Pulmonary embolism is a potentially life threatening condition characterized by the blockage of at least one of the arteries in the lungs reports the Mayo Clinic. The blockage often results when blood clots break away from the deep veins in the legs and travel to the lungs. In some instances other substances such as tumor cells cause the blockage. The blockage prevents the flow of blood to the lung, causing severe damage and death of lung tissue. This impairs the ability of the lungs to supply oxygen to the rest of the body. In order to minimize complications and prevent death, pulmonary embolism treatment should be prompt.
The severity of symptoms of pulmonary embolism varies according to the size and location of the clot as well as how healthy the person is, but often include chest pain, a cough that may be accompanied by blood or bloody sputum, and shortness of breath. Additional symptoms of pulmonary embolism include a weak pulse, irregular heartbeat, wheezing, lightheadedness, fainting, skin that is clammy or bluish, and swollen legs, notes the National Institutes of Health.
Anticoagulant therapy is a treatment option for pulmonary embolism. Anticoagulants thin the blood and prevent the formation of additional clots. Clot-preventing medications that are commonly used include heparin, fondaparinux and warfarin. In patients who are stable, warfarin is typically administered by mouth in conjunction with heparin administered intravenously. Individuals who survive a pulmonary embolism may be at risk for future embolisms and may be advised to take anticoagulants for at least 6 months, according to the NIH. Treatment regimens will vary according to the individual circumstances. Individuals on blood thinners for an extended amount of time must be closely monitored and must be careful to avoid injuries. Severe bleeding is a side effect of anticoagulant therapy.
Thrombolytic therapy is used when the pulmonary embolism is life threatening. It is indicated for pulmonary embolisms with a large clot, in hemodynamically unstable patients or when right heart strain is present according to Dr. Nader Kamangar, author of “Pulmonary Embolism: Treatment & Medication”. According to the NIH, thrombolytic drugs such as tissue plasminogen activator (t-PA) or Streptokinase are administered to dissolve the clots that are blocking the artery in the lungs. These clot-busting drugs also dissolve the source clot, typically located in the deep veins of the leg or in the hip area. Thrombotic therapy has a higher risk of bleeding compared to anticoagulant therapy.
Inferior Vena Cava Filter
Some patients, such as those who have had a recent surgery or hemorrhagic stroke or those who would not survive a recurrent embolism, may require an inferior vena cava filter, or IVC filter, to prevent any additional clots from reaching the lungs. The IVC filter is placed in the inferior vena cava where it filters the blood coming from the legs to the right side of the heart. The IVC filter may be used in individuals who can’t take heparin-like medications or in cases where the anticoagulants fail to work well.
Mayo Clinic: Pulmonary Embolism
National Institutes of Health: Pulmonary Embolus
Medscape; “Pulmonary Embolism: Treatment & Medication”; Nader Kamangar; 2010