Why do patients with pulmonary embolism feel sleepy?

Written by Yuan Qing
Pulmonology
Updated on September 26, 2024
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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 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 Wei Shi Liang
Intensive Care Unit
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Pulmonary embolism is caused by what?

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 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 Wang Li Bing
Intensive Care Medicine Department
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Pulmonary embolism belongs to which department?

Pulmonary embolism mainly refers to the detachment of thrombi in the blood, leading to the obstruction of the main trunk of the pulmonary artery and its branches, causing a series of syndromes. Pulmonary embolism is an emergency in clinical practice. If the patient's circulation becomes unstable after the embolism, thrombolytic therapy should be considered. If the patient's respiratory circulation remains stable after the embolism, anticoagulation therapy can be considered. In clinical practice, pulmonary embolism is primarily diagnosed through pulmonary artery CTA examination to further clarify the diagnosis, and patients generally consult the respiratory medicine department.

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Written by Wang Chun Mei
Pulmonology
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Is there a lot of phlegm in pulmonary embolism?

Pulmonary embolism is a relatively common acute disease in clinical practice. It usually occurs when blood clots from the veins in the legs or pelvis detach, travel through the bloodstream to the pulmonary arteries, and cause an embolism. The onset of this disease is often very sudden. Due to different triggers, the clinical symptoms vary. Typical symptoms of pulmonary embolism include difficulty breathing, chest pain, coughing up blood, and coughing. Coughs are often dry, and patients may also have a small amount of white sputum. Some patients might even experience wheezing and other clinical symptoms. Therefore, the occurrence of excessive sputum is rare in patients with pulmonary embolism.