Pulmonary Embolism Treatment
The main goal of treating pulmonary thromboembolism is avoiding a life-threatening outcome by stopping the formation of blood clots and the progression of the disease. This reduces the chances of new episodes after the acute cardiovascular event that would increase the risk of death due to pulmonary thromboembolism. Another goal is to prevent the progression of pulmonary thromboembolism to chronic venous insufficiency, pulmonary hypertension, and other complications.
To achieve these goals, your doctor will likely follow these steps:
1. Treating your risk factors
There are risk factors for blood clot formation that can be addressed to reduce the incidence and complications of pulmonary embolism. For instance, your doctor might take out certain medications that will contribute to clot formation, such as oral contraceptives and vitamin K. Another measure will be controlling your weight, reducing the time you spent sitting, lying down or immobilized, lowering your blood pressure in cases of hypertension, and advising against tobacco use. In some cases, your doctor might notice a blood imbalance of a substance called homocysteine. When it’s elevated, he will prescribe folic acid with or without vitamin B6.
2. Early deambulation
It means walking or moving around closely after being treated for a pulmonary embolism. It is recommended in most cases unless the patient has a case of massive pulmonary thromboembolism with a large blood clot or several blood clots compromising various parts of the vascular network. It is also not recommended in cases of unstable blood clots and hypotension. Early deambulation or walking is recommended 5 to 7 days after starting treatment with anticoagulants.
3. Heparin
It is a potent anticoagulant administered subcutaneously or in intravenous solutions with strict control of laboratory parameters. Your doctor will order several exams and keep ordering them as you go through heparin treatment, which is why it requires to be hospitalized in order to be administered.
This drug inactivates the enzymes and blood factors that trigger blood clotting, and the type of heparin that is advised for pulmonary thromboembolism is low molecular weight heparin, which is equally effective as another group called unfractionated heparin. Doses are calculated considering the patient’s weight, and it is administered every 12 hours along with oral anticoagulants for 5 days or more.
∗ Heparin use should be closely monitored in a hospitalized patient.
