A patient presented with pulmonary embolism the treatment to be given is
(B) i.v. Heparin with continuous infusion followed by coumarin for 4-5 months # Thrombolysis:> Successful thrombolytic therapy rapidly reverses right heart failure and leads to a lower rate of death and recurrent PE.# Thrombolysis usually:> Dissolves much of the anatomically obstructing pulmonary arterial thrombus;> Prevents the continued release of serotonin and other neurohumoral factors that exacerbate pulmonary hypertension; and Dissolves much of the source of the thrombus in the pelvic or deep leg veins, thereby decreasing the likelihood of recurrent PE.> The preferred thrombolytic regimen is 100 mg of recombinant tissue plasminogen activator (tPA) administered as a continuous peripheral intravenous infusion over 2 h.> Patients appear to respond to thrombolysis for up to 14 days after the PE has occurred.> Contraindications to thrombolysis include intracranial disease, recent surgery, or trauma. There is a 1 to 2% risk of intracranial hemorrhage.> Careful screening of patients for contraindications to thrombolysis is the best way to minimize bleeding risk.
Urokinase with fibrinolytics
i.v. Heparin with continuous infusion followed by coumarin for 4-5 months
Subcutaneous Heparin 5000 units
Warfarin with INR 1-1.5
Miscellaneous