Pulmonary embolus is a blockage of an artery in the lungs by fat, air, tumour tissue, or blood clot. PE is the third most common cause of death in the US, with at least 650,000 cases occurring annually. Symptoms may include difficulty breathing, pain in the chest during breathing, and in more severe cases collapse, circulatory instability and sudden death. Symptoms of infarction often last several days but usually become milder every day. It usually comes from smaller vessels in the leg, pelvis, arms, or heart. When a clot forms in the legs or arms, it is referred to as a deep venous thrombosis (DVT). PE can arise from DVT anywhere in the body. Fatal PE often results from thrombus that originates in the axillary or subclavian veins (deep veins of the arm or shoulder) or in veins of the pelvis.

Thrombus that forms around indwelling central venous catheters is a common cause of fatal PE. The most common sources of embolism are proximal leg deep venous thrombosis (DVTs) or pelvic vein thromboses. Any risk factor for DVT also increases the risk that the venous clot will dislodge and migrate to the lung circulation, which happens in up to 15% of all DVTs. The conditions are generally regarded as a continuum termed venous thromboembolism (VTE).

Emergency treatment and hospitalization may be necessary. Anticoagulant therapy prevents the formation of more clots and allows the body to re-absorb the existing clots faster. Oxygen therapy may be required to maintain normal oxygen concentrations. Surgery is sometimes needed in patients at great risk for recurrent embolism.

Heparin therapy (low doses of heparin injected under the skin) may be used for those on prolonged bedrest. Clot-dissolving medication (thrombolytic therapy) includes streptokinase, urokinase, or t-PA. Thrombolytic therapy is used for people who appear to be in danger of dying of pulmonary embolism. Subcutaneous low-molecular weight heparin is substituted for intravenous heparin in many circumstances. Patients who have reactions to heparin or related medications may need other medications. Prevention of deep venous thrombosis (DVT) among at-risk patients is very important. Walking and staying active as soon as possible after surgery or during a prolonged medical illness can reduce the risk for pulmonary embolus.

Pulmonary Embolus Treatment and Prevention Tips

1. Surgery is sometimes needed in patients at great risk for recurrent embolism.

2. Oxygen therapy may be required to maintain normal oxygen concentrations.

3. Walking and staying active as soon as possible after surgery.

4. Heparin therapy may be used for those on prolonged bedrest.

5. Subcutaneous low-molecular weight heparin is substituted for intravenous heparin in many circumstances.

6. Other preventive measures include compression stockings.