What are the precursors of pulmonary embolism?

Written by Wang Li Bing
Intensive Care Medicine Department
Updated on September 21, 2024
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Pulmonary embolism is also relatively common in clinical practice. Its precursors may include varying degrees of respiratory difficulty, chest tightness, and shortness of breath, among others. If such symptoms occur, medical attention should be sought promptly, primarily to rule out the possibility of acute myocardial infarction. Pulmonary artery CTA can further confirm whether there is a pulmonary embolism. In cases of extensive pulmonary embolism, there is a high risk of sudden death, and aggressive thrombolytic and anticoagulation treatments should be administered. If the patient's chest tightness and shortness of breath are relieved after the aforementioned treatments, hospitalization for observation and treatment is still necessary.

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Written by Wang Li Bing
Intensive Care Medicine Department
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The most common symptoms of pulmonary embolism.

Pulmonary embolism is also relatively common in clinical practice, primarily caused by an embolus blocking the pulmonary artery system, leading to a group of clinical syndromes. The clinical manifestations of pulmonary embolism mainly include the following points: The first is that patients may experience unexplained difficulty breathing and shortness of breath, especially after activity. The second is that patients experience significant chest pain. The third may be accompanied by hemoptysis, but usually, the amount of blood expectorated is not large. The fourth is that patients may experience restlessness, panic, and even a sense of impending doom. Clinically, there sometimes appears the so-called triad, which includes simultaneous occurrence of difficulty breathing, chest pain, and hemoptysis, etc. Pulmonary embolism is primarily diagnosed clinically through pulmonary artery CT.

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Written by Yuan Qing
Pulmonology
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Why do patients with pulmonary embolism feel sleepy?

Patients with pulmonary embolism primarily suffer from emboli within the venous system, which travel back to the right heart and then become lodged in the pulmonary artery, forming a pulmonary artery thrombus. This reduces pulmonary blood flow and impacts the exchange of air in the lungs, leading to hypoxia in the patient. Following hypoxia, the brain tends to enter a sleepy state, thus many patients with pulmonary embolism exhibit sleepiness. This sleepiness is related to the pathophysiological mechanisms of pulmonary embolism. At this point, it is crucial to provide sufficient oxygen to the patient to address their hypoxemia. Ultimately, the most fundamental treatments are prompt thrombolysis or anticoagulation therapy to resolve the embolus, addressing the condition fundamentally.

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Written by Wang Chun Mei
Pulmonology
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Will acute pulmonary embolism get better in two days?

Acute pulmonary embolism is a type of disease with very many and complex inducing factors. Clinically, acute pulmonary embolism has a very sudden onset, and patients often present with unexplained symptoms such as pale complexion, chest tightness, chest pain, and difficulty breathing. During the acute phase of pulmonary embolism, immediate and effective anti-shock and other symptomatic resuscitation are essential upon arrival at the hospital. Generally, after timely and effective resuscitation, the patient's condition may be somewhat controlled. Usually, the first 1-3 days after the onset of pulmonary embolism are the most dangerous; therefore, continuous monitoring of the patient's vital signs is crucial during this time, followed by anti-shock and anticoagulation treatment as needed. Therefore, acute pulmonary embolism will not improve by the second day, although some of the patient's clinical symptoms may slightly improve after treatment.

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Written by Li Jian Wu
Pulmonology
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Early symptoms of pulmonary embolism

In the early stages of pulmonary embolism, symptoms such as difficulty breathing, chest tightness, shortness of breath, and decreased oxygen saturation can occur. Early signs may include chest pain, as chest pain is often an initial symptom of pulmonary embolism. Sometimes the pain can be severe, and some patients may experience coughing, dry cough, and even cough up blood. There may also be symptoms of short exhalation and difficulty breathing, especially in patients with main trunk blockages, where the difficulty in breathing can be very pronounced. In more severe cases, some may experience fainting, suddenly collapsing while walking.

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Written by Yuan Qing
Pulmonology
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Is it good to place a filter for pulmonary embolism or not?

Whether it is good or not to place a filter for pulmonary embolism mainly depends on the cause of the pulmonary embolism and whether there are indications for placing a filter. Generally speaking, if pulmonary embolism is caused by the formation of blood clots in the lower limbs or the inferior vena cava, placing a filter can generally be beneficial. However, not all cases of lower limb venous thrombosis require a filter. Filters are usually only used for deep or large vein thromboses that are not suitable for thrombectomy or thrombolysis treatments. If a filter is placed under other conditions, it is very likely that thrombosis will re-form on the surface of the filter, potentially leading to some recurrent pulmonary embolisms or iatrogenic pulmonary embolisms. Therefore, the decision to place a filter is complex and requires a doctor to weigh the pros and cons before deciding whether or not to proceed.