Can a secondary recurrence of pulmonary embolism be treated?

Written by Yuan Qing
Pulmonology
Updated on March 18, 2025
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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 Li Jian Wu
Pulmonology
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Early symptoms of pulmonary embolism

In the early stages of pulmonary embolism, symptoms such as difficulty breathing, chest tightness, shortness of breath, and decreased oxygen saturation can occur. Early signs may include chest pain, as chest pain is often an initial symptom of pulmonary embolism. Sometimes the pain can be severe, and some patients may experience coughing, dry cough, and even cough up blood. There may also be symptoms of short exhalation and difficulty breathing, especially in patients with main trunk blockages, where the difficulty in breathing can be very pronounced. In more severe cases, some may experience fainting, suddenly collapsing while walking.

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Written by Wang Li Bing
Intensive Care Medicine Department
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Pulmonary embolism should be treated in the department of respiratory medicine.

Pulmonary embolism is an emergency in clinical settings, with rapid progression and extreme danger, and is generally treated by the department of respiratory medicine. Pulmonary embolism primarily occurs due to dislodged blood clots that block the pulmonary artery and its branches, leading to pulmonary infarction. The clinical manifestations of pulmonary embolism mainly include severe breathing difficulties, chest pain, coughing up blood, and even circulatory disturbances. After a pulmonary embolism occurs, a pulmonary artery CT scan can be used to further confirm the diagnosis. Treatment options may include thrombolysis, and possibly anticoagulation therapy with low molecular weight heparin or warfarin. (Specific medications should be used under the guidance of a physician.)

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Written by Wei Shi Liang
Intensive Care Unit
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Can pulmonary embolism lead to pneumonia?

Pulmonary embolism itself does not cause pneumonia; however, during the treatment of pulmonary embolism, procedures such as oral tracheal intubation and the creation of an artificial airway might be employed. These can lead to nosocomial infections of iatrogenic origin, resulting in pneumonia. Pulmonary embolism often manifests as unexplained respiratory difficulty, pleuritic pain, tachycardia, and decreased oxygen saturation. Other high-risk factors include being over the age of 40, having a history of DVT (Deep Vein Thrombosis), obesity, prolonged immobilization, stroke, congestive heart failure, malignancy, lower limb fracture, anesthesia time exceeding 30 minutes during surgery, pregnancy and childbirth, use of estrogen, and a hypercoagulable state. These are all potential high-risk factors for pulmonary embolism.

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Written by Wang Li Bing
Intensive Care Medicine Department
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Pulmonary embolism means

The formation of thrombotic foreign bodies in the human venous system or the right atrium and ventricle system, ultimately leading to the blockage in the pulmonary artery, is referred to as pulmonary embolism. After the onset of pulmonary embolism, patients may experience symptoms such as shortness of breath, chest pain, coughing, and even coughing up blood. It is crucial to immediately conduct a pulmonary artery CTA scan for further diagnosis. If the diagnosis of pulmonary embolism is confirmed, thrombolytic or interventional treatments can be considered.

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Written by An Yong Peng
Pulmonology
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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.