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 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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Is there a lot of phlegm in pulmonary embolism?

Pulmonary embolism is a relatively common acute disease in clinical practice. It usually occurs when blood clots from the veins in the legs or pelvis detach, travel through the bloodstream to the pulmonary arteries, and cause an embolism. The onset of this disease is often very sudden. Due to different triggers, the clinical symptoms vary. Typical symptoms of pulmonary embolism include difficulty breathing, chest pain, coughing up blood, and coughing. Coughs are often dry, and patients may also have a small amount of white sputum. Some patients might even experience wheezing and other clinical symptoms. Therefore, the occurrence of excessive sputum is rare in patients with pulmonary embolism.

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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 Liu Jing Jing
Pulmonology
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Is there a relationship between pulmonary embolism and lung cancer?

Pulmonary embolism and lung cancer can be related; common causes of pulmonary embolism include amniotic fluid embolism, air embolism, and deep vein thrombosis. In patients with lung cancer, when cancerous emboli enter the bloodstream, they can cause pulmonary embolism. Additionally, if the patient's condition is poor, with difficulties in eating, prolonged bed rest, and increased blood viscosity, deep vein thrombosis can occur, leading to pulmonary embolism. Therefore, there is no absolute relationship between pulmonary embolism and lung cancer, but lung cancer may trigger pulmonary embolism.

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Written by Wei Shi Liang
Intensive Care Unit
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Pulmonary Embolism Interventional Treatment Methods

Interventional treatment for pulmonary embolism is mainly used for large pulmonary embolisms in the main trunk or major branches of the pulmonary artery. It is applicable in the following scenarios: contraindications to thrombolysis and anticoagulation therapy, inefficacy after thrombolysis or aggressive medical treatment, or lack of surgical conditions. Interventional therapy for pulmonary embolism can involve removing the embolus or breaking it into fragments, allowing it to move to the distal pulmonary arteries, thereby opening the central pulmonary arteries, rapidly reducing pulmonary artery resistance, significantly increasing total pulmonary blood flow, improving cardiopulmonary hemodynamics, and right ventricular function. The treatment involves catheter fragmentation and suction of large clots in the pulmonary artery or performing balloon angioplasty, and it also enables local administration of small-dose thrombolysis. These are the primary methods of interventional treatment for pulmonary embolism.