What should I do if my leg swells after a pulmonary embolism?

Written by Yuan Qing
Pulmonology
Updated on May 27, 2025
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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.

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Written by Yuan Qing
Pulmonology
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Why do patients with pulmonary embolism feel sleepy?

Patients with pulmonary embolism primarily suffer from emboli within the venous system, which travel back to the right heart and then become lodged in the pulmonary artery, forming a pulmonary artery thrombus. This reduces pulmonary blood flow and impacts the exchange of air in the lungs, leading to hypoxia in the patient. Following hypoxia, the brain tends to enter a sleepy state, thus many patients with pulmonary embolism exhibit sleepiness. This sleepiness is related to the pathophysiological mechanisms of pulmonary embolism. At this point, it is crucial to provide sufficient oxygen to the patient to address their hypoxemia. Ultimately, the most fundamental treatments are prompt thrombolysis or anticoagulation therapy to resolve the embolus, addressing the condition fundamentally.

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Written by Yuan Qing
Pulmonology
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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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Written by Wang Li Bing
Intensive Care Medicine Department
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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.

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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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The difference between pulmonary embolism and chronic obstructive pulmonary disease.

The differences between pulmonary embolism and chronic obstructive pulmonary disease (COPD) mainly include the following aspects: 1. Different mechanisms of onset: Pulmonary embolism refers to the blockage of the pulmonary arteries by thrombi, while COPD is a disease of the small airways, primarily characterized by the narrowing of these airways. 2. Different clinical manifestations: Pulmonary embolism is often acute, with symptoms such as chest tightness, difficulty breathing, and may also include chest pain, coughing up blood, and fainting. COPD is a chronic disease, usually presenting with chronic chest tightness and difficulty breathing, and may also include symptoms such as coughing and expectoration. 3. Different diagnostics: Pulmonary embolism can often be diagnosed through CT pulmonary angiography, whereas COPD typically requires lung function tests for diagnosis.