Treatment options for pulmonary embolism (PE) depend on the severity of the blood clot and whether the pulmonary embolism is immediately life threatening. The primary goals of all pulmonary embolism treatments are to prevent the existing clot from enlarging and to stop new clots from forming. Medications that thin the blood, called anticoagulants, prevent new clots and stop enlargement of existing clots. Other medications called thrombolytics dissolve existing clots quickly and are used in life-threatening cases. Additional treatments include surgery to remove a clot and the placement of a filter in the main vein to prevent clots from entering the heart and lungs.
Anticoagulants are a class of medicines commonly called blood thinners. These medications are used to prevent the blood from clotting, stopping the formation of new clots. Blood thinners are one of the pulmonary embolism treatments used in patients who are in stable condition without life-threatening symptoms. Warfarin, a widely used blood thinner, is administered by mouth and takes several days to a week to effectively thin the blood.
While the warfarin begins working, another type of anticoagulant, heparin, is given as an injection. It has a different mechanism of action and quickly begins thinning the blood. Treatment for pulmonary embolism using anticoagulants generally lasts for three to six months or longer, and the patient is carefully monitored to ensure that the proper degree of blood thinning is achieved. Bleeding gums and bruising are common side effects of blood thinners.
Thrombolytics, commonly called clot dissolvers or clot busters, quickly break up and dissolve existing clots. These medications are used only in life-threatening cases, because they can cause severe bleeding. Large clots cause dangerously low levels of oxygen in the blood and blood pressure collapse. Clot-dissolving medications include reteplase, urokinase and streptokinase.
Other emergency pulmonary embolism treatments include surgery to remove the clot and the use of a catheter to extract the clot or administer medication directly to it. Patients who cannot take blood thinners might have a vena cava filter placed in the major vein that moves blood from the body to the heart, the inferior vena cava. A vena cava filter is also used when medications are ineffective in preventing clot formation.
Pulmonary embolisms are potentially lethal, causing damage to the lungs and other organs. The causes of pulmonary embolisms include a deep vein thrombosis, a condition where a clot forms in the veins of the legs or other parts of the body. The clot can break free and travel to the heart and eventually to the lungs, becoming a pulmonary embolism. Pulmonary embolism treatments effectively reduce the risk of death from this serious condition.