Pulmonary Embolism Treatment

A comprehensive overview of pulmonary embolism covering subjects as: treatment, symptoms, diagnostics, research, causes, pictures and images
Pulmonary Embolism Treatment

Pulmonary embolism treatment

     Pulmonary embolism treatment is based on prevention of further episodes of pulmonary embolism by using anticoagulant medicines. They prevent the already existing thrombus growth in size and the appearance of new ones.

     If symptoms are severe and are life threatening for the patient, it is required immediately an aggressive treatment. Aggressive pulmonary embolism treatment may include thrombolytic medicines that can quickly dissolve the thrombus, but may also increase the risk of severe hemorrhage. Another option for serious cases is surgical removal of the thrombi, called embolectomy surgery, but this procedure is performed only in some large hospitals.

     Some people may benefit from placing a filter in the vena cava. It can prevent thrombi to reach the lungs. The filter is used when anticoagulants can not be used, when thrombi form despite the existence of anticoagulant treatment or when there is an increased risk of death if a new episode of embolism would occur.

Outpatient pulmonary embolism treatment (at home)

     No pulmonary embolism treatment is recommended to start at home. However it is important to prevent formation of thrombus and deep vein thrombosis because they can lead to recurrent pulmonary embolism.

     The measures which decrease the risk of deep vein thrombosis are:

  • Physic exercise: it can maintain good blood circulation, by bringing the feet fingertips closer to the head, so that the legs are stretched, then you relax and repeat the operation; this exercise is important especially when you sit on a chair for a long period of time (for example during long trips by car or plane)
  • Mobilizing as early as possible after surgery or after an illness which required prolonged bed rest is very important; if the mobilization is not possible the exercises for calves must be carried out as described above at every hour to help the blood circulate
  • Quitting smoking: this is especially important for people who follow treatment with estrogen (such as oral contraceptives)
  • Use of elastic stockings to prevent deep vein thrombosis, in individuals at risk.

Medication choices

     Drug therapy may prevent the recurrence of the pulmonary embolism episode by preventing thrombus formation and increase in dimensions of the existing ones.

     Anticoagulant drugs: are prescribed when pulmonary embolism is diagnosed or strongly suspected. Normally the appearance of a wound that causes bleeding, the body sends signals that result in the formation of a thrombus site. Thrombi dissolve as the wound heals. A person with coagulopathy (clotting disease) shows an imbalance between production and dissolvent of thrombus. Anticoagulants prevent the production of some necessary proteins for blood to clot. Although anticoagulants can prevent new thrombus formation and their increase in size, they can not dissolve the already formed thrombi.

     Heparin and warfarin are anticoagulants used in the treatment of major pulmonary embolism.

Pulmonary embolism surgery treatment

     Surgical removal of thrombus is called embolectomy. This treatment method is rarely used in cases of pulmonary embolism. It is considered that thrombi from the main pulmonary artery are very large and very dangerous and can cause serious symptoms. Embolectomy may also be an option for those whose clinical condition is stable but they have signs of significant reduction of the blood flow in the pulmonary artery.

Other pulmonary embolism treatments

     Some people can not follow treatment with anticoagulants or they may continue to produce thrombi despite medical treatment. If it can not be used any drugs or surgery, one can use other methods for preventing pulmonary embolism, one of them being the use of vena cava filters.

     Filter can be inserted in the vena cava, the vein that crosses the abdomen and bring everything back to the heart blood. This filter can prevent thrombi from the legs and from the pelvic veins to reach the lungs, thrombi which are permanent or removable.

     Studies show that these filters help prevent pulmonary embolism but are more effective when used in combination with anticoagulant medication.