Pulmonary embolism

A pulmonary embolism (thromboembolism) occurs when a blood clot, generally a venous thrombus, becomes dislodged from its site of formation and embolizes to the arterial blood supply of one of the lungs. Symptoms may include difficulty breathing, pain during breathing, and more rarely circulatory instability and death. Treatment is with anticoagulant medication, such as warfarin.

Treatment

Acutely, supportive treatments, such as oxygen or analgesia, are often required. Massive PE, as confirmed by imaging or echocardiography, is treated with thrombolysis.

Related Topics:
Oxygen - Analgesia - Thrombolysis

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In most cases, anticoagulant therapy is the mainstay of treatment. Heparin or low molecular weight heparins are administered initially, while warfarin therapy is commenced (this may take several days, usually while the patient is in hospital). Warfarin therapy is usually continued for 3-6 months, or "lifelong" if there have been previous DVTs or PEs, or none of the usual risk factors is present. Warfarin therapy often requires frequent dose adjustment and monitoring of the INR. In PE, INRs between 2.0 and 3.0 are generally considered ideal. If another episode of PE occurs under warfarin treatment, the INR window is often increased to 3.0-4.0 (unless there are contraindications). If anticoagulant therapy is contraindicated and/or ineffective an inferior vena cava filter may be implanted.

Related Topics:
Anticoagulant - Heparin - Low molecular weight heparin - Warfarin - INR - Contraindicated - Inferior vena cava filter

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