Treatment:

A pulmonary embolus requires emergency treatment. You will have to stay in the hospital. You will receive oxygen.

In cases of severe, life-threatening pulmonary embolism, treatment may involve dissolving the clot. This is called thrombolytic therapy. Clot-dissolving medications include:

• Streptokinase
• T-plasminogen activator (t-PA)

Blood thinners are given to prevent clots. This is called anticoagulation therapy.

• The most common blood thinners are heparin and warfarin (Coumadin).
• Fondaparinux (Arixtra) is a newer blood thinner used under special circumstances.

Heparin or heparin-type drugs are usually tried first. They can be given through a vein (by IV) or by injection under the skin.

Warfarin is later given in pill form. When you first start taking warfarin, you will need frequent blood tests. This will help your doctor properly adjust your dose. You will likely need to take the warfarin for several months.

Patients who have reactions to heparin or related medications may need other medications.

Patients who cannot tolerate blood thinners or for whom they may be too risky may need a device called an inferior vena cava filter (IVC filter). This device is placed in the main vein in the belly area. It keeps large clots from traveling into the blood vessels of the lungs. Sometimes a temporary filter can be placed and removed later.

Expectations (prognosis):

How well a person recovers from a pulmonary embolus can be hard to predict. It often depends on what caused the problem in the first place. (For example, cancer, major surgery, or an injury.)

Death is possible in people with a severe pulmonary embolism.

Complications:

• Heart failure or shock
• Heart palpitations
• Pulmonary hypertension
• Severe breathing difficulty
• Severe bleeding (usually a complication of treatment)
• Sudden death

Calling your health care provider:

Go to the emergency room or call the local emergency number (such as 911) if you have symptoms of pulmonary embolus.