Pulmonary embolism is caused by what?

Written by Wei Shi Liang
Intensive Care Unit
Updated on September 09, 2024
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The most common cause of pulmonary embolism is a thrombus, with approximately 70%-95% of cases occurring when a deep vein thrombosis dislodges and enters the pulmonary arteries and their branches via the bloodstream, leading to pulmonary embolism. Conditions such as prolonged bed rest or immobilization of the lower limbs can lead to the occurrence of deep vein thrombosis. Therefore, the primary site of origin is mainly the deep veins of the lower limbs. Additionally, other types of emboli can also cause pulmonary embolism, such as fat emboli, air emboli, amniotic fluid emboli, parasitic emboli, and bacterial emboli, as well as detachment of cardiac tumors; all these can lead to pulmonary embolism.

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

Pulmonary embolism and pulmonary congestion are two completely different diseases. Pulmonary embolism is mainly caused by the thrombosis of the venous vessels entering the pulmonary artery, thereby causing restricted blood flow in the pulmonary artery and leading to pulmonary embolism. Pulmonary congestion is often due to left heart failure, where the blood flow in the lungs cannot return to the left heart, causing the blood to be retained and congested in the lungs, forming this disease. However, they do have some similarities, such as presenting symptoms of difficulty breathing, shortness of breath, low blood pressure, shock, etc. But through diagnosis and additional examinations, these two diseases can be clearly differentiated. Therefore, careful differentiation is required in clinical practice because the treatments for the two diseases are completely different. If misdiagnosed, the treatment could be incorrect, leading to serious consequences from mistreatment.

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

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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Can pulmonary embolism cause bloating and abdominal distension?

Pulmonary embolism can, in rare cases, cause bloating and abdominal distension. The primary clinical manifestations of pulmonary embolism are chest tightness and difficulty breathing. Severe pulmonary embolism can also lead to a drop in blood pressure and sometimes may even cause the patient to faint. However, it is important to note that in severe cases of pulmonary embolism, patients may also experience abdominal distension. Patients with pulmonary embolism might also have acute pulmonary heart disease, which could include symptoms of gastrointestinal congestion. In such cases, patients may experience abdominal bloating. Additionally, there is a special condition known as chronic thromboembolic pulmonary hypertension, where patients may experience chronic pulmonary heart disease and chronic hypoxia, which can also lead to abdominal distension.

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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.