Treating and Managing Pulmonary Embolism

Treating Pulmonary Embolism

Treatment is aimed at managing the size of the blood clot and preventing new clots from forming. Timely treatment is important in order to prevent serious complications, like pulmonary hypertension or heart failure, or death.

Medications

Blood thinners or anticoagulants are the most common treatment for a blood clot in the lung. They work by interfering with your body’s ability to form new clots and prevent existing clots from getting larger. It is important to note that blood thinners won’t dissolve blood clots. In most cases, the hope is that your body will eventually dissolve the clot on its own. If it doesn’t, more drastic measures may need to be taken. Anticoagulants are usually prescribed for a few months but may be needed for life if you have an increased risk for developing clots. They can be taken in the form of a pill, an injection or through an IV.

In severe, life-threatening situations, thrombolytic therapy may be used to more immediately dissolve clots. These medications, also known as “clot busters”, are given intravenously, but because they can cause severe bleeding, are reserved for truly severe situations.

Surgery

Embolectomy, sometimes called thrombectomy, is a surgical procedure that might be necessary in cases where the clot is very large, and medications aren’t an option or haven’t adequately worked. This procedure can be done by inserting a thin, flexible tube (catheter) threaded through your blood vessels to either break the clot up, or suction it out, or a more complex, traditional surgery where the chest is opened to access the clot. These procedures pose additional risks and recovery time.

Some patients require a surgical procedure to insert a filter into the vena cava, which is the vein that circulates blood from your legs to the right side of your heart. This filter prevents clots from traveling to the lungs and heart. This procedure is used when anticoagulant treatments can’t be used due to medical reasons or when clots continue to develop when taking anticoagulants.

Managing Pulmonary Embolism

While a pulmonary embolism can be life-threatening, most patients survive and need to learn how to live with the risk of recurrence. Your healthcare provider may prescribe anticoagulants, or blood thinners, which may be needed for as little as three months but may be a lifelong requirement. The length of treatment depends on the underlying cause of the clot.

Appropriate caution must be taken due to the bleeding risk when on anticoagulants. Your doctor may suggest staying away from certain foods (such as foods rich in vitamin K), alcohol, or some over-the-counter medicines (such as aspirin and sleeping pills). It is also important for people taking blood thinners to take steps to avoid injuries which could increase the risk of bleeding.

In around five percent of patients with a pulmonary embolism, the arteries can form scar-like tissue which blocks or narrows the arteries, leading to a form of pulmonary hypertension called chronic thromboembolic pulmonary hypertension (CTEPH). If you continue to have breathing difficulty six months after a pulmonary embolism, you should talk to your doctor about getting tested for CTEPH.

Your healthcare provider may complete a "hypercoagulability" evaluation at some point after your diagnosis. This could include blood tests looking for a genetic or acquired cause of your deep vein thrombosis. If there is no identifiable risk factor, your provider may recommend additional tests to search for other health conditions.

It is important to maintain a healthy lifestyle after a pulmonary embolism. In addition to taking your medications as prescribed, stay active, eat healthy, maintain a healthy weight, avoid tobacco products and wear compression socks, especially when in situations where you will be sitting for long periods of time.