Pulmonary embolism means

Written by Wang Li Bing
Intensive Care Medicine Department
Updated on September 11, 2024
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The formation of thrombotic foreign bodies in the human venous system or the right atrium and ventricle system, ultimately leading to the blockage in the pulmonary artery, is referred to as pulmonary embolism. After the onset of pulmonary embolism, patients may experience symptoms such as shortness of breath, chest pain, coughing, and even coughing up blood. It is crucial to immediately conduct a pulmonary artery CTA scan for further diagnosis. If the diagnosis of pulmonary embolism is confirmed, thrombolytic or interventional treatments can be considered.

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Written by Yuan Qing
Pulmonology
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Why should one lie flat for acute pulmonary embolism?

When acute pulmonary embolism occurs, it is primarily due to a thrombus from the venous system being carried by the venous blood flow back to the right heart, and then due to the ejection from the right heart, this thrombus gets lodged in the pulmonary artery, forming a pulmonary embolism. After the onset of pulmonary embolism, the primary treatment measure is to have the patient lie down and remain still. The reason is mainly that if the patient is standing or moving, it is very likely that the thrombus in the venous system could continue to detach and move within the venous system. This can worsen the symptoms of pulmonary embolism or lead to new embolic sites, so the treatment for the patient involves immobilization and lying down to avoid further movement, making this the most basic approach to treatment.

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Written by Wei Shi Liang
Intensive Care Unit
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Is pulmonary embolism related to pneumonia?

If unexplained shortness of breath, pleuritic chest pain, tachycardia, and decreased oxygen saturation occur, one should be highly vigilant about pulmonary embolism. Generally, pulmonary embolism has no direct relationship with pneumonia. High-risk factors for pulmonary embolism include obesity, prolonged immobilization, stroke, congestive heart failure, malignant tumor, inflammatory bowel disease, lower limb fracture, anesthesia time exceeding 30 minutes, and acquired or genetic hypercoagulable state. It usually manifests as difficulty breathing, rapid breathing, and pleuritic chest pain.

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Written by An Yong Peng
Pulmonology
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Can a pulmonary embolism be detected by an X-ray?

Pulmonary embolism cannot be detected by X-ray. Although in rare cases, some signs might appear on an X-ray, such as localized sparse lung markings, these signs are typically not characteristic. For conditions like pulmonary embolism, color Doppler ultrasound can be used to assist in diagnosis. If the ultrasound suggests deep vein thrombosis in the legs along with pulmonary hypertension, it indicates a high possibility of pulmonary embolism. Additionally, testing for D-dimer and blood gas analysis can also help in diagnosing pulmonary embolism. CT pulmonary angiography can also be used to diagnose the condition. CT and pulmonary angiography have a high diagnostic value for pulmonary embolism, and most cases can be definitively diagnosed through these tests.

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Written by Yuan Qing
Pulmonology
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Can a secondary recurrence of pulmonary embolism be treated?

Pulmonary embolism, even if it recurs for the second time, is treatable, but the approach should differ from the first recurrence. It's vital to determine the cause of the pulmonary embolism, although many patients with this condition do not have an identifiable cause. For such patients, long-term oral anticoagulants might be recommended. With long-term use of oral anticoagulants, the likelihood of thrombosis, especially in the venous system, significantly reduces. This means that the chance of recurrence in patients also decreases considerably. However, if the cause can be identified, it is better to address and eliminate it. For instance, if the cause is long-term use of oral contraceptives or the presence of varicose veins, these primary or secondary factors should be resolved. The treatment should not just focus on anticoagulation or thrombolytic therapy, as there could still be a possibility of a future pulmonary embolism recurrence.

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Written by Wang Li Bing
Intensive Care Medicine Department
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Pulmonary embolism belongs to which department?

Pulmonary embolism mainly refers to the detachment of thrombi in the blood, leading to the obstruction of the main trunk of the pulmonary artery and its branches, causing a series of syndromes. Pulmonary embolism is an emergency in clinical practice. If the patient's circulation becomes unstable after the embolism, thrombolytic therapy should be considered. If the patient's respiratory circulation remains stable after the embolism, anticoagulation therapy can be considered. In clinical practice, pulmonary embolism is primarily diagnosed through pulmonary artery CTA examination to further clarify the diagnosis, and patients generally consult the respiratory medicine department.