a doctor examines a chest xray to treat a pulmonary embolism

Treatments for Pulmonary Embolism

A pulmonary embolism (PE) occurs when a blood clot (or thrombus) in the blood vessels breaks loose, travels through the body (becoming an embolus or mobile clot), and eventually lodges in one of the smaller vessels of the lungs. When a blood clot causes issues in another set of blood vessels, it is called a thromboembolism. When a thromboembolism is particular to the lungs, this constitutes a pulmonary embolism. Here’s a look at what a pulmonary embolism is and how PE can be treated.

What is a Pulmonary Embolism?

PE can be life threatening. When an embolus comes to lodge in the heart, it causes a heart attack. If it lodges in the brain, a type of ischemic stroke can occur. Clearly, embolisms are serious business. When it comes to a pulmonary embolism, the blood clot can lodge in the blood vessels that help replenish oxygen for the whole body. Generally, blood clots begin in the legs and deep veins of the muscles (the source of the term deep vein thrombosis). It is these clots that can break free from vessels in the legs.

While a clot in the legs can be problematic and dangerous, it doesn’t completely disrupt the circulatory system in the way that a pulmonary embolism can. Additionally, the Mayo Clinic reports that most cases of PE involve multiple embolisms, although they may not all arise at the same time.  The most common signs and symptoms of PE include shortness of breath, coughing up blood, and chest pain similar to that of a heart attack. It is imperative that you seek immediate medical care if you experience these or other signs of PE.

Treating PE with Medication

The goal of treatment for a pulmonary embolism is to reduce future clotting while also limiting complications arising from the present embolism. In most cases, medication may be an effective means of both treatment and continuing prevention. Anticoagulants, such as heparin or warfarin, are known generally as blood thinners because of the function they perform in limiting coagulation. Heparin can be injected so that it acts quickly, while warfarin is generally oral and can take a few days to become effective. The goal is to combine these medications to keep new embolisms from forming while the body breaks down the current issue.

In more dire situations, thrombolytics, or clot dissolvers, can be used. These medications pose a danger of increasing the risk of bleeding by a dangerous amount. They are generally reserved for situations in which the clot must be dissolved quickly, rather than waiting for the body to do so on its own.

Treating PE with Procedures

In some cases, a type of surgical procedure can be a treatment option. Clot removal involves threading a catheter (a long, thin tube) through the vein, destroying the clot. Obviously, this isn’t as feasible when the pulmonary embolism is the result of several, smaller clots because it can be difficult to hunt down each and every embolism in the tiny pulmonary veins. For larger clots that pose an immediate and fatal risk, clot removal via catheterization may be an option.

Not everyone responds well to the medications used to manage clotting. This leaves a gap between large, removable clots and small clots generally managed with anticoagulants or thrombolytics. As an alternative, a vein filter can be inserted into the inferior vena cava (a major vein entering the heart). Some filters are removable, but their purpose is to catch any clots passing from the legs into the heart, thus preventing a pulmonary embolism.