Treatments for Pulmonary Embolism
Pulmonary embolism (PE) can be a life-threating condition, and emergency assessment and treatment should be conducted quickly.1 Treatment will depend on when your symptoms started and how soon you can access treatment.
In the acute phase of PE, you may require supportive treatments1 to help counteract the effects of the blocked blood vessel. You may be given respiratory support such as high-flow oxygen treatment. In addition, you may receive haemodynamic treatments such as intravenous fluids and vasopressors to help return your blood pressure back to a healthy level.1
Most patients with acute PE are given an anticoagulant,1,2 which is a type of drug that manipulates the blood coagulation process to prevent blood clots from forming too easily. In acute PE, the anticoagulant should stop the clot from getting larger while your body’s natural processes break it down.2
Anticoagulants generally include non-vitamin K antagonist oral anticoagulants (NOACs), heparins and vitamin K antagonists.3 All of these have different ways of working. Due to their pharmacological mode of action, the use of anticoagulants may be associated with an increased risk of occult or overt bleeding from any tissue or organ. The signs, symptoms and severity will vary according to the location (e.g. blood in urine, severe bruising) and degree or extent of the bleeding. For most people, the benefits of taking an anticoagulant outweigh the risk of serious bleeding.3
What are anticoagulants? Anticoagulants may play an important part in your management of pulmonary embolism, find out more about them here Read more
For some patients, additional therapy may be needed to help break up the blood clot.1,2 During thrombolysis patients with suspected high-risk PE are injected with a fast-acting fibrinolytic drug to quickly dissolve the blood clot.
Drugs in this class include streptokinase.1
Some patients with high-risk PE are unable to receive conventional treatments due to the presence of other medical conditions. In these instances, an embolectomy – the surgical removal of a PE blood clot – may be performed instead.1
Preventing recurrent events
Most patients need to continue taking anticoagulants for some time after their PE to help reduce the risk of a recurrent event.1 Your doctor will decide how long you should continue to take an anticoagulant for, depending on the cause of the first PE and the risk of recurrence.1
Inferior vena cava (IVC) filter
If you are unable to receive anticoagulant therapy, you may need to be fitted with an IVC filter. The procedure involves inserting a filter into a vein to prevent any large fragments that may break loose from clots from lodging in your lungs.1
- Konstantinides SV, Meyer G, Becattini C, Bueno H, Geersing GJ, et al. 2019 ESC Guidelines for the diagnosis and management of acute pulmonary embolism developed in collaboration with the European Respiratory Society (ERS): The Task Force for the diagnosis and management of acute pulmonary embolism of the European Society of Cardiology (ESC). Eur Heart J. 2020;41(4):543–603 Return to content
- Healthily. Pulmonary Embolism [Internet]. [cited 2020 Nov 5]. Available from: https://www.livehealthily.com/embolism Healthily. Pulmonary Embolism [Internet]. [cited 2020 Nov 5]. Available from: https://www.livehealthily.com/embolism Return to content
- NHS. Anticoagulant medicines [Internet] [cited 2020 Nov 5]. Available from: https://www.nhs.uk/conditions/anticoagulants/ NHS. Anticoagulant medicines [Internet] [cited 2020 Nov 5]. Available from: https://www.nhs.uk/conditions/anticoagulants/ Return to content