Why does pulmonary embolism cause cardiac arrest?

Written by Li Qiang

Intensive Care Unit

Updated on September 23, 2024

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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 Yuan Qing

Pulmonology

51sec

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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

1min 35sec

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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 Chen Tian Hua

Cardiology

53sec

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What are the early symptoms of pulmonary embolism?

The early symptoms of pulmonary embolism are clinically diverse and often non-specific. Mild cases may not present any symptoms at all. Common symptoms include the following: 1. Unexplained difficulty in breathing; 2. Pain in the precordial region; 3. Some patients initially present with fainting as the first clinical symptom; 4. Some patients may also experience irritability, fear, or a near-death feeling; 5. Early symptoms can also include coughing, coughing up blood, and palpitations. Pulmonary embolism is a critical condition in clinical settings. Once it occurs, it is essential to go to the hospital promptly for an accurate diagnosis and to receive effective treatment to avoid severe clinical consequences.

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Written by Yuan Qing

Pulmonology

56sec

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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

45sec

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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.