The difference between pulmonary embolism and pulmonary edema

Written by Yuan Qing
Pulmonology
Updated on June 04, 2025
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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 Li Qiang
Intensive Care Unit
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Why does pulmonary embolism cause cardiac arrest?

The mechanisms causing cardiac arrest due to acute pulmonary embolism mainly encompass several aspects. One is a large-scale acute extensive pulmonary embolism, which prevents the blood from being ejected from the right heart, potentially leading to acute right heart failure. At this time, the entire body's blood circulation will encounter issues. Another scenario is that following the pulmonary embolism, it causes severe hypoxia. This hypoxia can lead to oxygen deficiency in all organs of the body, including the heart. The coronary arteries that supply nutrients to the heart can also become ischemic. Both of these factors can cause the heartbeat to lead to sudden cardiac arrest. These are the primary mechanisms that can cause a sudden stop in the heartbeat.

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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 Li Bing
Intensive Care Medicine Department
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Pulmonary embolism should be treated in the department of respiratory medicine or cardiology.

Pulmonary embolism is a pathological process in which a blood clot in the vessels detaches, affecting the pulmonary artery and its branches. After the occurrence of a pulmonary embolism, patients generally visit the respiratory medicine department. Clinically, a pulmonary artery CTA can be performed to further confirm the diagnosis. The treatment methods in clinical practice are mainly as follows: If the patient experiences circulatory disturbances, emergency thrombolytic therapy may be considered; if the patient's circulation is stable, treatment with low molecular weight heparin and warfarin anticoagulation can be considered. Of course, it is important to monitor the patient's respiration and blood pressure.

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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 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.