What Happens If You Have a Blood Clot in Your Lung?

A pulmonary embolism (PE) is a blood clot that has traveled to the lungs. Getting the right treatment for a PE is important because the condition can lead to life-long complications, or even death. 

The type of treatment depends on the size of the blood clot, its location in the lungs, and how much it interferes with the function of the heart and lungs. We’ll go into more detail about the treatment of this condition and what to expect if you or someone you know has a PE.

What’s the treatment for a blood clot in the lung? 

Treatment for almost all PEs involves anticoagulants, more commonly known as “blood thinners.” These medications work by interfering with the blood’s ability to clot. But these medications don’t immediately break up the existing clot. Instead, they stop the clot from getting bigger. This way, the body has the chance to slowly dissolve the clot over time. 

In many cases, when someone gets a PE diagnosis, a healthcare provider will immediately give them a dose of intravenous (IV) heparin. Healthcare providers use this anticoagulant at the start of treatment because it works quickly. Then they’ll transition from heparin to an oral anticoagulant for long-term treatment. 

Common anticoagulant options are:

• Warfarin (Coumadin): This is one of the oldest anticoagulants. One disadvantage is that you need to monitor your blood levels. But warfarin can be easily reversed, so it might be a good choice for someone who is at a higher risk of bleeding. 

• Direct-acting oral anticoagulants: These are a bit newer. Examples are apixaban (Eliquis) and rivaroxaban (Xarelto). They’re more convenient because they don’t need frequent blood testing. But they may be harder to reverse if you develop life-threatening bleeding. 

• Lovenox (enoxaparin): This is an injection into the skin. Sometimes people use it for a short period of time while they transition to warfarin. It’s safe during pregnancy.

More serious cases of a PE need treatment that also immediately breaks up the blood clot. This is sometimes necessary if the blood clot is particularly large, or if it puts a lot of strain on the heart or lungs. Healthcare teams can break up a blood clot with:

• Fibrinolytics: Examples include tissue plasminogen activator (tPA) and tenecteplase. These are IV medications that break apart any existing blood clots (rather than prevent further clotting), so they also carry a high risk of bleeding complications in comparison to anticoagulants. 

• Catheter-directed lysis: In this procedure a provider threads a catheter through the veins to the exact site of the blood clot. They administer the fibrinolytic medication directly onto the clot. This helps to decrease bleeding risk because it allows for a smaller dose of medication.

These treatments carry a higher risk of life-threatening bleeding, so healthcare teams typically only use them in more serious cases. 

Will I have to stay in the hospital if I have a pulmonary embolism?

Similar to how treatment depends on your specific case, whether you need to stay in the hospital varies according to your condition. If you’re otherwise healthy and have a small blood clot that doesn’t affect the function of your heart and lungs, you may not need to stay in the hospital. In such mild cases, you may simply start taking an anticoagulant at home and then follow up with your provider. 

But many times, providers will recommend a short stay in the hospital to monitor your breathing and vital signs while they start the necessary medication. This is especially true when:

• You have a preexisting heart or lung condition, which can put you at increased risk for complications from the blood clot.

• You have a particularly large blood clot, which also increases the risk of complications.

• You have low oxygen levels, or you feel significantly short of breath.

• There’s a possibility that you’ll need treatment with fibrinolytics to quickly break up the clot.

How long is the recovery time for a blood clot in the lungs? 

The recovery from a PE depends on both the treatment approach and the size of the blood clot. A larger blood clot will take longer to dissolve, but these are also the types of clots that might require fibrinolytics (which break down the clot right away). 

Most people will need to take blood thinners for at least 3 months. Some people may need them longer — or for the rest of their life if they have a medical condition that permanently increases their risk for blood clots. This might also be the case after having more than one blood clot or PE. 

After getting a PE diagnosis and starting treatment, it will likely take a few days to start feeling better. You’ll gradually feel better as your body slowly breaks down the blood clot. The good news is that you can return to normal daily activities after starting treatment (if your symptoms allow). 

After starting treatment for a PE, it’s important to closely follow up with your provider. If your symptoms improve and don’t come back, you might not need any additional testing. But if you have persistent symptoms, you might need testing to check on the clot or for possible complications related to the PE.

What’s the prognosis for a blood clot in the lung? 

The prognosis of blood clots depends on the size of the clot. Most PEs are small and aren’t life-threatening. Usually, people will make a full recovery from a PE after they start treatment.

There are some potential long-term complications of blood clots. About 1 in 30 people who get a blood clot will develop a condition called “pulmonary hypertension.” This is essentially high blood pressure of the arteries that travel from the heart to the lungs. This condition can lead to chronic shortness of breath as well as heart failure.

Large blood clots are much more serious and can be life-threatening. This is because they interfere with the vital function of the heart and lungs, potentially leading to failure of these organs. But these types of PE aren’t common. Less than 2% of PEs are fatal. 

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Written by:

Michael Dreis, MD

Dr. Dreis is an emergency medicine physician currently practicing in Milwaukee, Wisconsin. He went to medical school at the University of Wisconsin – Madison and completed his residency at Henry Ford Hospital in Detroit, Michigan.

Edited by:

Katie E. Golden, MD

Katie E. Golden, MD, is a board-certified emergency medicine physician and a medical editor at GoodRx.

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