Pulmonary embolism should be treated in the department of respiratory medicine.

Written by Wang Li Bing
Intensive Care Medicine Department
Updated on September 03, 2024
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Pulmonary embolism is an emergency in clinical settings, with rapid progression and extreme danger, and is generally treated by the department of respiratory medicine. Pulmonary embolism primarily occurs due to dislodged blood clots that block the pulmonary artery and its branches, leading to pulmonary infarction. The clinical manifestations of pulmonary embolism mainly include severe breathing difficulties, chest pain, coughing up blood, and even circulatory disturbances. After a pulmonary embolism occurs, a pulmonary artery CT scan can be used to further confirm the diagnosis. Treatment options may include thrombolysis, and possibly anticoagulation therapy with low molecular weight heparin or warfarin. (Specific medications should be used under the guidance of a physician.)

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Written by Wei Shi Liang
Intensive Care Unit
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How long does the treatment for pulmonary embolism take?

The timing of pulmonary embolism treatment mainly depends on the severity of the pulmonary embolism. The main goals of pulmonary embolism treatment are to save lives by addressing life-threatening right heart dysfunction and obstructive shock caused by the pulmonary embolism, to re-establish pulmonary vascular patency, restore lung tissue perfusion, and prevent the recurrence of pulmonary embolism. Main treatment methods include: respiratory and circulatory support, anticoagulation, thrombolysis, interventional or surgical removal of blood clots, placement of inferior vena cava filters, etc. General management: Patients who are highly suspected or diagnosed with pulmonary embolism should be closely monitored, tracking changes in respiration, heart rate, blood pressure, venous pressure, electrocardiogram, and blood gases to prevent the dislodgement of clots again. Absolute bed rest is required, and care should be taken not to overly bend the lower limbs, maintain bowel regularity, and avoid straining. For patients experiencing anxiety and panic symptoms, reassurance should be provided, along with appropriate use of sedatives. If there is chest pain, analgesics may be administered. For symptoms like fever and cough, corresponding symptomatic treatments should be given. To prevent lung infections and treat phlebitis, antibiotics may be used. Additionally, support treatments for respiratory and circulatory functions, as well as anticoagulation therapy, should be provided.

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Written by Yuan Qing
Pulmonology
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The difference between pulmonary embolism and pulmonary congestion

Pulmonary embolism and pulmonary congestion are two completely different diseases. Pulmonary embolism is mainly caused by the thrombosis of the venous vessels entering the pulmonary artery, thereby causing restricted blood flow in the pulmonary artery and leading to pulmonary embolism. Pulmonary congestion is often due to left heart failure, where the blood flow in the lungs cannot return to the left heart, causing the blood to be retained and congested in the lungs, forming this disease. However, they do have some similarities, such as presenting symptoms of difficulty breathing, shortness of breath, low blood pressure, shock, etc. But through diagnosis and additional examinations, these two diseases can be clearly differentiated. Therefore, careful differentiation is required in clinical practice because the treatments for the two diseases are completely different. If misdiagnosed, the treatment could be incorrect, leading to serious consequences from mistreatment.

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Written by Wei Shi Liang
Intensive Care Unit
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Can a pulmonary embolism be detected by a CT scan?

CT can detect acute pulmonary embolism, using CT angiography, which is the preferred imaging method for diagnosing pulmonary embolisms. It mainly shows central filling defects, as well as eccentric and abdominal wall filling defects, and complete filling defects. A diagnosis of pulmonary embolism can be made through the visualization of these filling defects on a CT scan. Additionally, some indirect signs, such as pulmonary hypertension, right ventricular enlargement, and the common mosaic sign, can also be observed. These are characteristic CT manifestations of acute pulmonary embolism.

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Written by Wang Li Bing
Intensive Care Medicine Department
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What are the precursors of pulmonary embolism?

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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What are the symptoms of a pulmonary embolism warning sign?

Pulmonary embolism is also very common in clinical settings, mainly seen in patients who have been bedridden for a long time, undergone various major surgeries, suffered from long bone fractures, pregnancy, etc. In the early stages of pulmonary embolism, patients generally experience varying degrees of chest pain, hemoptysis, and difficulty breathing, among others. If pulmonary embolism is suspected and the patient's condition permits, a pulmonary artery CTA scan should be immediately carried out to further confirm the diagnosis of pulmonary embolism. If the pulmonary embolism has already caused circulatory disturbances, thrombolytic therapy should then be considered.