The most common symptoms of pulmonary embolism.

Written by Wang Li Bing
Intensive Care Medicine Department
Updated on September 29, 2024
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Pulmonary embolism is also relatively common in clinical practice, primarily caused by an embolus blocking the pulmonary artery system, leading to a group of clinical syndromes. The clinical manifestations of pulmonary embolism mainly include the following points: The first is that patients may experience unexplained difficulty breathing and shortness of breath, especially after activity. The second is that patients experience significant chest pain. The third may be accompanied by hemoptysis, but usually, the amount of blood expectorated is not large. The fourth is that patients may experience restlessness, panic, and even a sense of impending doom. Clinically, there sometimes appears the so-called triad, which includes simultaneous occurrence of difficulty breathing, chest pain, and hemoptysis, etc. Pulmonary embolism is primarily diagnosed clinically through pulmonary artery CT.

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Written by Wei Shi Liang
Intensive Care Unit
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Can a pulmonary embolism be detected by a CT scan?

CT can detect acute pulmonary embolism, using CT angiography, which is the preferred imaging method for diagnosing pulmonary embolisms. It mainly shows central filling defects, as well as eccentric and abdominal wall filling defects, and complete filling defects. A diagnosis of pulmonary embolism can be made through the visualization of these filling defects on a CT scan. Additionally, some indirect signs, such as pulmonary hypertension, right ventricular enlargement, and the common mosaic sign, can also be observed. These are characteristic CT manifestations of acute pulmonary embolism.

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Written by Yuan Qing
Pulmonology
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The difference between pulmonary embolism and pulmonary edema

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 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 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.

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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.