Treatment 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.
- Blood thinners (anticoagulants). These drugs prevent 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. A newer class of anticoagulants, referred to as novel oral anticoagulants (NOACs), has been tested and approved for treatment of venous thromboembolism, including pulmonary embolism. These medications work quickly and have fewer interactions with other medications. Some NOACs have the advantage of being given by mouth, without the need for overlap with heparin. However, all anticoagulants have side effects, with bleeding being the most common.
- Clot dissolvers (thrombolytics). While clots usually dissolve on their own, there are medications given through the vein that 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 — called the inferior vena cava — that leads from your legs to the right side of your heart. This filter can help keep clots from being carried into your lungs. This procedure is typically reserved for people who can't take anticoagulant drugs or when anticoagulant drugs don't work well enough or fast enough. Some filters can be removed when they are no longer needed.
Aug. 18, 2016
- Pulmonary embolism. National Heart, Lung, and Blood Institute. http://www.nhlbi.nih.gov/health/health-topics/topics/pe. Accessed June 27, 2016.
- Thompson BT. Overview of acute pulmonary embolism in adults. http://www.uptodate.com/home. Accessed June 27, 2016.
- Marx JA, et al., eds. Pulmonary embolism and deep vein thrombosis. In: Rosen's Emergency Medicine: Concepts and Clinical Practice. 8th ed. Philadelphia, Pa.: Saunders Elsevier; 2014. http://www.clinicalkey.com. Accessed June 28, 2016.
- Bauer KA, et al. Overview of the causes of venous thrombosis. http://www.uptodate.com/home. Accessed June 27, 2016.
- Deep vein thrombosis. American Academy of Orthopaedic Surgeons. http://orthoinfo.aaos.org/topic.cfm?topic=A00219. Accessed June 27, 2016.
- Goldman L, et al., eds. Pulmonary embolism. In: Goldman-Cecil Medicine. 25th ed. Philadelphia, Pa.: Saunders Elsevier; 2016. http://www.clinicalkey.com. Accessed June 28, 2016.
- What is pulmonary hypertension? National Heart, Lung, and Blood Institute. http://www.nhlbi.nih.gov/health/health-topics/topics/pah. Accessed June 27, 2016.
- Ferri FF. Pulmonary embolism. In: Ferri's Clinical Advisor 2017. Philadelphia, Pa.: Elsevier; 2017. https://www.clinicalkey.com. Accessed June 28, 2016.
- General nuclear medicine. Radiological Society of North America. http://www.radiologyinfo.org/en/info.cfm?PG=gennuclear. Accessed June 27, 2016.
- Catheter angiography. Radiological Society of North America. http://www.radiologyinfo.org/en/info.cfm?PG=Angiocath. Accessed June 27, 2016.
- Bauer KA. Approach to the diagnosis and therapy of lower extremity deep vein thrombosis. http://www.uptodate.com/home. Accessed June 27, 2016.
- Hoeper MM, et al. Chronic thromboembolic pulmonary hypertension. Circulation. 2006;113:2011.
- AskMayoExpert. Pulmonary embolism. Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2014.
- Bauer KA. Drug-induced thrombosis and vascular disease in patients with malignancy. http://www.uptodate.com/home. Accessed June 27, 2016.
- Your guide to preventing and treating blood clots. Agency for Healthcare Quality and Research. http://www.ahrq.gov/patients-consumers/prevention/disease/bloodclots.pdf. Accessed June 27, 2016.
- Raja AS, et al. Evaluation of patients with suspected acute pulmonary embolism: Best practice advice from the Clinical Guidelines Committee of the American College of Physicians. Annals of Internal Medicine. 2015;163:701.
- Pai M, et al. Prevention of venous thromboembolism in adult travelers. http://www.uptodate.com/home. Accessed July 5, 2016.