A Complete Guide to Pulmonary Embolism Treatment

Managing Pulmonary Embolism: Risk Factors and Prevention Strategies

Treatment for pulmonary embolism focuses on preventing blood clots from getting bigger and stopping new ones from forming. Doctors usually use blood-thinning medicines to reduce the risk of further blockage.

In more severe cases, treatment may involve medicines that break down blood clots or procedures to remove them and restore blood flow in the lungs. The approach depends on how serious the condition is and the person’s overall health.

Keep reading to know more!

What is Pulmonary Embolism?

Pulmonary embolism (PE) is a potentially fatal condition where a blood clot blocks a blood vessel in the lungs. It occurs when a clot that originates from other parts of the body (mostly from the legs or arms) travels through the bloodstream into the lungs. The clot obstructs blood flow in the lungs, impairing oxygen exchange and reducing oxygen delivery to the body. It can also increase pressure in the pulmonary arteries (pulmonary hypertension).

It is a severe health issue, and failure to manage it in time may result in damage to the heart or lungs and even lead to death. However, with timely diagnosis and treatment, mortality rates are significantly reduced, often to below 10% in treated patients.

The effects of PE include:

Damage to the lungs.
Increased strain on the heart
In severe cases, life-threatening complications

Common Symptoms of Pulmonary Embolism

There are various signs and symptoms of pulmonary embolism, which largely depend on the extent to which the lungs are affected, the size of the clots, and whether there is a pre-existing condition involving the lungs and/or heart.

Signs and symptoms commonly associated with a pulmonary embolism include:

Breathlessness: This sign typically occurs abruptly. Breathing becomes laboured even when the person is at rest. It also worsens when the patient exercises.
Chest pain: One experiences intense chest pain while breathing, similar to what they would feel during a heart attack. The discomfort may make it impossible for them to take deep breaths. In addition, chest pains can occur when the patient coughs, bends down, or leans forward.
Fainting: Fainting results when the heart rate and blood pressure suddenly drop.

Other symptoms may include:

Persistent cough, which produces bloody sputum (thick mucus from the lungs)
Rapid heartbeat
Dizziness
Sweating heavily
Fever
Pain and swelling in one leg, especially in the calf area
Pale, blue, or discolored skin due to low oxygen levels

Common Causes of Pulmonary Embolism

The causes of pulmonary embolism are as follows:

Pooling of blood in a particular area of the body (most commonly, either the arm or the leg). It occurs as a consequence of inactivity for long hours, especially after surgery, prolonged bed rest, or a journey by plane.
Any trauma or injury in the blood vessel, specifically in the pelvic area, hip, knee, or leg, because it may increase the risk of blood clot formation.
A pre-existing illness, which includes conditions related to heart diseases such as congestive heart failure, atrial fibrillation, heart attack, or stroke.
High or low levels of clotting factors in your blood. High levels may be caused by certain cancers, hormone replacement therapy, or contraceptive pill use.

Who Does Pulmonary Embolism Affect?

People at risk of developing a PE include those who:

Have a blood clot in the leg, known as deep vein thrombosis (DVT)
Lead a sedentary life due to travel by motor vehicles, trains, or aircraft
Have sustained recent trauma or injury to a vein, either because of surgery, a bone fracture, or due to varicose veins
Use hormonal contraceptives
Have a blood-clotting disorder
Have family history of blood clots
Smoke often
Have diabetes
Have cancer
Are older than sixty years old
Have a history of heart failure, stroke, or heart attack
Are overweight (BMI more than 25) or obese (BMI more than 30)
Are pregnant or have given birth in the past six weeks
Have suffered from the insertion of a central venous catheter in the arm or leg

In case you suffer from one of the above risk factors and have had a history of suffering from blood clots in the past, you should discuss the matter with your doctor.

How is Pulmonary Embolism Diagnosed?

Based on your symptoms and risk factors, a doctor may use the following tests to diagnose pulmonary embolism:

Complete blood counts (CBC), including a D-dimer test, which helps check for signs of blood clot formation
Computed Tomography Angiogram, an imaging test that helps detect blood clots in the lungs
Leg ultrasound, used to find blood clots in the leg, known as deep vein thrombosis (DVT), which may travel to the lungs
Ventilation/perfusion (V/Q) scan, used when a CT scan is not suitable, especially if contrast cannot be used. It helps identify areas of reduced blood flow in the lungs
Pulse Oximetry Test, which measures your oxygen level using a pulse oximeter on your finger
Echocardiogram, which helps assess how well the heart is functioning

Additional tests that may be ordered include:

Pulmonary Angiography
Chest X-Ray

What is the Treatment of Pulmonary Embolism?

The pulmonary embolism treatment includes stabilisation of the patient, preventing blood clots from growing, and restoring regular blood flow in the lungs.

Anticoagulant medications: Anticoagulants are the primary method for the treatment of the disease. The medication reduces the blood's ability to clot, prevents the growth of a clot already formed, and reduce the risk of new clots formation. Proper dosing and monitoring are essential when taking anticoagulants.
Thrombolysis: In some situations, the use of thrombolytics, or clot dissolvers, might be required. The medication accelerates the process of dissolving the clot; therefore, it is administered in emergency care facilities or ICU units.
Surgical or catheter intervention: When the medication is ineffective or the condition is severe, doctors may remove the clot surgically or by catheter intervention.
Vena cava filter: In some situations, doctors insert a small device into a big vein to trap the blood clots before they reach the lungs.

Complications of Untreated Pulmonary Embolism

Pulmonary embolism may lead to the following complications if not treated in time:

Bluish skin discoloration (cyanosis)
Heart attack
Stroke
High blood pressure in the lungs
Circulatory shock
Death of lung tissue (pulmonary infarction)

Prevention Tips to Avoid Pulmonary Embolism

Preventing clot formation in the deep veins in your legs can avoid the risk of pulmonary embolism. With this in mind, most doctors suggest the following precautions against blood clots:

1. Anticoagulation therapy

The use of anticoagulant drugs is common among people at high risk of developing clots before and following surgeries. Anticoagulant drugs are also recommended for those admitted to the hospital due to particular illnesses, such as myocardial infarction, stroke, or complications resulting from cancer.

2. Compression stockings

Wearing these stockings continuously compresses your legs and facilitates blood circulation within your legs and foot muscles. Moreover, they provide an affordable way of reducing the chances of blood collecting in the veins post-surgery.

3. Elevation of the legs

Raising your legs when necessary and during nighttime can improve blood circulation. Placing blocks under your bed frame can help elevate the bottom part of your bed by 4 to 6 inches (10 to 15 centimeters).

4. Physical activities

Postoperative movement can help prevent pulmonary embolism and ensure faster recovery. This explains why nurses always encourage starting moving early, even on the same day of the surgery.

5. Pneumatic compression

This procedure employs thigh-high or calf-high inflatable sleeves to periodically compress your veins and promote blood circulation in your legs.

Conclusion

Pulmonary embolism can be managed with timely diagnosis and proper treatment. Doctors may use pulmonary embolism treatment drugs such as anticoagulants, while severe cases may need more advanced procedures.

Recognising symptoms early, seeking medical care, and following the right pulmonary embolism treatment guidelines can help improve outcomes and reduce the risk of serious complications.

Reader Information: The information provided in this article is intended for general educational purposes only and should not be considered a substitute for professional medical advice, diagnosis, or treatment. Pulmonary embolism is a serious medical condition that requires prompt evaluation and care by a qualified healthcare provider.

If you experience symptoms such as sudden shortness of breath, chest pain, coughing up blood, or fainting, seek immediate medical attention. Always consult your doctor or a licensed medical professional before starting, stopping, or modifying any treatment, medication, or lifestyle changes.