How can I prevent getting a pulmonary embolism?
Pulmonary embolism (PE) is a venous thromboembolism from deep vein thrombosis (DVT) disease. It has a high mortality rate which creates an urgency for prevention in those at risk. The risk factors are the same as those for DVT, which include inherited (genetic) and acquired (fractures, cancer, pregnancy) factors. Thrombus formation is from:
- Venous stasis from immobilization, such as from hospitalization, postoperative convalescence, or a sedentary lifestyle
- Endothelial injury
- Hypercoagulable state
Swelling, pain, and warmth/redness can indicate a DVT. Prevention of initial episodes of PE depends on identifying those at risk for DVT and consideration of prophylactic anticoagulation. A strong family history of PE or DVT puts a patient at risk, and conservative measures should be employed:
- Exercise, mobility, and ambulation
- Avoid prolonged sitting with the legs in a dependent position, as in long airplane trips. Standing up and walking every 1-2 hours
- Cessation of tobacco products
- Keep hydrated.
- Compression stockings
- Passive range of motion exercises via physical therapy
- Avoid medications that enhance coagulation, such as the estrogens in contraceptives or in menopausal hormone replacement
- Consideration of prophylactic anticoagulation
Inferior vena cava (IVC) filter to act as a weir for thrombi to prevent their upward migration to the lungs.
For those with past or current episodes of PE, long-term and indefinite anticoagulation is the mainstay of therapy for prevention of subsequent DVT and recurrence of PE.