Pulmonary Embolism - Thrombolytic Therapy

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Thrombolytic therapy

Pulmonary embolism can be fatal, especially if there is a large amount of clot present within the pulmonary arteries. Tissue plasminogen activator (tPA) is a medication given to break up blood clots, known as thrombolytic therapy. Thrombolytic therapy with tPA is indicated in patients with pulmonary emboli who also have hypotension (low blood pressure), since this may be one sign of shock. Others signs of shock include:

  • confusion,
  • coma, or
  • damage to other organs including the heart and kidneys.

tPA helps break up or dissolve the arterial clot. It may be given peripherally in an IV or centrally, through a catheter that is inserted in the arm or groin and threaded into the pulmonary artery, so that the medication can be delivered directly to the clot. Evidence of right heart strain on CT scan or by echocardiogram, or blood tests that show the heart to be under strain (for example, troponin levels), also may be an indication for thrombolytic therapy, depending upon the clinical situation.

Thrombolytic therapy with tPA is an emergent treatment that thins the blood immediately. Warfarin and factor X inhibitors are not prescribed immediately in this situation, though unfractionated heparin may be used initially while decisions regarding the use of tPA are considered.

Return to Pulmonary Embolism (Blood Clot in the Lung)

See what others are saying

Comment from: Erika, 65-74 Female (Patient) Published: December 26

I collapsed on the street on my way to see my family doctor because of a sudden unfamiliar pain in the calf of my right leg. I was taken by ambulance to the emergency room of the nearest hospital, diagnosed correctly (with massive pulmonary embolism) and treated in the intensive care unit with thrombolytic therapy. This was 5 weeks ago. I am now on warfarin and will have follow up in a hematology clinic.

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Comment from: Carol, 55-64 Female (Patient) Published: March 21

After developing a pulmonary embolism (PE) after a hysterectomy. I was on Lovenox and warfarin for 6 months. My doctor sent me for blood work to see if I was at risk for more clots. I found out that I have a blood disorder called Factor V Leiden which is a gene mutation that causes blood to clot more than normal people. I had multiple miscarriages during my youth which is a result of this issue also. If you have had deep vein thrombosis (DVT) or PE, get tested for this. If you carry this gene your children should be tested also to see if they carry the gene because if they do they are at risk.

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