Why should one lie flat for acute pulmonary embolism?

Written by Yuan Qing
Pulmonology
Updated on October 30, 2024
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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 Yuan Qing
Pulmonology
1min 4sec home-news-image

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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Written by Yuan Qing
Pulmonology
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What are the symptoms when pulmonary embolism becomes severe?

Pulmonary embolism can vary in severity, with serious cases primarily causing unstable vital signs. The disease primarily arises from venous thrombi in the venous system, which travel with the venous blood back to the right heart, and then with the blood flow from the right heart back to the aorta. If the thrombus is relatively large, it can easily become lodged in the pulmonary artery, forming a pulmonary embolism. The symptoms of pulmonary embolism can range from mild to severe. Based on the patient's symptoms and vital signs, pulmonary embolism is categorized into low risk, intermediate risk, and high risk. Low and intermediate risk typically indicate that the patient's vital signs are relatively stable, with normal blood pressure, heart rate, and pulse oximetry saturation. In severe cases, patients may exhibit noticeable symptoms such as coughing up blood, difficulty breathing, low blood pressure, shock, and oliguria. These represent the more severe cases of pulmonary embolism.

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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 Wei Shi Liang
Intensive Care Unit
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Is pulmonary embolism related to pneumonia?

If unexplained shortness of breath, pleuritic chest pain, tachycardia, and decreased oxygen saturation occur, one should be highly vigilant about pulmonary embolism. Generally, pulmonary embolism has no direct relationship with pneumonia. High-risk factors for pulmonary embolism include obesity, prolonged immobilization, stroke, congestive heart failure, malignant tumor, inflammatory bowel disease, lower limb fracture, anesthesia time exceeding 30 minutes, and acquired or genetic hypercoagulable state. It usually manifests as difficulty breathing, rapid breathing, and pleuritic chest pain.

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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.