How is a pulmonary embolism treated?
Taking anticoagulant drugs
The main treatment for pulmonary embolism is called an anticoagulant. This is a drug that causes chemical changes in your blood to stop it clotting easily. This drug will stop the clot getting larger while your body slowly absorbs it. It also reduces the risk of further clots developing.
There are different types of anticoagulants, so you should discuss them with your health care professional to make sure you get the most suitable one for you. These anticoagulants include:
- warfarin
- rivaroxaban
- dabigatran
- apixaban
- edoxaban
- heparin (given as an injection)
Your doctor or nurse should tell you how much of your anticoagulant medicine to take and when to take it. Most anticoagulant medicines should be taken at the same time once or twice a day. It’s important to take your medicines as prescribed, because the effects of some anticoagulant medicines can start to wear off within a day.
You will usually be recommended to take these drugs for a minimum of three months to prevent recurrent blood clots. However, some people need to take them for longer periods of time. For example, people who have had significant, life-threatening pulmonary embolism, recurrent clots or an unprovoked clot may be advised to stay on the drug indefinitely.
Like any drugs, anticoagulants may have side effects, which will vary from person to person. One of the most important problems is bleeding more easily and excessively. Because of this, if you’re prescribed warfarin you will need regular blood tests to make sure you’re on the correct dose. Newer anticoagulant tablets generally don’t need regular blood tests. If you’re not sure what anticoagulant you’re on and why, ask your health care professional.
Anticoagulants interact with many other drugs, including herbal remedies. They can also be affected by alcohol and certain foods. You can read more about issues to consider when on anticoagulants on the NHS website, including food and drink, surgery and other medications. Your doctor, nurse and pharmacist can also help you to manage your medication.
Other treatment for pulmonary embolism
In more severe cases of pulmonary embolism, other treatments may be needed to remove or break up a clot. This might be done with drugs called thrombolytics which help break up and dissolve the clot, or less commonly, surgery to remove it.
Will I be treated in hospital or at home?
As part of your diagnosis, you should have had an assessment to check the risk of coming to harm from the pulmonary embolism. If you are thought to be at intermediate or high risk of coming to harm, then you will be treated as an in-patient in hospital. If you are deemed to be at low risk of coming to harm then you may be diagnosed and treated as an outpatient.
If you are managed as an outpatient, you should be reviewed by a senior clinician before going home. You should also be given information on potential complications and treatment, as well as a point of contact at the hospital.
If it’s confirmed that you have had a pulmonary embolism and are being treated as an outpatient, you should have an initial review within seven days of being discharged. You should also have a later follow-up check with a senior clinician with expertise in pulmonary embolism management.
Recovering from a pulmonary embolism
Often, your GP will follow up after your embolism. But it’s becoming more common to go back to a thrombosis service based in a hospital. This is to make sure you understand all the information and there are no problems with the drug you’re taking.
Most people are treated for pulmonary embolism for at least three months, and some may be treated for the rest of their lives.
How long will I feel breathless?
It’s common to feel breathless for a few weeks or months after a pulmonary embolism. In the unlikely event you develop sudden, significantly worsened breathlessness, you should seek urgent medical attention.
If your breathing hasn’t returned to its normal state after three months, then your doctor may recommend tests to assess whether a significant amount of clot remains and whether this is putting strain on the right side of the heart.
Call 999 if:
- you have severe breathing difficulty or
- your heart is beating very fast or
- someone has passed out
These could be signs of a pulmonary embolism or another serious condition.