Why can't patients with pulmonary embolism get out of bed?

Written by Wang Chun Mei
Pulmonology
Updated on September 28, 2024
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Pulmonary embolism is a relatively common clinical disease, with many and complex inducing factors. The most common cause of pulmonary embolism in patients is due primarily to thrombi dislodging from the veins of the lower limbs or the pelvic deep veins, traveling through the bloodstream to the pulmonary arteries, thus causing the disease. Therefore, bed rest is essential during the acute phase of pulmonary embolism. The purpose of bed rest is to prevent further embolisms, to avoid the dislodging of pelvic or lower limb deep vein thrombi, which could lead to the formation of new thrombi. Therefore, for patients with pulmonary embolism, it is crucial to provide timely treatments such as thrombolysis to control the clinical symptoms caused by the pulmonary embolism effectively.

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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.

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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 An Yong Peng
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Can pulmonary embolism cause bloating and abdominal distension?

Pulmonary embolism can, in rare cases, cause bloating and abdominal distension. The primary clinical manifestations of pulmonary embolism are chest tightness and difficulty breathing. Severe pulmonary embolism can also lead to a drop in blood pressure and sometimes may even cause the patient to faint. However, it is important to note that in severe cases of pulmonary embolism, patients may also experience abdominal distension. Patients with pulmonary embolism might also have acute pulmonary heart disease, which could include symptoms of gastrointestinal congestion. In such cases, patients may experience abdominal bloating. Additionally, there is a special condition known as chronic thromboembolic pulmonary hypertension, where patients may experience chronic pulmonary heart disease and chronic hypoxia, which can also lead to abdominal distension.

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Can acute pulmonary embolism be cured by anticoagulation?

Anticoagulation has a partial curative effect on acute pulmonary embolism. Based on the area of the embolism and the patient's vital signs, it is classified into mild, moderate, and severe pulmonary embolism. If it is a mild to moderate pulmonary embolism, anticoagulation can completely cure it, because anticoagulation can help the body's fibrinolytic system remove the blood clots that have already formed, and it can also prevent new clots from forming. However, in cases of severe pulmonary embolism, especially when the patient presents unstable vital signs and is in life-threatening condition, it is not advisable to rely solely on anticoagulant therapy. This is because the effect of anticoagulant treatment is relatively slow, and it requires a certain amount of time for the body's immune and fibrinolytic systems to clear the embolism. Therefore, at such times, thrombolytic treatment is recommended. Of course, this requires an experienced physician to assess the patient's vital signs and overall condition.

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Can a pulmonary embolism be detected by an X-ray?

Pulmonary embolism cannot be detected by X-ray. Although in rare cases, some signs might appear on an X-ray, such as localized sparse lung markings, these signs are typically not characteristic. For conditions like pulmonary embolism, color Doppler ultrasound can be used to assist in diagnosis. If the ultrasound suggests deep vein thrombosis in the legs along with pulmonary hypertension, it indicates a high possibility of pulmonary embolism. Additionally, testing for D-dimer and blood gas analysis can also help in diagnosing pulmonary embolism. CT pulmonary angiography can also be used to diagnose the condition. CT and pulmonary angiography have a high diagnostic value for pulmonary embolism, and most cases can be definitively diagnosed through these tests.