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General Practice 2023

Treatment for pulmonary embolism (and possible sequelae)

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Treatment for pulmonary embolism (and possible sequelae)
Treatment for pulmonary embolism (and possible sequelae)

In suspected pulmonary embolism, treatment in the hospital can be started even before confirming the diagnosis, and is usually performed with the administration of oxygen and injection of an anticoagulant directly into the vein, which is a drug that helps to prevent that the clot can increase in size or that new clots can form, worsening the situation.

If diagnostic tests, such as chest X-ray or pulmonary angiography, confirm the diagnosis of embolism, the person needs to be hospitalized to continue treatment for more days with anticoagulants and thrombolytics, which are another type of medications that help dissolve clots that already exist.

Pulmonary embolism is a serious condition and should be treated as soon as possible in the hospital, to avoid putting life at risk.If symptoms arise that lead to a suspicion of pulmonary embolism, such as a sudden feeling of shortness of breath, severe cough or severe chest pain, it is advisable to go to the emergency room, to assess the situation and start treatment, if necessary. Learn about other symptoms that may indicate a pulmonary embolism.

Signs of improvement and worsening

Symptom improvement appears a few minutes after emergency treatment with relief of difficulty breathing and decreased chest pain. However, when treatment is not started quickly, signs of worsening may appear, such as difficulty breathing, fainting and a decrease in the amount of oxygen in the body, which can lead to cardiac arrest.

When surgery is necessary

Surgery to treat pulmonary embolism is usually done when the use of anticoagulants and thrombolytics is not enough to improve symptoms and dissolve the clot that is preventing blood from passing to the lung.

In these cases, surgery is required in which the doctor inserts a thin flexible tube, known as a catheter, through an artery in the arm or leg until it reaches the clot in the lung, removing it.

A catheter can also be used to place a filter in the main vein, called the inferior vena cava, preventing clots from moving through the bloodstream towards the lungs. This filter is usually placed on people who cannot take anticoagulant medication.

How long do you need to stay in hospital

After eliminating the clot from the lung, it is usually necessary to stay hospitalized to ensure that no new clots appear and to monitor that the oxygen levels in the body are normalized.

When the condition seems to be stabilized, the doctor discharges the patient, but usually also prescribes anticoagulant drugs, such as Warfarin or Heparin, which must continue to be used daily at home, as they keep the blood thin and decrease the risk of re-emergence of a new clot.In addition to these, the doctor may also recommend analgesic drugs to relieve chest pain in the first few days and after treatment.

Possible sequelae of embolism

Since pulmonary embolism prevents the passage of blood to a part of the lung, the first sequel is related to the decrease in gas exchange and, therefore, there is less oxygen available in the blood. When this happens, the heart is overloaded, which makes it work much faster to try to get the same amount of oxygen to the entire body.

Usually the embolism occurs in a small area of ​​the lung and, thus, the person does not suffer serious consequences. However, and although rare, the obstruction can also happen in a larger blood vessel, which is responsible for supplying a greater part of the lung, and in this case the consequences can be more serious because the tissue that does not receive oxygenated blood becomes retracts and there is no gas exchange in that part of the lung.As a result, the person may have a sudden death, which happens suddenly, or they may have pulmonary sequelae, such as pulmonary hypertension.

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