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

Written by Wang Li Bing
Intensive Care Medicine Department
Updated on September 01, 2024
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Pulmonary embolism is a pathological process in which a blood clot in the vessels detaches, affecting the pulmonary artery and its branches. After the occurrence of a pulmonary embolism, patients generally visit the respiratory medicine department. Clinically, a pulmonary artery CTA can be performed to further confirm the diagnosis. The treatment methods in clinical practice are mainly as follows: If the patient experiences circulatory disturbances, emergency thrombolytic therapy may be considered; if the patient's circulation is stable, treatment with low molecular weight heparin and warfarin anticoagulation can be considered. Of course, it is important to monitor the patient's respiration and blood pressure.

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Written by An Yong Peng
Pulmonology
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The difference between pulmonary embolism and chronic obstructive pulmonary disease.

The differences between pulmonary embolism and chronic obstructive pulmonary disease (COPD) mainly include the following aspects: 1. Different mechanisms of onset: Pulmonary embolism refers to the blockage of the pulmonary arteries by thrombi, while COPD is a disease of the small airways, primarily characterized by the narrowing of these airways. 2. Different clinical manifestations: Pulmonary embolism is often acute, with symptoms such as chest tightness, difficulty breathing, and may also include chest pain, coughing up blood, and fainting. COPD is a chronic disease, usually presenting with chronic chest tightness and difficulty breathing, and may also include symptoms such as coughing and expectoration. 3. Different diagnostics: Pulmonary embolism can often be diagnosed through CT pulmonary angiography, whereas COPD typically requires lung function tests for diagnosis.

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Written by Li Qiang
Intensive Care Unit
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Why does pulmonary embolism cause cardiac arrest?

The mechanisms causing cardiac arrest due to acute pulmonary embolism mainly encompass several aspects. One is a large-scale acute extensive pulmonary embolism, which prevents the blood from being ejected from the right heart, potentially leading to acute right heart failure. At this time, the entire body's blood circulation will encounter issues. Another scenario is that following the pulmonary embolism, it causes severe hypoxia. This hypoxia can lead to oxygen deficiency in all organs of the body, including the heart. The coronary arteries that supply nutrients to the heart can also become ischemic. Both of these factors can cause the heartbeat to lead to sudden cardiac arrest. These are the primary mechanisms that can cause a sudden stop in the heartbeat.

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Written by An Yong Peng
Pulmonology
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Can a pulmonary embolism cold cause a fever?

Pulmonary embolism combined with a cold can indeed cause a fever, which is a relatively common occurrence. However, it typically results in a low-grade fever. Additionally, it is important to note that if pulmonary embolism is combined with pulmonary infarction, it can also lead to a fever, usually manifesting as a low-grade fever. Therefore, pulmonary embolism itself can potentially cause a fever. Furthermore, it is crucial to be aware that if pulmonary embolism leads to a fever, it should not be misdiagnosed as a common cold or pneumonia. Especially in patients with concurrent pulmonary infarction, the presence of a fever, and subpleural patchy shadows seen on chest CT can resemble the manifestations of pneumonia. Care must be taken to avoid misdiagnosis as pneumonia, which could delay treatment for the patient and potentially lead to severe consequences.

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

The difference between pulmonary embolism and pulmonary edema lies in their mechanisms of onset, clinical manifestations, and treatments; they are completely different diseases. Pulmonary embolism primarily occurs when thrombi from the inferior vena cava or superior vena cava, or other emboli, travel with the bloodstream to the right heart and then block the pulmonary artery. The symptoms mainly include coughing, chest pain, difficulty breathing, and coughing up blood. On the other hand, pulmonary edema is mostly due to left heart dysfunction, caused by coronary artery disease or acute heart failure, leading to the inability of the pulmonary blood to return to the left heart. This results in an excessive retention of blood in the lungs, causing edema in the alveoli and interstitial space of the lungs. The symptoms are primarily characterized by difficulty breathing, coughing, and pink frothy sputum. The treatments for the two are also entirely different: pulmonary embolism is primarily treated with thrombolysis, while pulmonary edema is mainly treated by correcting heart function. Thus, it is crucial to differentiate between these two diseases.

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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.