelium, and alveolar basement membrane. On average, this barrier is only 0.5 µm thick, which allows excellent gas exchange, provided V matches Q. This barrier is disturbed in ARDS. ARDS results from one or more insults that cause diffuse lung injury. The injury results in pro-inflammatory cytokine release including interleukins (IL-1, IL-6, and IL-8) and tumor necrotic factor (TNF), which mediate damage and activation of the endothelium, resulting in increased permeability and release of fluid and proteins into the interstitium, leading to interstitial edema. This protein-rich edema also interferes with surfactant function, leading to an increase in lung compliance. The overall effect is V/Q mismatch leading to impaired gaseous exchange and a decrease in lung compliance causing stiff lungs [1,4]. There are more than 60 etiologies resulting in ARDS, and the list continues to get longer. The most common causes of ARDS include pneumonia, sepsis, and aspiration [5]. Our patient was diagnosed with ARDS using the Berlin definition. A list of differential diagnoses leading to ARDS in our patient with supporting and negating evidence is listed below (Table 2). 

Suspected differentials as a cause of ARDS in our patient Supporting evidence Negating evidence
Sepsis Sepsis is the most common cause of ARDS. The repair of a second-degree vaginal tear was recently performed. Fever, tachycardia, tachypnea, and leukocytosis were present. The patient meets the SIRS criteria for sepsis (temperature > 100, HR > 90, RR > 20, WBC > 12,000). Sudden onset of severe ARDS in a hemodynamically stable patient without definitive sepsis is unlikely secondary to sepsis. The symptoms started within six hours of vaginal tear repair, and the development of sepsis and causing ARDS is unlikely to happen within six hours only.
Infectious pneumonia Infectious pneumonia is a common cause of ARDS. Dyspnea, tachypnea, fever, and tachycardia were present when the symptoms started. Worsening leukocytosis was observed as the symptoms worsened. Dense bilateral pulmonary infiltrates were present, and pneumonia can have a similar appearance on imaging. No cough, dyspnea, or fever were present at the time of admission. The symptoms started within six hours of admission and quickly worsened, which is a short time for pneumonia to develop and get worse. Respiratory cultures and respiratory viral PCR panel including COVID-19 were negative, and no definitive respiratory infection was found.
Aspiration pneumonia Aspiration pneumonia is a common cause of ARDS. Sudden onset of symptoms may be seen with aspiration pneumonitis. The patient did not have any risk factors for aspiration. No nausea, vomiting, loss of consciousness, or any other aspiration events were observed before the symptoms started. Imaging showed diffuse bilateral pulmonary infiltrates rather than segmental or lobar infiltrates especially in dependent pulmonary segments.
Transfusion-related acute lung injury Sudden onset of symptoms No blood products were transfused before the symptoms started.
Amniotic fluid embolism The symptoms started after delivery. Rapid onset and worsening of symptoms are typical for amniotic fluid embolism. One-fourth of the cases of amniotic fluid embolism present with an atypical presentation, which may lack the other clinical features. No fever was present during labor. Amniotic fluid embolism is a rare cause of ARDS. The symptoms usually start within 30 minutes of delivery. No hemodynamic instability, cardiovascular collapse, seizures, or DIC were observed. 

Sepsis is the most common cause of ARDS, and it should be the first differential in consideration in patients with severe infection or new hypotension. Sepsis causes ARDS mainly secondary to systemic inflammation leading to increased pulmonary capillary endothelial permeability. Our patient had nonspecific symptoms related to sepsis, including fever, tachycardia, tachypnea, and leukocytosis, and she met the systemic inflammatory response syndrome (SIRS) criteria for sepsis (as shown in Table 2); however, most of these symptoms are nonspecific and can be seen in systemic inflammation from various etiologies. SIRS criteria are sensitive but lack specificity compared to qSOFA (Quick SOFA) criteria, and the patient met only one qSOFA criterion (RR > 22/min). Furthermore, she remained hemodynamically stable despite severe ARDS, and no definitive source of infection was found [6].

Infectious pneumonia is a common cause of ARDS outside the hospital and is mostly caused by COVID-19, Streptococcus pneumonia, Legionella pneumophila, and gram-negative bacilli. It is unlikely to be the cause of ARDS in our patient as infectious pneumonia presents with cough, dyspnea, and fever and is unlikely to cause sudden onset ARDS in a patient without any preceding respiratory symptoms [7,8]. Furthermore, laboratory workup including respiratory viral panel (includes COVID-19 PCR) and respiratory bacterial cultures was normal. Our patient was fully vaccinated against COVID-19.

Aspiration pneumonia is a recognized complication of general anesthesia, trauma, and ICU patients, especially with an altered level of consciousness. The gastric contents with acidic pH with or without particulate food are aspirated into the lungs, which leads to initial chemical pneumonitis and later may get infected and develop into bacterial pneumonia. Severity can range from mild pneumonitis to severe ARDS. Most events leading to aspiration are either unwitnessed or silent. Our patient did not have any risk factors for aspiration, and no aspiration events were observed. Aspiration can cause chemical pneumonitis initially, however, unlikely to cause a sudden onset of severe ARDS with dense bilateral infiltrates as initial presentation [9].

Transfusion-related acute lung injury (TRALI) is a clinical diagnosis and develops during or shortly after blood product transfusion is performed. ARDS should develop within six hours of blood product transfusion to meet the diagnostic criteria for TRALI. Our patient did not receive any blood transfusions before or during the symptoms started, making this diagnosis unlikely [10].

AFE remains one of the most dreadful complications of pregnancy. It is a rare condition, and the incidence varies in different parts of the world, usually between 1.9 and 6.1 cases per 100,000 deliveries [11]. It was initially reported in 1926, though it was described in the case series for the first time in 1941. The pathogenesis is not clear; however, it is believed to result from the entry of amniotic fluid into the maternal systemic circulation secondary to disruption of a barrier between the amniotic fluid and maternal circulation usually at the time of delivery. Entry of amniotic fluid into maternal circulation results in a severe inflammatory response that causes clinical manifestations of AFE. There is no mechanical obstruction of pulmonary vasculature from the amniotic fluid; however, elevated pulmonary pressures are still seen due to ARDS.

Elevated pulmonary pressures and the direct effect of the inflammatory mediators on the myocardium may lead to cardiac dysfunction, which may also contribute to pulmonary edema. Symptoms usually start during labor or 30 minutes after delivery; however, cases occurring during the first and second trimesters have been reported. Onset is abrupt most of the time, and the symptoms progress rapidly in a catastrophic manner. Clinical features include hypoxic respiratory failure secondary to ARDS, hemodynamic compromise usually from cardiac arrest (typically ventricular tachycardia or fibrillation), and bleeding secondary to disseminated intravascular coagulopathy (DIC). Laboratory workup may show findings suggestive of DIC (elevated D-dimer, low fibrinogen, and thrombocytopenia), leukocytosis, and anemia (secondary to hemorrhage). Chest imaging shows dense bilateral infiltrates. The diagnosis is clinical, and it is a diagnosis of exclusion as there is no confirmatory test available [1,12]. However, all clinical findings are not seen in every patient, and there are many atypical cases described in case reports. One-fourth of all patients present only with hypotension and acute respiratory failure. Rarely, DIC may be an initial presentation, or it may be absent [13]. Our patient may have atypical AFE as the patient was completely asymptomatic at the time of admission, and the symptoms rapidly developed and progressed after vaginal delivery to the point that she required intubation and later ECMO over less than 24 hours. Sepsis can be another possibility; however, AFE is more likely to cause a rapid onset of worsening ARDS after delivery in a patient without any evidence of sepsis or septic shock.

Other risk factors for ARDS include lung and hematopoietic stem cell transplant, drug overdose and idiosyncratic reaction, severe trauma including lung contusion and fat embolism, acute pancreatitis, near drowning, thoracic surgery, etc., none of which were observed or suspected in our patient.

ARDS is characterized by noncardiogenic pulmonary edema and is one of the most common diagnoses requiring ICU admission. It presents with acute onset hypoxic respiratory failure, associated with new bilateral pulmonary infiltrates. It is important to promptly diagnose and treat ARDS to reduce the associated high mortality. There are over 60 known causes of ARDS, and the list is getting longer with time. AFE is a very rare cause of ARDS, which is seen within six hours after delivery, and is usually associated with hemodynamic instability secondary to cardiac arrhythmias and bleeding secondary to DIC. Many atypical cases of AFE have been reported. Our patient did not have a clear cause of ARDS, and after ruling out the other diagnoses, the atypical AFE remained the most likely explanation for ARDS. The purpose of this case report is to highlight the importance of having atypical AFE among the differential diagnoses if ARDS develops in a pregnant woman especially after delivery, even if some of the clinical features of AFE are missing. 

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Hyperventilation is a condition when you breathe deeper and more rapid than normal. It is more common in women than men and in people between 15 to 55 years of age. It is also most commonly associated with panic attacks.

We breathe in oxygen and breathe out carbon dioxide. During hyperventilation, we tend to breathe excessively, that is, we over-breathe and this leaves us breathless. This increases the removal of carbon dioxide from the blood, so the carbon dioxide pressure inside the blood decreases causing a condition called respiratory alkalosis where the blood becomes more alkaline. Alkalosis further causes the blood vessels supplying blood to the brain to constrict.


Scientists believe hyperventilation is more of a consequence rather than a cause of certain diseases or conditions. In most cases, hyperventilation is caused by –

  • Stress, anxiety, depression, anger
  • Bleeding
  • Severe pain
  • Drug overdose, for example, aspirin overdose
  • Pregnancy

Risk Factors

There are few clinical conditions that increase your risk of suffering from hyperventilation. These include -

Anxiety or panic disorder: Anxiety and panic disorder which is a severe form of anxiety, is probably the most common cause of hyperventilation. This type of hyperventilation is called acute or sudden hyperventilation. The two almost form a vicious cycle, in the sense, anxiety can lead to hyperventilation, and this rapid breathing can make you panic. Anxiety is also accompanied by faster heart rate, sweating, trembling and dizziness.

Heart failure and heart attack: Heart failure, a chronic condition in which your heart is no longer able to pump out oxygen-rich blood, can cause you to hyperventilate. But this type of hyperventilation is called chronic hyperventilation. You can have heart failure if your high blood pressure is not well controlled or if you have coronary artery disease wherein the blood vessels supplying blood to the heart become narrow.

Lung diseaseLung disease such as asthma, chronic obstructive pulmonary disease (COPD), pulmonary embolism are some of the common lung diseases that cause chronic hyperventilation.

  • Asthma – This disease is caused by inflammation in the airways in which the airways of the lungs swell and narrow. Symptoms include cough, wheezing, hyperventilation, shortness of breath, tightness in the chest, difficulty breathing, anxiety, and sweating.
  • Chronic obstructive pulmonary disease (COPD) – This is a disease where you have long-term cough with mucus (chronic bronchitis) mostly in combination with emphysema which gradually destroys your lungs. Smoking, second hand smoke and pollution are the leading cause of COPD.
  • Pulmonary embolus – Any embolus is a blockage of artery because of blood clot, tumor cells or fat. When the blockage is in the artery leading to the lungs it is called pulmonary embolus.

PneumoniaPneumonia is an infection of the lung by the Streptococcus pneumoniae bacteria. COPD, smoking, brain disorders, immune system problems, or sometimes even a surgery can increase the chances of being infected by pneumonia.

KetoacidosisKetoacidosis is a condition in which your body cannot use sugar as fuel (energy source) because of insufficient or no insulin. During such cases, the body fat break down to supply the required fuel. This results in build-up of waste products called ketones. Ketoacidosis normally occurs in diabetics and is considered to be a life threatening condition.

Here's what you should know about RRate – an app to measure breathing rate within 10 seconds.


The symptoms are usually caused due to reduced blood supply to the brain. These include -

  • Lightheadedness and dizziness
  • Numbness and tingling in the fingertips, arms and around the mouth
  • Chest pain
  • Confusion, palpitation and shortness of breath
  • Shortness of breath
  • Bloating and belching
  • Weakness

However, severe hyperventilation can even cause loss of consciousness.


The treatment options depend on what’s causing your hyperventilation. Let’s take a look at some of them.

Anxiety or panic disorder: 

  • Psychotherapy
  • Cognitive-behavioural therapy where you are guided to identify and challenge the negative thinking patterns causing anxiousness and panic.
  • Exposure therapy where you confront your fears in a controlled environment.
  • Medication such as benzodiazepines and anti-depressants combined with self help therapies and behavioural therapies.

Heart failure and heart attack:

  • Medicines that treat the symptoms and prevent the heart failure from getting worse, for example, drugs to reduce cholesterol, keep your blood from clotting, reduce arrhythmias, open up clogged blood vessels, and other symptoms. Caution – Ibuprofen and naproxen may worsen heart failure.
  • Devices such as pacemaker and defibrillator.
  • Coronary bypass surgery or angioplasty with or without stenting. Heart valve surgery may also be suggested by surgeons.
  • Intra-aortic balloon pump (IABP) and left ventricular assist device (LVAD) are two treatments in case of end stage heart failure when no other treatment work and you are waiting for a heart transplant.


  • Inhalers with steroids or long acting beta-agonists as maintenance or controller medicines.
  • Quick relief medicines such as short-acting inhaled bronchodilators or oral corticosteroids.
  • Hospital stay in case of severe asthma where you will be given breathing assistance and intravenous medications.

Chronic obstructive pulmonary disease (COPD):

  • Bronchodilators to open the airways.
  • Steroids administered orally, intravenously, or through inhalers.
  • Antibiotics in case of respiratory infections.

Pulmonary embolus: Pulmonary embolus is an emergency situation that needs hospitalization. You will be given clot dissolving medication and then blood thinners to prevent formation of new clots.


  • Fluids
  • Antibiotics
  • Oxygen therapy

Ketoacidosis: The treatment requires hospitalization where the doctor will correct the high blood sugar level and/ or treat the infection causing ketoacidosis.

Read how to beat respiratory disorders with yoga.

Alternative Remedies

If you are over-breathing due to stress, panic, anger or depression, (and this is the most common cause) try the following breathing techniques to control hyperventilation.

  • Try breathing once every 5 seconds or slow enough till gradually your over-breathing stops.
  • Purse your lips as if you are whistling and breathe.
  • Pinch one nostril and breathe through your nose.
  • Place one hand on your belly and the other on your chest. Take a deep breath as if you are filling your belly and let your belly push your hand out. Exhale slowly pushing the air out of your belly with your hands. Repeat these steps 5 to 10 times.

The purpose of these breathing techniques is to get more carbon dioxide circulating in your blood. If hyperventilation continues for 30 minutes, get medical help. Also get medical attention if you are hyperventilating for the first time, or if you have fever, bleeding or pain.

news starts

If you think your chest tightness may be a sign of a heart attack, call 911 immediately.

If you have asthma, you may experience a feeling of chest tightness from time to time. These episodes are usually accompanied by wheezing, shortness of breath, and a chronic cough. Chest tightness can be anxiety-provoking, and it is often a sign of worsening asthma control and/or an impending asthma attack.

This article will explain the symptoms and causes of chest tightness in asthma and how it is treated. It will also explain when chest tightness requires emergency treatment.

Theresa Chiechi / Verywell

Symptoms of Chest Tightness in Asthma

When you have chest tightness due to your asthma, you may feel like you can't easily push air in and out of your chest. With asthma, mild chest tightness can be present all or most of the time, but it may worsen in response to asthma triggers and in the hours or minutes before an asthma exacerbation.

Symptoms of chest tightness include:

  • A feeling that your chest is constricted, as if there's a band around it
  • A sense that you're trying to push against your chest from the inside as you breathe
  • A struggle to fully exhale (breathe out)
  • Difficulty inhaling (breathing in)

Not all people who have asthma experience chest tightness. But there is a type of asthma described as chest tightness variant asthma (CTVA) in which this symptom is especially frequent.

When the feeling of chest tightness triggers anxiety, your sense of not being able to move air through your lungs can worsen.

Asthma Doctor Discussion Guide

Get our printable guide for your next healthcare provider's appointment to help you ask the right questions.

Causes of Chest Tightness in Asthma

Chest tightness occurs as a result of several asthma-induced physical changes.

When asthma acts up, your bronchi constrict (narrow), and your lungs become inflamed and produce excess mucus. This makes it hard for air to pass through, even as you put all your effort into breathing.

A number of triggers can lead to worsened chest tightness when you have asthma, including:

How to Treat Chest Tightness

There are several different types of medications that can help control asthma symptoms, including chest tightness.

Medications commonly used to treat asthma symptoms include:

Bronchodilators: Bronchodilators relax muscles around the airways, reducing chest tightness and making it easier to breathe. Short-acting bronchodilator inhalers (also called "rescue inhalors") like albuterol work right away to provide immediate relief from symptoms. Long-acting bronchodilators like Spiriva (tiotropium bromide) are used long-term and are not intended for quick relief.

Corticosteroids: Inhaled corticosteroids, such as Pulmicort (budesonide) are available to reduce swelling in the airways and make it easier to breathe. In some cases, oral versions are recommended.

Anticholinergics: Anticholinergenics (given via an inhaler or nebulizer) prevent muscle bands from tightening around the airways to relieve chest tightness among other symptoms. This type of medicine is typically used in combination with an inhaled corticosteroid and taken daily.

If you have an established diagnosis of asthma with chest tightness, it's important that you promptly use your rescue asthma treatment when you develop this symptom.

Sometimes chest tightness in asthma is relieved with bronchodilators, but some people with asthma experience improvement of chest tightness only with other asthma treatments.

Asthma with chest tightness that is relieved with the use of asthma drugs except bronchodilators (CTRAEB) might differ from asthma with chest tightness relieved with bronchodilator use (CTRB). The latter is associated with inflammation and bronchoconstriction, while the former is only associated with inflammation.

Avoiding things that trigger your asthma can also keep asthma attacks at bay, as can reducing stress, a known asthma trigger.

Complications and Risk Factors Associated with Chest Tightness

Recurrent episodes of chest tightness may indicate that your asthma isn't well-controlled. When you have sudden chest tightness with asthma, it can be a sign that your symptoms are on the way to escalating into an asthma attack if you do not follow your asthma action plan.

Chest tightness and pain can also be a sign of serious conditions such as heart disease or pulmonary embolism (PE).

Are There Tests to Diagnose the Cause of Chest Tightness?

Several different types of tests may be used to help diagnose the cause of your chest tightness and whether asthma or another condition is to blame.

Common diagnostic tests include:

  • Lung function tests, including spirometry, to test how well your lungs work
  • Peak expiratory flow (PEF) tests to measure how fast you can blow air out using maximum effort
  • Fractional exhaled nitric oxide (FeNO) tests to measure levels of nitric oxide in your breath when you breathe out. High levels of nitric oxide may mean that your lungs are inflamed
  • Chest X-ray or computerized tomography (CT) scan

Your healthcare provider may also want to do tests to rule out other causes of chest tightness.
The list of chronic conditions that can cause chest tightness along with other symptoms similar to those of asthma is long and includes chronic obstructive pulmonary disease (COPD), lung cancer, and pulmonary sarcoidosis.

If you seem to be in distress, your medical team will rapidly assess you to determine if you are experiencing a medical emergency, such as a heart attack or a lung emergency (like a PE or a pneumothorax). Often, people who have chest tightness due to these and other emergencies are visibly short of breath.

Your medical team will check your pulse, respiratory rate, and blood pressure. Depending on your symptoms, you may have an electrocardiogram (EKG) to check your heart rhythm and pulse oximetry to check your oxygen saturation as well.

When to See a Healthcare Provider

Whether you have been diagnosed with asthma or not, it is important that you get medical help for your chest tightness.

Call your healthcare provider's office for an appointment if:

  • You experience mild chest tightness at the same time every day or when your asthma medicine is wearing off.
  • You only experience chest tightness along with your other asthma symptoms.
  • You started having occasional chest tightness when you had a change in your asthma medication.
  • Your chest tightness improves when you use your asthma rescue treatment, but is recurrent.

Call 911 or go to an emergency room for chest tightness if:

  • The discomfort is severe
  • You have associated chest pain, tachypnea (rapid breathing), nausea, sweating, dizziness, or fainting
  • The sensation is localized to a specific area of your chest
  • Your chest tightness is associated with physical activity or progressively worsens
  • You have a feeling of impending doom or that something is horribly wrong


Chest tightness is a common symptom in people with asthma and may be accompanied by wheezing, shortness of breath, and coughing. Chest tightness may be a sign that an asthma attack is coming on or that your asthma is worsening. In some cases, it may be a sign of serious heart and lung problems.

A Word From Verywell

Chest tightness is an especially distressing and anxiety-provoking symptom in asthma. If you tend to experience recurrent chest tightness as part of your asthma, it's important that you learn to recognize the need for rescue treatment and that you seek medical attention if your chest tightness seems worse or is accompanied by unfamiliar symptoms.

Frequently Asked Questions

  • What does chest tightness in asthma feel like?

    The main symptom of chest tightness include feeling like you have a band constricting your chest and finding it difficult to exhale.

  • How is chest tightness treated?

    Chest tightness is treated with a variety of medications, including long- and short-term bronchodilators, anticholinergenics, and corticosteroids. For immediate relief of symptoms, a short-acting, or "rescue" inhaler is necessary.

  • What causes chest tightness in asthma?

    Chest tightness occurs when your airways constrict, making it hard to exhale.

  • When is chest tightness in asthma an emergency?

    Chest tightness is an emergency when the discomfort is severe, especially in one area of the chest, and if it is accompanied by nausea, dizziness, or severe shortness of breath.

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PORT RICHEY — When Ryan Naylor hurt his ankle during kickball practice in May, he did what many would do: He Googled it.

Ice and an Epsom salts bath didn’t work. Turns out there is no surefire home remedy for a ruptured Achilles tendon.

Naylor, 26, didn’t have health insurance. So he stayed home for 36 hours until he couldn’t take the pain anymore.

His fiancé, Brittany Nolan, took him to the emergency room at HCA Florida Trinity Hospital where doctors wrapped his ankle in a splint. They told him to see a specialist. The hospital bill and the one for surgery came out to $14,000.

Related: How to recover from medical debt

The couple, who were saving for a fall wedding, were devastated. They had no way of knowing that Naylor was days away from a medical emergency that would almost claim his life and leave them $170,000 in debt.

“I’m trying to do the right thing but at the same time I feel there’s no way out,” he said. “I feel like I’m financially ruined.”

Medical debt common

Some 100 million Americans — including 41% of U.S. adults — are saddled with medical debt, according to a nationwide poll published in June by the Kaiser Family Foundation. In one quarter of cases, the debt is more than $5,000.

The survey found that medical debt is often hidden in credit card debt, loans from family or friends and payment plans to hospitals and clinics.

Medical debt also remains the largest single cause of bankruptcy in America, according to the National Consumer Law Center. An estimated 530,000 Americans cite medical debt in bankruptcy court filings every year.

The situation may be worse in Florida, one of 13 states that continue to reject a provision of the Affordable Care Act that would expand Medicaid eligibility to over 400,000 low-income residents. The state ranked 47th for access to health care and affordability of treatment in a national analysis released last month by the Commonwealth Fund, a New York foundation that supports independent research on health.

Ryan Naylor, 26, pushes himself up the stairs of his apartment complex in Port Richey. "This leg - I just wish I could cut it off sometimes and be done with it," Naylor said after getting back into his apartment.
Ryan Naylor, 26, pushes himself up the stairs of his apartment complex in Port Richey. "This leg - I just wish I could cut it off sometimes and be done with it," Naylor said after getting back into his apartment. [ LAUREN WITTE | Times ]
Related: Florida's preventable deaths rose during the pandemic. It wasn't just COVID.

After his May 13 surgery, Naylor followed his surgeon’s orders to stay off his ankle.

Six days into recovery, he felt a sharp pain in his side that with every breath felt like “an icepick in his organs.” Fearing more debt, he endured clamminess, frozen feet and sweats for about 13 hours.

He only agreed to go to a hospital when he started to feel like he might die. Even then, he decided an ambulance would be too expensive.

His ankle still in a protective boot, he crawled down the 16 stairs from their second-floor apartment to his truck.

Emergency room doctors said he had suffered a saddle pulmonary embolism, a potentially fatal blockage of the main artery between the heart and lungs. He was given blood thinners and the next morning underwent emergency surgery. Doctors removed 27 blood clots, some several inches long. He spent almost four days in intensive care.

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About 27 blood clots were removed from Ryan Naylor during emergency surgery for a saddle pulmonary embolism on May 20.
About 27 blood clots were removed from Ryan Naylor during emergency surgery for a saddle pulmonary embolism on May 20. [ Ryan Naylor ]

The embolism was almost certainly a result of his ankle surgery, a cardiologist told Naylor. Inactivity after surgery causes blood flow to slow, increasing the likelihood of clots.

The bills started to arrive two weeks later: $652 for a chest X-ray; $2,161 for an electrocardiogram, $1,121 for two doctors who each provided an hour of critical care. Naylor hasn’t received his final hospital bill yet but a 12-page itemized hospital statement also came in the mail; it totaled $155,000.

Deb Gordon, a contributor at MoneyGeek, a personal finance website, and co-director of the Alliance of Professional Health Advocates, said she’s not surprised so many Americans are on the hook to health care providers.

Her group represents professional health advocates who help consumers find and pay for health care. She said most households lack enough savings to deal with an unexpected medical bill, and many in debt feel they’ll never recover.

And health care costs and premiums have risen so sharply over the past three decades that many fear seeking medical attention, putting it off until it’s too late, she said.

“We have a system that leaves virtually half the population unable to pay for their care,” she said. “It’s crazy how this wealthy industrialized nation with the ‘best medical care in the world’ cannot provide basic services.”

Care for the uninsured

In the United States, some safety nets exist for the uninsured.

Those just below the federal poverty level qualify for Medicaid in most states. Administrators at HCA Trinity screened Naylor on his first visit but determined he earned too much to be eligible for the program.

Hillsborough, Pinellas and Polk counties provide basic safety-net programs known as indigent care, but Pasco County, where Naylor lives, has no such option.

Naylor may have qualified for insurance through the Affordable Care Act, but he said he didn’t know about it. A record 14.5 million Americans obtained insurance through the federal program this year.

Related: Florida sets new record for Affordable Care Act enrollment

Hospitals typically treat anyone who arrives in the emergency room.

Some, like Bayfront Health St. Petersburg, offer free care to uninsured patients who earn less than 225% of the federal poverty level. That’s about $30,000 for a single individual or $62,400 for a family of four. The hospital also provides help in cases where a medical bill is more than a quarter of a patient’s gross income.

The Trinity hospital where Naylor was treated operates charity programs for patients who cannot afford treatment. In 2021, its charity and uncompensated care totaled $21.5 million.

Naylor has applied for assistance but has yet to hear if he will qualify.

Recovering financially

Patients have some options to try and get out of medical debt.

A recent study by Forbes found that 10% of medical bills are wrong and can be challenged. Gordon said people should scrutinize bills to ensure itemized treatments and medicines match what was given.

Medical charges, especially unexpected ones, can also be challenged. Those in debt should also reach out to the medical provider and try to negotiate a smaller debt or a manageable repayment plan.

A medical credit card can be a good option but only if it can be paid off quickly, she said.

“Otherwise, you will find yourself in a situation with a crushing medical bill bearing high interest rates,” she said.

Bankruptcy should only be used as a last resort, she said. Once on someone’s record, it can affect their ability to rent or buy a home or borrow money as well as negatively impact their credit score.

“It can have a lot of implications for your financial life and take a lifetime to recover from,” she said.

Lingering problems

Three weeks after the surgery that likely saved his life, Naylor still feels pain in his lungs and sometimes coughs up blood.

His ankle may take up to a year to heal. Naylor should be in physical therapy but can’t afford it. Instead, he uses resistance bands for exercises and stretches at home.

Concerned about the risk of further blood clots, his cardiologist also advised exercise. At least once an hour, he stands up and circles his small apartment with a walker.

His cardiologist prescribed blood thinners for at least six months but, depending on test results, he may need to take the medication permanently.

He knows he could have died but the weight of medical debt has made it hard to feel like he got a second chance.

With so many different bills to pay, it feels impossible to know where to start. He’s already started getting second bills that warn his balance may be passed to debt collectors.

The $9,000 he put on a medical credit card must be paid off in six months or the interest rate will rise to about 22%.

Adding to his stress is that he’s not recovered enough to work at his job in the lumber section of Home Depot in New Port Richey. He is getting about 60% of his regular pay through short-term disability.

Ryan Naylor, 26, stretches his leg out in preparation to walk outside while Brittany Nolan, 32, gets his bands out on Thursday, July 7, 2022 in Port Richey.
Ryan Naylor, 26, stretches his leg out in preparation to walk outside while Brittany Nolan, 32, gets his bands out on Thursday, July 7, 2022 in Port Richey. [ LAUREN WITTE | Times ]

Like many in medical debt, the couple started a GoFundme campaign to try and raise money. It has brought in $6,300, but donations have slowed.

They had planned a wedding this fall with upward of 50 guests in Daytona Beach where many of Nolan’s family lives.

Instead, they married June 26 so Naylor can be added to the medical insurance his wife gets through HCA where she works as a patient care tech. They hope that will cover the cost of physical therapy and blood-thinning medication. Even with a prescription drug card, it costs about $600 a month.

The couple said their vows in front of about 15 close friends and family at A.L. Anderson Park then celebrated with a meal at Tarpon Turtles restaurant.

Instead of a wedding gown, Nolan wore a $21 white floral maxi dress she ordered online. The ring she placed on Naylor’s finger was silicone not gold.

After living for six years in their 750-square foot, one-bedroom apartment, they are desperate to move somewhere bigger, ideally their own home where they could start a family.

That modest dream now feels beyond their reach.

Editor’s note: After the Tampa Bay Times contacted HCA West Florida Division, hospital officials told Naylor his application for assistance for the $4,000 hospital bill for his Achilles tendon treatment will be significantly reduced. When asked how much the aid would reduce his bill, officials didn’t elaborate.

Ryan Naylor, right, and Brittany Nolan during their wedding ceremony at A.L. Alexander Park in Tarpon Springs on June 26.
Ryan Naylor, right, and Brittany Nolan during their wedding ceremony at A.L. Alexander Park in Tarpon Springs on June 26. [ Ryan Naylor ]

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Oxygen saturation is a measure of how much oxygen is in your blood. Your organs and tissues need oxygen to work. Oxygen can "hitch a ride" in your red blood cells and travel through the bloodstream to get where it needs to go in your body.

For most healthy adults, a normal oxygen saturation level is between 95% and 100%. An "O2 sat" level below this range requires medical attention because it means your body isn't getting enough oxygen.

This article covers conditions that affect the amount of oxygen in your blood and the complications of having low oxygen saturation. You will also learn how to measure your blood oxygen levels and when to seek treatment.

Verywell / Laura Porter

How Blood Gets Oxygenated

To understand how blood gets saturated with oxygen, you have to know about the air sacs in the lungs called alveoli. There are millions of these microscopic air sacs in the lungs. They exchange oxygen and carbon dioxide molecules to-and-from the bloodstream.

As oxygen molecules pass through the alveoli, they bind to a substance in the blood called hemoglobin.

Oxygen "hitches a ride" on the hemoglobin as it circulates until it gets dropped off to the body's tissues. Then, hemoglobin picks up carbon dioxide from the tissues and transports it back to the alveoli. Once there, the cycle can begin all over again.

The level of oxygen in your blood depends on several factors:

  • How much oxygen you breathe in
  • How well the alveoli swap carbon dioxide for oxygen
  • How much hemoglobin is concentrated in red blood cells
  • How well hemoglobin attracts oxygen

Most of the time, hemoglobin contains enough oxygen to meet the body's needs. However, some diseases reduce hemoglobin's ability to bind to oxygen.

Each one of your blood cells contains around 270 million molecules of hemoglobin. Any health condition that limits your body's ability to produce red blood cells can result in low hemoglobin levels, which in turn limits the amount of oxygen that can saturate your blood.

Conditions That Affect Oxygen Saturation

Blood disorders, problems with circulation, and lung issues can prevent your body from absorbing or transporting enough oxygen. When this happens, it can lower your blood's oxygen saturation level.

Examples of conditions that can affect your oxygen saturation include:

  • Respiratory infections (e.g., a cold, the flu, COVID-19): Any condition that affects your ability to breathe will affect your oxygen intake
  • Chronic obstructive pulmonary disease (COPD): A group of chronic lung diseases that make it difficult to breathe
  • Asthma: A chronic lung disease that causes airways to narrow
  • Pneumothorax: A partial or total collapse of the lung
  • Anemia: Not having enough healthy red blood cells
  • Heart disease: A group of conditions that affect the heart's function
  • Pulmonary embolism: When a blood clot causes blockage in an artery of the lung
  • Congenital heart defects: A structural heart condition that is present at birth

How to Measure Your Blood Oxygen Levels

Oxygen saturation is measured in one of two ways: an arterial blood gas test (ABG or Sa02) or pulse oximetry (Sp02).

ABG is usually only done in a hospital, while pulse oximetry can be done in other healthcare settings (like a provider's office) and even at home.


An ABG value refers to the levels of oxygen and carbon dioxide in blood running through your veins.

During an ABG, a nurse or lab technician draws blood from an artery, such as the radial artery in the wrist or the femoral artery in the groin. The sample is immediately analyzed by a machine or in a lab.

Your ABG value can give your healthcare provider a sense of how efficiently the hemoglobin in your blood exchanges oxygen and carbon dioxide.

Pulse Oximetry

A pulse oximetry reading reflects the percentage of oxygen found in arterial blood.

Unlike the ABG test, pulse oximetry does not involve a needle (non-invasive). Instead, the test uses a sensor to read wavelengths reflected from the blood. The probe is attached to your finger, earlobe, or another place on the body. A pulse oximeter can give results on a screen in just a few seconds.

People can monitor their oxygen saturation levels using wearable pulse oximetry devices—some smartwatches even have this feature. You can also buy a pulse oximetry device at your local pharmacy or online.

Oxygen Saturation Levels
Reading ABG Level O Sat Result
Below Normal < 80 mm Hg  < 95%
Normal > 80 mm Hg 95% to 100%

What Causes Decreased Oxygen Saturation?

A drop in oxygen saturation in the blood is called hypoxemia. It can be caused by:

  • Less oxygen in the air (for example, when you are flying in an airplane)
  • Conditions that affect breathing (such as asthma and COPD)
  • Conditions that affect oxygen absorption (such as pneumonia)
  • Having too few red blood cells or hemoglobin (anemia)
  • Breathing in another substance (such as carbon monoxide or cyanide) that binds more strongly to hemoglobin than oxygen does

How to Raise Blood Oxygen Fast

If your O2 saturation level is low, you need to call your provider. If they're very low, you might need to seek emergency medical care.

You can also take a few steps right away to try to increase your blood oxygen levels:

  • Sit up straight rather than laying flat
  • Get some fresh air or go inside if you are outdoors and it is very hot/very cold
  • Cough to loosen up any mucus (like from allergies or a cold/the flu)
  • Check that you are not taking "shallow" breaths; you need to take deep, full breaths to get oxygen into your blood

Complications of Low Oxygen Saturation

Low oxygen saturation in the blood can mean there's less oxygen in the body's tissues, including the organs and muscles. When this happens, it's called hypoxia.

Your cells can adapt to a lack of oxygen when the deficiency is small. However, with larger deficiencies, cell damage and cell death can happen.

Hypoxia usually happens because there is not enough oxygen in the blood (hypoxemia). However, it can also happen when:

  • There are not enough red blood cells to carry oxygen to the tissues (e.g., from severe bleeding after a trauma or conditions like sickle cell anemia).
  • There is inadequate blood flow (e.g., a stroke occurs when there is low blood flow to a region of the brain; a heart attack occurs when there is low blood flow to the heart muscles).
  • The tissues require even more oxygenated blood than can be delivered (e.g., severe infections that cause sepsis may result in hypoxemia and eventually organ failure)

Treating Low Oxygen Saturation

Generally speaking, an oxygen saturation level below 95% is considered abnormal. An O2 sat below 90% is an emergency.

If someone's oxygen saturation is dangerously low, they will need oxygen therapy—sometimes urgently.

The brain is the most susceptible organ to hypoxia. Brain cells can begin to die within five minutes of oxygen deprivation. If hypoxia lasts longer, it can lead to coma, seizures, and brain death.

It is very important to find out the cause of low oxygen saturation so the problem can be fixed.

For example, with chronic conditions such as COPD and asthma, the cause of hypoxia is usually low air exchange in the lungs and alveoli. In addition to oxygen therapy, steroids or rescue inhalers (bronchodilators) might be needed to open the airways.

In circulatory conditions like heart disease, inadequate blood flow reduces oxygen delivery. In this case, medications that improve heart function, such as beta-blockers for heart failure or prescription medications to treat heart arrhythmias, can help improve oxygenation.

With anemia, the blood supply to the tissues is reduced because there are not enough healthy red blood cells with hemoglobin to carry oxygen. Sometimes, a red blood cell transfusion is necessary to increase a person's level of healthy red blood cells.


Oxygen saturation is the measure of how much oxygen is traveling through your body in your red blood cells. Normal oxygen saturation for healthy adults is usually between 95% and 100%.

If you have a chronic health condition that affects your lungs, blood, or circulation, regularly tracking your oxygen saturation is important. An O2 sat level below 95% is not normal and requires immediate medical attention.

Frequently Asked Questions

  • Which finger is best for an oximeter?

    Most oximeters work best when used on the middle finger. Some studies have shown that the right middle finger works best. In some people, the right thumb may also work well.

  • How long does it take for oxygen levels to return to normal after COVID?

    COVID-19 can damage your lungs and affect your breathing. A lot of people who have COVID experience low 02 sats—sometimes dangerously low.

    We are still learning about how COVID affects the lungs. It can take months for the lungs to heal after COVID. Some people develop lasting breathing problems after they have the infection.

  • What is a normal O2 sat for a child?

    Normal oxygen saturation levels are the same for kids as they are in adults; between 95% and 100%.

  • Is 93 SpO2 normal while sleeping?

    Oxygen levels above 90% are normal when you're asleep. If your O2 sats are lower than that while you're sleeping, it could be a sign that you have a disorder like sleep apnea.

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Hafen BB, Sharma S. Oxygen Saturation. [Updated 2021 Aug 12]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-.

  2. Minnesota Department of Health. Oxygen Saturation, Pulse Oximeters, and COVID-19.

  3. U.S. Food and Drug Administration. Pulse oximeter accuracy and limitations: FDA safety communication.

  4. McGill - Office for Science and Society. Under the microscope: Blood.

  5. Collins JA, Rudenski A, Gibson J, Howard L, O'Driscoll R. Relating oxygen partial pressure, saturation and content: the haemoglobin-oxygen dissociation curve. Breathe. 2015;11(3):194–201. doi:10.1183/20734735.001415

  6. Sarkar M, Niranjan N, Banyal PK. Mechanisms of hypoxemia. Lung India. 2017 Feb;34(1):47-60. doi:10.4103/0970-2113.197116

  7. Doyle GR, McCutcheon, JA. 5.6: Management of Hypoxia. Clinical Procedures for Safer Patient Care; Chapter 5: Oxygen Therapy.

  8. McKenna H, Murray A, Martin D. Human adaptation to hypoxia in critical illnessJ Appl Physiol. 2020 Sep;129(4):656-663. doi:10.1152/japplphysiol.00818.2019

  9. Caboot J, Allen J. Hypoxemia in sickle cell disease: Significance and management. Paediatr Respir Rev. 2014 Mar;15(1)17-23. doi:10.1016/j.prrv.2013.12.004

  10. Ferdinand P, Roffe C. Hypoxia after stroke: a review of experimental and clinical evidenceExp Trans Stroke Med. 2016 Dec;8(9):1-8. doi:10.1186/s13231-016-0023-0

  11. Pavez N, Kattan E, Vera M, et al. Hypoxia-related parameters during septic shock resuscitation: Pathophysiological determinants and potential clinical implications. ATM. 2020 Jun;8(12):784. doi:10.21037/atm-20-2048

  12. Yale Medicine. Should you really have a pulse oximeter at home?.

  13. National Institute of Neurological Disorders and Stroke. Cerebral hypoxia information page.

  14. Cortés Buelvas A. Anemia and transfusion of red blood cellsColomb Med. 2013 Dec;44(4):236-242.

  15. Basaranoglu G, Bakan M, Umutoglu T, Zengin SU, Idin K, Salihoglu Z. Comparison of SpO2 values from different fingers of the handsSpringerplus. 2015;4:561. Published 2015 Sep 29. doi:10.1186/s40064-015-1360-5

  16. Johns Hopkins Medicine. COVID-19 Lung Damage.

  17. Children's Health. Pediatric Oxygen Titrations.

  18. University of Iowa Health Care. Pulse oximetry basic principles and interpretation.

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Each year, around 900,000 people in the United States are affected by pulmonary embolism and deep vein thrombosis (DVT), which are conditions involving blood clots.

Though there are many causes of blood clots, living a sedentary lifestyle may increase your risk of developing them and therefore staying physically active may be a form of protection.

However, if you’ve recently experienced a pulmonary embolism, it’s important to recover before resuming or beginning an exercise program. This may leave you wondering when the right time to exercise is during your pulmonary embolism recovery.

This article tells you all you need to know about exercising during recovery from a pulmonary embolism, including its safety and the best exercises.

A pulmonary embolism is a blockage of one of the pulmonary arteries in the lungs. It’s often caused by a blood clot (thrombus) that develops in a blood vessel, breaks off, and travels to the lungs. Air bubbles, tumors, and other debris can also cause this blockage.

Usually, blood clots that cause a pulmonary embolism originate in the lower extremities, such as the calves and thighs, due to a condition known as DVT in which blood clots develop in deep veins.

Most commonly, DVT occurs in the lower legs. Symptoms of DVT include leg pain, swelling, soreness or tenderness, discoloration, and warmth in the legs.

When blood flow is blocked in the lungs, it can cause symptoms such as shortness of breath, chest pain, lightheadedness or dizziness, low blood pressure, irregular heartbeat, heart palpitations, sweating, and anxiousness.

Due to the severity of these symptoms, it’s crucial that you get immediate medical attention if you’re experiencing any unexplained shortness of breath or chest pain.

Resuming exercise after a pulmonary embolism is important as it can help prevent another one from happening. Additionally, exercise can further strengthen your heart and improve circulation, which are both important for preventing recurrent pulmonary embolisms.

“Once you have been cleared for activity by your pulmonologist and or cardiologist, low level exercise is extremely beneficial for recovery following pulmonary embolism,” says physical therapist Dr. Jason Schuster, owner of Intricate Art Spine & Body Solutions.

That said, it’s important that you don’t immediately jump back into an exercise program before receiving clearance from a healthcare professional. Until then, it’s important to take it easy and do light activity (e.g., light housework, gentle walking).

As long as you’ve been cleared for exercise, research suggests it’s safe to gradually introduce it back into your life.

However, up to 50% of people who’ve had a pulmonary embolism report having chronic functional limitations, which may mean that you could quickly become short of breath or easily fatigued during exercise. As you continue to exercise and recover, you may find that some symptoms lessen.

Additionally, a healthcare professional may prescribe you a blood thinner or anticoagulant, which helps to improve blood flow and prevent blood clots.

Deciding which exercise is best for you will depend on your recovery, the severity of the embolism, and other factors, such as concurrent medical treatments.

“The best ones to start with are mild exercises that are also easily managed and progressed,” says Kristopher Ceniza, a physical therapist, a trainer, and the manager for KneeForce.

In the very early stages of recovery, Ceniza suggests simple tasks such as “walking from [the] bed to the door, then gradually progress[ing] further [to] ankle raises and ankle pumps to promote circulation from the legs back to the heart.”

As a person gradually recovers and is cleared for exercise, Schuster recommends “low level, nonresistant exercise, walking on level surfaces, stationary bikes, bodyweight exercises, etc.,” which help to promote blood flow without too much strain on the body.

“When the patient has raised [their] conditioning enough, swimming and strength training could also be implemented,” says Ceniza.

Though each person’s abilities will vary, it’s generally recommended to start with walking as your main form of exercise, gradually increasing from a few minutes to upwards of 30 minutes per day. Here’s an example:

  • Week 1: Walking for 5 minutes, 2 to 4 times per day
  • Week 2: Walking for 10 minutes, 2 to 4 times per day
  • Week 3: Walking for 15 to 20 minutes, 1 to 2 times per day
  • Week 4: Walking for 30+ minutes, once per day

Though useful as a guide, it’s important to work closely with a healthcare professional and make adjustments as needed. For some, rehabilitation may take longer; others may be able to resume activity more quickly.

As you begin to feel stronger, you can gradually increase other forms of activity, such as strength training and higher intensity exercise.

The length of recovery time is unique to the individual who has experienced a pulmonary embolism. Therefore, there’s no specific timeframe in which a person is expected to be ready to exercise.

“Once the embolism is cleared, low grade exercise is typically part of the rehab protocol. The intensity/frequency depends on if you meet certain markers that indicate it is safe to perform certain activity,” says Schuster.

According to a 2020 pilot study, patients were able to safely begin or return to low or moderate intensity exercise as early as 4 weeks after they had a pulmonary embolism.

“Common sense is necessary. Only do exercises that are not physically taxing and take plenty of rest in between each bout of exercise,” says Ceniza.

“Start by walking to nearby places. As a start, the nearer the better. If that means walking only from your couch to your room, that’s fine. Do this several times a day. When you get more comfortable, gradually increase the distance you’re walking,” Ceniza adds.

Since each person will recover differently, it’s crucial to get clearance from a healthcare professional before returning to exercise.

“If you have a blood clot, you need to get it taken care of ASAP. You should not exercise until you have been seen by a medical doctor,” Schuster warns.

Once the blood clot has cleared and you’ve received clearance from a healthcare professional, then you can gradually start to increase your physical activity. But the amount will depend on where you are in your recovery.

“The more consistent the exercise, the better. That means the patient will be better off if they can [move their body] multiple times a day, every day, for at least the next few weeks. But, again, only do what’s comfortable,” Ceniza adds.

Considering the risk of DVT may be worsened by prolonged sitting, it’s important to frequently move your body and avoid being in one position for too long. For example, try to get up and walk a few times per day, even just for a few minutes, to improve blood flow.

Once you’re fully recovered, you may return to your usual exercise routine as long as it’s cleared by a healthcare professional.

If you’re new to exercise, you may wish to consult a qualified healthcare professional, such as a physical therapist, who can design a customized exercise plan for you.

If you’re currently recovering from a pulmonary embolism and wonder if you can start exercising, here are some important considerations and suggestions:

  • Get medical clearance: Before starting exercise, it’s important to get clearance from a healthcare professional. Your body needs time for healing, which may be hindered if you push yourself too hard.
  • Listen to your body: If you’re struggling with exercise, lower the intensity. This will ensure you’re exercising at a pace that you can safely tolerate.
  • Start slowly: It may be tempting to return to vigorous activity, but your body may need more time to recover before it can tolerate high volumes of physical activity.
  • All activity counts: If you’re only able to walk for a few minutes before feeling fatigued, don’t worry. Any movement is beneficial for your body, and it can add up.
  • Be patient: Your body just went through a traumatic and stressful event. Be patient and allow it to heal.
  • Take your medication: If a healthcare professional prescribed medication, such as a blood thinner, it’s important to take it. Exercise isn’t a stand-alone treatment for DVT or pulmonary embolisms.
  • Wear compression socks: Compression socks help to promote blood flow in the lower extremities. In some cases, a healthcare professional may recommend wearing compression socks during or outside of physical activity.

Do lungs heal after a pulmonary embolism?

After pulmonary embolism, you may have a full recovery or experience some permanent damage. The amount of damage to the lungs depends on a variety of factors, such as the amount of tissue damage caused by a lack of oxygen.

A healthcare professional can help you understand the level of damage to your lungs and discuss appropriate treatments.

How long does it take for a pulmonary embolism to dissolve?

One review found that resolution from a pulmonary embolism was 24% after 3 to 7 days, 47% after 8 to 21 days, and 78% after 22 to 90 days.

“[Recovery time] depends from person to person. Full recovery from pulmonary embolism can take weeks for some; months for others,” says Ceniza.

Can you exercise on blood thinners?

Yes, you can exercise on blood thinners. Blood thinners are often prescribed for the first few months after a pulmonary embolism, and it’s generally considered safe to exercise while on this medication.

However, a healthcare professional may suggest you avoid vigorous activity or contact sports due to risk of bleeding. For personalized recommendations, it’s best to consult a healthcare professional.

If you’ve experienced a pulmonary embolism, returning to exercise can be a scary and confusing experience.

Once you’ve recovered and have been cleared by a healthcare professional, you can slowly start to exercise again. It’s usually recommended to start with a few minutes of walking each day and gradually increase your time as you become stronger.

As long as it’s done safely, exercising after a pulmonary embolism may help to prevent another one from occurring and help build back your strength.

That said, always be sure to work closely with a healthcare professional to ensure you’re giving yourself enough time to recover before returning to exercise.

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Coughing up blood — a symptom known as hemoptysis — can be a sign of several different conditions. Many of these conditions can be serious, and some even life threatening.

One of the conditions in which hemoptysis may appear is a pulmonary embolism, a blood clot in your lung. When these two occur together, it can be a challenge for doctors. The standard treatments for each condition can actually cause the other condition to worsen.

This article will highlight how hemoptysis happens in pulmonary embolism and how doctors treat the two conditions.

A pulmonary embolism (PE) is essentially a blood clot that becomes lodged somewhere in the lungs. These clots usually come from somewhere else (often your leg) and travel to the lungs.

Once lodged in place, these clots can cut off blood flow in your lungs, causing blood to back up behind the clot. The backup results in increased pressure in the vessels on one side of the clot, and a lack of blood flow and oxygen on the other side.

PE can lead to further blood clots, obstructions, and smaller infarcts — or areas where tissue has died from a lack of oxygen. The increased pressure or lack of oxygen can damage your lung tissue, causing bleeding. This can appear as blood in your sputum.

A PE that can cause such high blood pressure in the lungs would need to be very large and high risk (massive). You would likely experience other serious symptoms and could even become unconscious.

There are different degrees of hemoptysis. Mild hemoptysis is when you cough up less than 100 milliliters of blood in 24 hours. Mild hemoptysis goes away on its own in 9 out of 10 cases.

Massive hemoptysis is when you cough up greater than 100 milliliters of blood in 24 hours. This is when the condition is potentially life threatening. In 90% of cases, massive hemoptysis is due to injury or damage to the bronchial artery.

A 2015 case study suggests that people with chronic PE should seek treatment for even mild hemoptysis.

Since there can be several possible causes of your hemoptysis, your doctor will first need to determine the location of the bleeding. Pinpointing a location can help identify a cause.

Your doctor will usually use imaging like a chest X-ray or computed tomography (CT) scan. With these scans, they should be able to determine the location and severity of the problem.

In addition to diagnostic imaging, your doctor may run other tests to determine the effect of hemoptysis on your overall health. Possible tests include:

Once your doctor has determined the cause and extent of your hemoptysis, they will begin to develop a treatment plan. In the case of PE, treatment options can be more complicated. How doctors treat PE depends on:

  • where the clot is
  • how large the clot is
  • how much damage the clot has already caused

Regardless of the extent or location of the blood clot, immediate medical treatment for PE is critical. The goal of treatment is to either dissolve the clots and keep new ones from forming, or to physically remove or break up the clot and restore blood flow.

The standard treatment for PE is anticoagulation. But when hemoptysis is present, doctors face a dilemma. Anticoagulation can increase your risk of bleeding.

Vena cava filter

In this case, your doctor may opt for a vena cava filter. Your doctor will place this filter in your inferior vena cava, a large blood vessel. Doctors only use a vena cava filter for patients who can’t take anticoagulants.

A vena cava filter won’t treat the clot in your lungs, but it can prevent new clots from traveling to your lungs.

Tranexamic acid

But doctors still need to stop the bleeding. They’ll often use tranexamic acid (TXA) to relieve hemoptysis. In case studies from 2017 and 2021 of patients with both hemoptysis and PE, doctors administered TXA by IV.

Previous studies have raised concerns about TXA leading to blood clots and PE. But a large 2019 Japanese study and a 2021 review found it safe.

Bronchial artery embolization

Doctors may also use bronchial angiography to both locate the source of the bleeding and treat it. This minimally invasive procedure allows them to first view the source, and then treat it using a process called trans-catheter bronchial artery embolization (BAE).

In trans-catheter BAE, doctors thread a small tube through your thigh up to your bronchial artery. Doctors then inject tiny particles through the catheter that clot the vessel to stop the bleeding.

BAE is usually very effective, with studies finding its initial success rate to be between 70% and 99%. But there is a chance that hemoptysis may reoccur. Studies found the recurrence rate to be between 10% and 57%.

Several case studies report successful use of BAE to manage hemoptysis with PE. But some older studies saw mixed results.

A 2019 study found that BAE was a safe and effective way to treat hemoptysis in people with chronic thromboembolic pulmonary hypertension (CTEPH), a complication of PE. But the study was small, and researchers stressed the need for more studies.

Coughing up blood isn’t necessarily a sign of PE, but it can happen. More common signs of PE that could suggest a problem include:

Your recovery from PE will depend almost entirely on the size and location of the clot and how quickly you get medical attention.

Without treatment, about 30% of people who develop PE die, according to 2013 research. About 10% of people who develop severe and sudden PE die almost immediately. However, with proper diagnosis and treatment, the mortality rate for PE drops to about 8%.

According to a 2021 review, the mortality rate for hemoptysis is between 9% and 38%. But the same review found that treatment with tranexamic acid reduced mortality rate, bleeding time, and duration of hospital stay.

A 2017 study looking into symptoms of PE found that hemoptysis was usually linked to massive (high-risk) PE. This means that the presence of hemoptysis indicates that your PE is more severe. According to a landmark study, massive PE has a mortality rate of up to 65%.

Early diagnosis and treatment are key to achieving the best possible outlook.

Coughing or spitting up blood can be a sign of several conditions. It doesn’t always appear with pulmonary embolism. But if PE is the cause of this symptom, you need to get medical attention right away.

Immediate and accurate diagnosis and treatment of PE can significantly improve your chances of survival.

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Life after deep vein thrombosis (DVT) or pulmonary embolism (PE) can be stressful. Recovery can take upwards of several months and you’ll need to make sure you adhere to your doctor’s medication and treatment schedule.

After the initial recovery you’ll also need to take precautions to prevent future blood clots. This is especially important because a history of DVT may increase your risk of another blood clot, per Cleveland Clinic.

Individual risk will depend on the cause of the blood clot, says Scott Cameron, MD, a specialist in blood vessel disorders and platelet dysfunction at Cleveland Clinic.

For example, DVT patients who have a genetic mutation that puts them at higher risk of blood clots have a very high risk of recurrent DVT and will need to be on blood thinners for life, Dr. Cameron says. But for patients whose DVT is the result of a temporary risk factor, such as surgery or trauma, the risk of future blood clots is quite low.

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In recent weeks, an article by Queensland’s leading training organisation, First Aid Brisbane, has caused quite a stir.

It is an organisation recognised by that state of Australia, of mammoth size and great tradition and authority, which has expressed a position that we can describe as ‘non Ilcor’, so to speak.

We therefore went looking for that of the Australian Ministry of Health, which we quote in full.

With one caveat: the two positions are not mutually exclusive.  Australia, in fact, is a federal state in which the individual member states enjoy an autonomy, in some areas, that is unparalleled in the world.


CPR, what the government of Australia says

CPR (short for cardiopulmonary resuscitation) is a first aid technique that can be used if someone is not breathing properly or if their heart has stopped.

  • CPR is a skill that everyone can learn — you don’t need to be a health professional to do it.
  • Try to stay calm if you need to do CPR.
  • Performing CPR may save a person’s life.
  • If you know CPR, you might save the life of a family member or friend.

Start CPR as soon as possible

CPR involves chest compressions and mouth-to-mouth (rescue breaths) that help circulate blood and oxygen in the body. This can help keep the brain and vital organs alive.

You should start CPR if a person:

  • is unconscious
  • is not responding to you
  • is not breathing, or is breathing abnormally

How to perform CPR — adults

Watch this video from Royal Life Saving Australia about how to perform CPR on an adult, or read the DRS ABCD action plan and step-by-step instructions below.

Follow these steps before starting CPR. (Use the phrase “doctor’s ABCD” — DRS ABCD — to help you remember the first letter of each step.)


Letter Representing                  What to do

D            Danger  Ensure that the patient and everyone in the area is safe. Do not put yourself or others at risk. Remove the danger or the patient.

R            Response            Look for a response from the patient — loudly ask their name, squeeze their shoulder.

S             Send for help     If there is no response, phone triple zero (000) or ask another person to call. Do not leave the patient.

A            Airway  Check their mouth and throat is clear. Remove any obvious blockages in the mouth or nose, such as vomit, blood, food or loose teeth, then gently tilt their head back and lift their chin.

B            Breathing            Check if the person is breathing abnormally or not breathing at all after 10 seconds. If they are breathing normally, place them in the recovery position and stay with them.

C            CPR        If they are still not breathing normally, start CPR. Chest compressions are the most important part of CPR. Start chest compressions as soon as possible after calling for help.

D            Defibrillation      Attach an Automated External Defibrillator (AED) to the patient if one is available and there is someone else who is able to bring it. Do not get one yourself if that would mean leaving the patient alone.


Carry out chest compressions:

  • Place the patient on their back and kneel beside them.
  • Place the heel of your hand on the lower half of the breastbone, in the centre of the person’s chest. Place your other hand on top of the first hand and interlock your fingers.
  • Position yourself above the patient’s chest.
  • Using your body weight (not just your arms) and keeping your arms straight, press straight down on their chest by one third of the chest depth.
  • Release the pressure. Pressing down and releasing is 1 compression.

Give mouth-to-mouth:

  • Open the person’s airway by placing one hand on the forehead or top of the head and your other hand under the chin to tilt the head back.
  • Pinch the soft part of the nose closed with your index finger and thumb.
  • Open the person’s mouth with your thumb and fingers.
  • Take a breath and place your lips over the patient’s mouth, ensuring a good seal.
  • Blow steadily into their mouth for about 1 second, watching for the chest to rise.
  • Following the breath, look at the patient’s chest and watch for the chest to fall. Listen and feel for signs that air is being expelled. Maintain the head tilt and chin lift position.
  • If their chest does not rise, check the mouth again and remove any obstructions. Make sure the head is tilted and chin lifted to open the airway. Check that yours and the patient’s mouth are sealed together and the nose is closed so that air cannot easily escape. Take another breath and repeat.

Give 30 compressions followed by 2 breaths, known as “30:2”. Aim for 5 sets of 30:2 in about 2 minutes (if only doing compressions about 100 – 120 compressions per minute).

Keep going with 30 compressions then 2 breaths until:

  • the person recovers — they start moving, breathing normally, coughing or talking — then put them in the recovery position; or
  • it is impossible for you to continue because you are exhausted; or
  • the ambulance arrives and a paramedic takes over or tells you to stop

Doing CPR is very tiring so if possible, with minimal interruption, swap between doing mouth-to-mouth and compressions so you can keep going with effective compressions.

If you can’t give breaths, doing compressions only without stopping may still save a life.


How to perform CPR — children over 1 year

Use these instructions only if the child’s chest is too small for you to use both hands to do chest compressions. Otherwise, use the instructions for adult CPR above.

Watch this video from Royal Life Saving Australia about how to perform CPR on a child, or read the DRS ABCD action plan and step-by-step instructions below.

Follow these steps before starting CPR. (Use the phrase “doctor’s ABCD” — DRS ABCD — to help you remember the first letter of each step.)


Letter Representing                           What to do

D            Danger  Ensure that the patient and everyone in the area is safe. Do not put yourself or others at risk. Remove the danger or the patient.

R            Response            Look for a response from the patient — loudly ask their name, squeeze their shoulder.

S             Send for help     If there is no response, phone triple zero (000) or ask another person to call. Do not leave the patient.

A            Airway  Check their mouth and throat is clear. Remove any obvious blockages in the mouth or nose, such as vomit, blood, food or loose teeth, then gently tilt their head back and lift their chin.

B            Breathing            Check if the person is breathing abnormally or not breathing at all after 10 seconds. If they are breathing normally, place them in the recovery position and stay with them.

C            CPR        If they are still not breathing normally, start CPR. Chest compressions are the most important part of CPR. Start chest compressions as soon as possible after calling for help.

D            Defibrillation      Attach an Automated External Defibrillator (AED) to the patient if one is available and there is someone else who is able to bring it. Do not get one yourself if that would mean leaving the patient alone.

To carry out chest compressions on a child:

  • Place the child on their back and kneel beside them.
  • Place the heel of one hand on the lower half of breastbone, in the centre of the child’s chest (the size of the child will determine if you do CPR with 1 hand or 2 hands).
  • Position yourself above the child’s chest.
  • Keeping your arm or arms straight, press straight down on their chest by one third of the chest depth.
  • Release the pressure. Pressing down and releasing is 1 compression.

To give mouth-to-mouth to a child:

  • Open the child’s airway by placing one hand on the forehead or top of the head and your other hand under the chin to tilt the head back.
  • Pinch the soft part of the nose closed with your index finger and thumb.
  • Open the child’s mouth with your thumb and fingers.
  • Take a breath and place your lips over the child’s mouth, ensuring a good seal.
  • Blow steadily into their mouth for about 1 second, watching for the chest to rise.
  • Following the breath, look at the child’s chest and watch for the chest to fall. Listen and feel for signs that air is being expelled. Maintain the head tilt and chin lift position.
  • If their chest does not rise, check the mouth again and remove any obstructions. Make sure the head is tilted and chin lifted to open the airway. Check that yours and the child’s mouth are sealed together, and the nose is closed so that air cannot easily escape. Take another breath and repeat.

Give 30 compressions followed by 2 breaths, known as “30:2”. Aim for 5 sets of 30:2 in about 2 minutes (if only doing compressions about 100 – 120 compressions per minute).

Keep going with 30 compressions then 2 breaths until:

  • the child recovers – they start moving, breathing normally, coughing or talking — then put them in the recovery position; or
  • it is impossible for you to continue because you are exhausted; or
  • the ambulance arrives and a paramedic takes over or tells you to stop

Doing CPR is very tiring so if possible, with minimal interruption, swap between doing mouth-to-mouth and compressions so you can keep going with effective compressions.

If you can’t give breaths, doing compressions only without stopping may still save a life.


How to perform CPR — babies under 1 year

Watch this video from Royal Life Saving Australia about how to perform CPR on a baby, or read the DRS ABC action plan and step-by-step instructions below.

Follow these life support steps before starting. (Use the phrase “doctor’s ABC” — DRS ABC — to help you remember the first letter of each step.)


D Danger Ensure that the baby/infant and all people in the area are safe. Remove the danger or the baby/infant.
R Response Look for a response from the baby/infant — check for a response to a loud voice, or gently squeeze their shoulders. Do not shake the baby/infant.
S Send for help If there is no response, phone triple zero (000) or ask another person to call. Do not leave the patient.
A Airway Gently lift the baby’s chin to a neutral position (with the head and neck in line, not tilted). Check in the mouth for any blockages, such as vomit, an object or loose teeth, and clear it out with your finger.
B Breathing Check if the baby/infant is breathing abnormally or not breathing at all after 10 seconds. If they are breathing normally, place them in the recovery position and stay with them.
C CPR If they are still not breathing normally, start CPR. Chest compressions are the most important part of CPR. Start chest compressions as soon as possible after calling for help…

To carry out chest compressions on a baby:

  • Lie the baby/infant on their back.
  • Place 2 fingers on the lower half of the breastbone in the middle of the chest and press down by one-third of the depth of the chest (you may need to use one hand to do CPR depending on the size of the infant).
  • Release the pressure. Pressing down and releasing is 1 compression.

To give mouth-to-mouth to a baby:

  • Tilt the baby/infant’s head back very slightly.
  • Lift the baby/infant’s chin up, be careful not to rest your hands on their throat because this will stop the air getting to their lungs from the mouth-to-mouth.
  • Take a breath and cover the baby/infant’s mouth and nose with your mouth, ensuring a good seal.
  • Blow steadily for about 1 second, watching for the chest to rise.
  • Following the breath, look at the baby/infant’s chest and watch for the chest to fall. Listen and feel for signs that air is being expelled.
  • If their chest does not rise, check their mouth and nose again and remove any obstructions. Make sure their head is in a neutral position to open the airway and that there is a tight seal around the mouth and nose with no air escaping. Take another breath and repeat.

Give 30 compressions followed by 2 breaths, known as “30:2”. Aim for 5 sets of 30:2 in about 2 minutes (if only doing compressions about 100 – 120 compressions per minute).

Keep going with 30 compressions to 2 breaths until:

  • the baby/infant recovers — they start moving, breathing normally, coughing, crying or responding — then put them in the recovery position (see above); or
  • it is impossible for you to continue because you are exhausted; or
  • the ambulance arrives and a paramedic takes over or tells you to stop

If you can’t give breaths, doing compressions only without stopping may still save a life


Using an automated external defibrillator (AED)

Using an AED can also save someone’s life. You do not need to be trained to use an AED since the AED will guide you with voice prompts on how to use it safely.

  • Attach the AED and follow the prompts.
  • Continue CPR until the AED is turned on and the pads attached.
  • The AED pads should be placed as instructed and should not be touching each other.
  • Make sure no-one touches the person while the shock is being delivered.
  • You can use a standard adult AED and pads on children over 8 years old. Children younger than 8 should ideally have paediatric pads and an AED with a paediatric capability. If these aren’t available, then use the adult AED.
  • Do not use an AED on children under 1 year of age.

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Health Gov Australia

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AEW star Chris Jericho has gone into graphic detail about his stint in hospital at the end of 2021, which ended up being as a result of a pulmonary embolism.

During a UK tour with his band Fozzy in December 2021, Jericho was admitted to hospital after suffering shortness of breath while performing at his concerts. While it was confirmed at the time that it wasn't related to COVID-19, the former AEW World Champion had trouble breathing. He went to a private hospital due to the advice of a doctor who accompanied the band while on tour.

Speaking on the latest episode of "Talk is Jericho," "The Wizard" explained what a pulmonary embolism is, and how it can lead to more serious health issues later down the line.

"They go, take me for the CT scan, that happens, and then they tell me very soon after, 'you have a pulmonary embolism.' What does that mean? It means your lungs are filled with blood clots and you are now staying in the hospital. They went and did an ultrasound and found there was evidence that a clot had been in my throat. If a clot gets in your throat, that's getting into stroke territory. The reason why these are so dangerous is if the blood clot breaks free and gets into your lungs, you can have serious issues. If it breaks free and gets into your heart, you can have serious issues. If it gets to your brain, serious issues." (H/T Fightful).

To combat the problem, Jericho was given blood thinners. He was eventually released after a stint in hospital, but had to remain in the UK as his oxygen levels were still uncertain.

''I was told I couldn't fly home until my oxygen levels were high enough. We knew the blood thinners were working for the clots, but they had to make sure I could breathe properly.'' (H/T Fightful).

Chris Jericho may have sent Ruby Soho to the hospital after AEW Dynamite

Chris Jericho's health has improved tremendously and he has even slimmed down massively since the beginning of the year.

Since returning to the ring, Jericho has been a thorn in Eddie Kingston's side. The people around Kingston have all suffered. The likes of Santana and Bryan Danielson are currently on the shelf with injuries, Ortiz has a bald head, and now, even Ruby Soho has been attacked.

During the July 6th edition of Dynamite, the Jericho Appreciation Society orchestrated an attack on Soho that resulted in Tay Conti slamming a car door on the fingers of the former WWE Superstar.

The attack was done to send a message to Kingston, who was in the ring at the time, cutting a promo with commentator Tony Schiavone. The Mad King will likely be looking for revenge on Chris Jericho and his friends in the coming weeks, but what will happen? Only time will tell!

Were there plans for an Undertaker vs. Sting match? Find out right here.

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Edited by Brandon Nell