Heparin should be stopped as soon as platelet counts drop considerably (often by 50% of baseline), and if anticoagulation is required, direct thrombin inhibitors like lepirudin or argatroban should be started.
Damage to lung tissue may result from a pulmonary embolism (PE), which can reduce blood flow. It may result in low blood oxygen levels, which may harm more body organs. Large PEs or many clots in particular can soon result in major issues that can be fatal.
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