Charles A. Bertrand, M.D., FACP, DIM-CD (Ret.)
Associate Clinical Professor of Medicine at New York Medical College
and at the Medical University of South Carolina


Pulmonary embolism is a blood clot in the lungs -- usually a piece of a clot that has broken off from one of the leg veins and migrated to the lungs.. This is a serious condition.

It is not the purpose of this article to review all the clinical features -- that's for another time and place. Briefly the presenting symptoms are usually malaise, chest pain, shortness of breath and fainting and with various combinations.

This process may be initiated by a long automobile ride. While seated in a car there is some compression of veins of the lower extremity particularly the back of the thigh behind the knee. And this leads to injury of the veins and blood clots may form -- a piece of which can break off and go to the lungs (pulmonary embolism). Many years ago there was a meeting of the NY State Cardiovascular Committee and the doctor from Albany reported a moderat incidence of the disorder in thruway drivers.. There were successive increases in Syracuse, Rochester and Buffalo. This condition was found particularly in drivers leaving New York City who would drive nonstop on the NY State Thruway. And it took about 3 hours to drive from the city to Albany and about 8 to 9 hours to Buffalo.

An analogous situation was reported in this week's New England Journal of Medicine -- Sept. 13th. But this involved air travel. The title of the article is "Severe Pulmonary Embolism Associated with Air Travel." It was a study done over a seven year period.. - and it involved 135 million passengers who arrived in the Paris airport. 56 people had confirmed pulmonary embolism on arrival. They were hospitalized, studied extensively and some interesting findings were reported.

This disorder occurred rarely for short flights but was more common in longer flights. Virtually all clots occurred in people who flew over 5000 km (3100 miles). The longer the distance covered in flight the greater the chance of having a pulmonary embolus. The greatest incidence occurred in those flying over 10,000km (about 6200 miles) and…. averaged about 4.7 cases per million passengers.

Pulmonary Embolism occurred primarily in people who simply sat and did not walk about at all. It was found more often in those flying economy class.

This is an interesting demographic study that indicates the sitting position to be associated with venous stasis and blood clotting. It appears , therefore, that when traveling it is best to get up and walk about every hour or two, if possible. Exercise is of great value in many situations and herein is an example of low-level exercise preventing a major vascular problem.

The advice provided on this website is intended to be general in nature and should not be relied upon for specific treatment. If you need personal medical attention please contact your physician.

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