Emergency treatment and a hospital stay are often necessary. The aim is to prevent new clots from forming. Oxygen therapy may be required to maintain normal oxygen levels.

In cases of severe, life-threatening pulmonary embolism, treatment may involve dissolving the clot and preventing new clots from forming.

Treatment to dissolve clots is called thrombolytic therapy. Clot-dissolving medications include:

• Streptokinase
• t-PA

Treatment to prevent clots is called anticoagulation therapy. Such drugs are commonly called blood thinners. Clot-prevention medicines include heparin and warfarin (Coumadin). Heparin or heparin-type drugs can be given intravenously (by IV, directly into a vein), or as injections under the skin. These are usually the first medications given, and are then transitioned over to warfarin given in pill form.

When you first start taking warfarin, you will need frequent lab tests to check the thickness of your blood. This will help your doctor properly adjust your dose.

Patients who have reactions to heparin or related medications may need other medications.

Patients who cannot tolerate blood thinners may need a device called an inferior vena cava filter (IVC filter). This device is placed in the main central vein in the belly area. It keeps large clots from traveling into the blood vessels of the lungs. Sometimes a temporary filter can be placed and removed later.

It is difficult to predict how well a patient will do. Often, the outlook is related to what put the person at risk for pulmonary embolism (for example, cancer, major surgery, trauma). In cases of severe pulmonary embolism, where shock and heart failure occur, the death rate may be greater than 50%.

• Heart failure or shock
• Heart palpitations
• Pulmonary hypertension
• Severe breathing difficulty
• Severe bleeding (usually a complication of treatment)
• Sudden death

Go to the emergency room or call the local emergency number (such as 911) if you have symptoms of pulmonary embolus.