What is the treatment for blood clots in the lungs?

A blood clot blocking an artery in your lungs is clinically known as a pulmonary embolism. It’s one type of venous thromboembolism (VT), a condition where blood clots form in the veins that carry blood to the heart. 

Treatment for blood clots in the lungs focuses on two things: Dissolving the existing clot and preventing the formation of new blood clots.

In some cases, when there are signs of heart strain or other complications, medical professionals may recommend surgery for removal.

A pulmonary embolism usually starts as deep vein thrombosis (DVT). This is when a blood clot forms in deep veins, most often in the legs. A piece of the clot breaks off and travels through the bloodstream to the lungs. Pulmonary embolisms are considered a complication of DVT.

A blood clot can also form in the small blood vessels of the lungs. This is also a pulmonary embolism, even though it does not come from DVT. According to the American Thoracic Society, about 70% of blood clots in the lungs start as DVT in the leg.

This article will discuss traditional medical treatment options for both types of pulmonary embolisms.

Treatment for pulmonary embolism

A pulmonary embolism is generally treated with blood thinners. These are also called anticoagulant medications because they change the thickness of your blood so that coagulation is less likely to occur. 

Prompt treatment for a blood clot in the lungs is key to preventing blood flow blockages to the lungs and heart, which could cause extremely low blood pressure and cardiac shock.

Pulmonary embolisms are considered a medical emergency, and recovery may take months or years.

But treatment may stop the clot from getting bigger and the body from making new clots. The goal of treatment is for the body to dissolve the clot. 

Blood thinners (anticoagulants)

In the hospital, your health team may prescribe blood thinners as a continuous infusion through an intravenous (IV) catheter or as an injection administered once or twice every day.

Anticoagulant medication options may include:

• heparin (continuous infusion)
• enoxaparin (injection)

If treatment is effective and no complications have been detected, you may be sent home within days. Your medical professionals may still recommend you continue to take blood thinners.

Depending on your overall health and outlook, you may continue with blood thinning therapy for about 3 months or indefinitely. This may reduce the chance of forming new blood clots in the lungs and other organs.

Among the oral anticoagulant medications they may prescribe may be:

• warfarin
• dabigatran (Pradaxa)
• rivaroxaban (Xarelto)
• edoxaban (Lixiana)
• apixaban (Eliquis)

Your health team may also prescribe an injectable blood thinner for use at home. Options may include:

• enoxaparin (Lovenox)
• dalteparin (Fragmin)

The use of anticoagulant medications typically requires your health team to monitor you. They may ask you to have blood work done every few months, and if the cause of the embolism is not established yet, they may recommend additional tests.

If you need help covering the cost of medications, the free Optum Perks Discount Card could help you save up to 80% on prescription drugs. Follow the links on drug names for savings on that medication, or search for a specific drug here.

Thrombolytics

A thrombolytic medication breaks up larger clots. Its side effects may include internal bleeding, including bleeding in the brain, so it is only used in severe cases of pulmonary embolism. 

Alteplase, a type of drug called a tissue plasminogen activator, is an example of a thrombolytic for blood clots in the lungs.

Your healthcare professional may administer the drug through an IV catheter or by a catheter passed through a vein from the neck or groin. This allows the medication to have a fast effect on your body.

Inferior vena cava filter

Because of the increased chance of bleeding when taking blood thinners, some people may not be able to take this type of drug. Your healthcare professional may instead recommend an inferior vena cava (IVC) filter if you live with deep vein thrombosis. 

Doctors place the filter in the IVC, the main vein in the lower body. This filter can prevent clots from moving up from the legs to the lungs. 

An IVC is temporary and should be taken out when no longer needed. The filter itself may sometimes cause blood clots, so regular monitoring is key when receiving this treatment. 

Surgery

If the blood clot in your lung does not respond to treatment or becomes life threatening, your health team may recommend surgery. 

The procedure is called an embolectomy or thrombectomy. It is performed by threading a catheter through the blood vessels to reach the blood clot. Sometimes, instead of using a catheter, a doctor will remove a clot through open surgery. 

Symptoms of pulmonary embolism

A blood clot in the lungs doesn’t always cause immediate symptoms. If there are signs of a pulmonary embolism, they may include:

• fast heartbeat (tachycardia) or irregular heartbeat (arrhythmia)
• breathing difficulty
• chest pain that worsens when you cough or take a deep breath
• coughing up blood
• severely low blood pressure (under 90/60 mm Hg)
• lightheadedness or fainting

These symptoms may indicate a medical emergency. It is highly advisable not to wait for a doctor’s appointment, and instead, call your emergency services or have someone take you to the nearest emergency room.

Summary 

Treatment for blood clots in the lungs focuses on thinning the blood so the clot dissolves or removing the clot with surgery.

Pulmonary embolisms are considered a medical emergency. If you experience symptoms of blood clotting in your lungs, do not hesitate to go to the emergency room. A health team may give you blood thinners, implant a filter in a vein, or do surgery to remove the clot.

Download the free Optum Perks Discount Card to save up to 80% on some prescription medications.