Unsuspected Pulmonary Embolism
Introduction
This page gives you general information about your condition and its treatment. Many of your questions should be answered by this page but if you have any concerns or require further explanation, you will have the opportunity to discuss this with the health professional involved in your care.
What is an Unsuspected Pulmonary embolism?
An unsuspected or incidental pulmonary embolism is a small blood clot in the lungs, diagnosed following a computed tomography (CT) scan that was done for other reasons. Most patients who have them do not know they have one because these blood clots are usually too small to cause any symptoms.
If these blood clots are left untreated, they can grow and start causing symptoms that, in some cases, can be troublesome, such as shortness of breath and fatigue.
Following a diagnosis of an incidental pulmonary embolism, you will be referred for assessment by a healthcare professional in the Same-Day Emergency Care (SDEC) unit, who has specific experience in managing unsuspected pulmonary embolisms.
The assessment may take place on the same day as your scan, or it might be done the next working day. However, if you feel unusually breathless or unwell following your scan, please get in touch with the SDEC triage number. You will be advised on what to do next.
What will happen during the assessment?
An anticoagulant, a medicine that thins the blood, is used to treat an unsuspected or incidental pulmonary embolism.
Anticoagulants can be given in several different ways:
- A heparin-based blood thinner that is injected under the skin may be prescribed, and you may leave the hospital with a supply of pre-filled syringes for you to inject yourself daily at home. The nurse undertaking your assessment will show you how to do this yourself
- Rivaroxaban is a tablet that you will initially need to take twice a day for three weeks and then just once a day for the duration of the treatment. Another blood thinner in the same category is Apixaban, taken twice daily. These tablets do not require monitoring with regular blood tests
- Warfarin is a blood-thinning tablet that takes several days to become effective, and regular blood tests are required to ensure the correct dose is given. Routine blood tests may be needed to monitor and stabilise your warfarin levels. You may have a combination of both warfarin and heparin
The healthcare professional involved in your care will inform you of the treatment you will be receiving.
In the rare case that you are already on an anticoagulant, the team will decide whether to adjust your dose or change the anticoagulant you are taking, depending on your specific circumstances.
Can there be any complications or risks?
As you receive a medicine to make your blood thinner, you may notice that you bruise more easily. Any bleeding, for example, if you accidentally cut yourself or have a nosebleed, will be heavier than normal.
If you are injecting a heparin-based blood thinner, you may notice bruising around the injection site. This is normal and is usually something not to be concerned about. You can help prevent this by touching the injection site as little as possible during and after the injection is given.
Serious bleeding is uncommon (less than 5%). If you experience any bleeding that you cannot control or explain or notice soft black tarry stools, you should report to the A&E Department of your nearest hospital.
Please share the information on this page with your partner and family (if you wish) so that they can be of help and support. There may be information they need to know, especially if they are taking care of you following the assessment.
What happens afterwards?
Following your assessment, if you are treated as an outpatient, you will receive a month's supply of your medication and an information pack.
You will need a repeat blood test seven days after starting heparin and will be given a follow-up appointment to see your consultant.
If you are admitted, treatment will be initiated on the ward. The expected length of stay will depend on your condition. On discharge, you will be given a small supply of medication and a follow-up appointment to see your consultant.
Your consultant will advise you on how long you need to take your medication; however, the length of treatment is usually 6 months but can vary according to your circumstances.
Future prescriptions for your medication should be obtained from your GP.
Please do not hesitate to contact us if you require further advice about the issues on this page.
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General advice and consent
This page should have answered most of your questions but remember that this is only a starting point for discussion with your doctor.
Consent to treatment
Before any doctor, nurse or therapist examines or treats you, they must seek your consent or permission. To make a decision, you need to have information from health professionals about the treatment or investigation offered to you. You should always ask them more questions if you do not understand, or if want more information.
During this assessment, you will be given verbal information and have time to ask questions about your condition and proposed treatment.
The information you receive should be about your condition, the alternatives available to you, and whether it carries risks and benefits. What is important is that your consent is genuine or valid. That means:
- You must be able to give your consent
- You must be given enough information to enable you to make a decision
- You must act under your own free will and not under the strong influence of another person.
Information about you
As part of your care, when you come to the hospital, information about you is shared between healthcare team members, some of whom you may not meet. It may be used to help train any staff involved in your care. Information we collect may also be used after you have been treated to allow us to maintain and improve the quality of our care, plan services, or research new developments.
All information is treated as strictly confidential and is not given to anyone who does not need it. If you have any concerns, please ask your doctor or the person caring for you.
How much do I need to know?
Some people want to know as much as possible about their condition and possible treatments; others prefer to leave decisions to the experts. If you do not want to know, no one providing healthcare will force information on you, for example, about the risks of treatment. Remember, the person in the best position to understand what matters most is you.