How to determine if a pulmonary embolism is acute or chronic?

Written by Yuan Qing
Pulmonology
Updated on October 26, 2024
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Pulmonary embolism can be distinguished between acute and chronic based on the duration of the patient's illness, symptoms, and supplemental examinations. Typically, patients with acute pulmonary embolism have no prior similar symptoms and suddenly experience severe symptoms such as chest pain, difficulty breathing, and coughing up blood. Additionally, through supplemental examinations like blood tests, abdominal ultrasound, and pulmonary artery CT angiography, it is possible to determine whether the thrombus is fresh or old. In contrast, chronic pulmonary embolism often presents with prolonged symptoms. Patients usually do not experience chest pain or cough, and the main issue is chronic breathing difficulty. In severe cases, pulmonary heart disease may occur, and patients may have swelling in the face and limbs. Ultrasound and pulmonary artery CT angiography can reveal the characteristics of the thrombus, which differ from those seen in acute pulmonary embolism. Thus, these examinations can help determine whether the condition is acute or chronic.

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Written by An Yong Peng
Pulmonology
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How is pulmonary embolism caused in young people?

Common causes of pulmonary embolism in young people include the following aspects: First, fractures, especially fractures of the lower limbs, are prone to deep vein thrombosis and pulmonary embolism; Second, thrombophilia, some young people due to congenital genetic factors, which can lead to easy formation of blood clots in arteries or veins, and potentially increase the incidence of pulmonary embolism; Third, prolonged immobilization, such as long periods of sitting, can lead to slow blood flow in the lower limbs, which might result in deep vein thrombosis and pulmonary embolism; Fourth, other factors like severe infections could also trigger pulmonary embolism; furthermore, the risk of pulmonary embolism is also higher in pregnant women during the perinatal period.

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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 An Yong Peng
Pulmonology
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Can I eat lamb if I have pulmonary embolism?

Patients with pulmonary embolism can appropriately eat mutton, as it is acceptable in their case. For pulmonary embolism, it is advocated to follow a light diet, avoiding spicy, irritating food, and excessively greasy food to prevent aggravating the gastrointestinal burden of the patient. Additionally, it is acceptable for patients with pulmonary embolism to consume some meat, as long as it is not fatty meat. Once diagnosed with pulmonary embolism, patients should receive active treatment, which often requires anticoagulant therapy. If the condition is not too severe, simple anticoagulant treatment may allow the patient’s condition to recover. However, if the pulmonary embolism is more severe, thrombolytic therapy may be necessary. After thrombolytic treatment, vascular anticoagulant therapy is given to manage the patient's condition.

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Written by Yuan Qing
Pulmonology
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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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Written by Yuan Qing
Pulmonology
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What should I do if my leg swells after a pulmonary embolism?

After a pulmonary embolism, swelling in the legs can occur, and this situation is very likely secondary to right heart dysfunction following the pulmonary embolism. At this time, the main treatment should focus on the pulmonary embolism. The mechanism of pulmonary embolism mainly involves thrombi from the venous system, which travel with the blood flow to the right heart and then are lodged in the pulmonary artery, causing a sudden increase in the load on the right heart and leading to right heart failure. Consequently, the blood flow from the superior and inferior vena cava cannot return to the right heart. If the blood flow in the inferior vena cava is blocked peripherally, it can cause swelling in the legs. Therefore, the primary focus should still be on treating the underlying disease, by using anticoagulants or thrombolytic therapy. Swelling in the legs can also be alleviated with diuretics, but it is crucial not to move the lower limbs carelessly, as there might still be thrombi present, and moving the limbs could lead to the dislodgment of new thrombi.