Diseases and Conditions

Pulmonary embolism

Treatment

Treatment of pulmonary embolism is aimed at keeping the blood clot from getting bigger and preventing new clots from forming. Prompt treatment is essential to prevent serious complications or death.

Medications

Medications include different types of blood thinners and clot dissolvers.

  • Blood thinners (anticoagulants). These drugs prevent existing clots from enlarging and new clots from forming while your body works to break up the clots. Heparin is a frequently used anticoagulant that can be given through the vein or injected under the skin. It acts quickly and is often overlapped for several days with an oral anticoagulant, such as warfarin, until it becomes effective, which can take days.

    Newer oral anticoagulants work more quickly and have fewer interactions with other medications. Some have the advantage of being given by mouth, without the need for overlap with heparin. However, all anticoagulants have side effects, and bleeding is the most common.

  • Clot dissolvers (thrombolytics). While clots usually dissolve on their own, sometimes thrombolytics given through the vein can dissolve clots quickly. Because these clot-busting drugs can cause sudden and severe bleeding, they usually are reserved for life-threatening situations.

Surgical and other procedures

  • Clot removal. If you have a very large, life-threatening clot in your lung, your doctor may suggest removing it via a thin, flexible tube (catheter) threaded through your blood vessels.
  • Vein filter. A catheter can also be used to position a filter in the body's main vein (inferior vena cava) that leads from your legs to the right side of your heart. This filter can help keep clots from going to your lungs. This procedure is typically reserved for people who can't take anticoagulant drugs or when they have had recurrent clots despite use of anticoagulants. Some filters can be removed when no longer needed.

Ongoing care

Because you may be at risk of another deep vein thrombosis or pulmonary embolism, it's important to continue treatment, such as remaining on blood thinners, and be monitored as often as suggested by your doctor. Also, keep regular doctor visits to prevent or treat complications.