Why should one lie flat for acute pulmonary embolism?

Written by Yuan Qing
Pulmonology
Updated on October 30, 2024
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When acute pulmonary embolism occurs, it is primarily due to a thrombus from the venous system being carried by the venous blood flow back to the right heart, and then due to the ejection from the right heart, this thrombus gets lodged in the pulmonary artery, forming a pulmonary embolism. After the onset of pulmonary embolism, the primary treatment measure is to have the patient lie down and remain still. The reason is mainly that if the patient is standing or moving, it is very likely that the thrombus in the venous system could continue to detach and move within the venous system. This can worsen the symptoms of pulmonary embolism or lead to new embolic sites, so the treatment for the patient involves immobilization and lying down to avoid further movement, making this the most basic approach to treatment.

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Written by Wang Li Bing
Intensive Care Medicine Department
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The most common symptoms of pulmonary embolism.

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 pulmonary embolism lead to pneumonia?

Pulmonary embolism itself does not cause pneumonia; however, during the treatment of pulmonary embolism, procedures such as oral tracheal intubation and the creation of an artificial airway might be employed. These can lead to nosocomial infections of iatrogenic origin, resulting in pneumonia. Pulmonary embolism often manifests as unexplained respiratory difficulty, pleuritic pain, tachycardia, and decreased oxygen saturation. Other high-risk factors include being over the age of 40, having a history of DVT (Deep Vein Thrombosis), obesity, prolonged immobilization, stroke, congestive heart failure, malignancy, lower limb fracture, anesthesia time exceeding 30 minutes during surgery, pregnancy and childbirth, use of estrogen, and a hypercoagulable state. These are all potential high-risk factors for pulmonary embolism.

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Written by Wang Chun Mei
Pulmonology
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Will acute pulmonary embolism get better in two days?

Acute pulmonary embolism is a type of disease with very many and complex inducing factors. Clinically, acute pulmonary embolism has a very sudden onset, and patients often present with unexplained symptoms such as pale complexion, chest tightness, chest pain, and difficulty breathing. During the acute phase of pulmonary embolism, immediate and effective anti-shock and other symptomatic resuscitation are essential upon arrival at the hospital. Generally, after timely and effective resuscitation, the patient's condition may be somewhat controlled. Usually, the first 1-3 days after the onset of pulmonary embolism are the most dangerous; therefore, continuous monitoring of the patient's vital signs is crucial during this time, followed by anti-shock and anticoagulation treatment as needed. Therefore, acute pulmonary embolism will not improve by the second day, although some of the patient's clinical symptoms may slightly improve after treatment.

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Written by Yuan Qing
Pulmonology
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What are the symptoms when pulmonary embolism becomes severe?

Pulmonary embolism can vary in severity, with serious cases primarily causing unstable vital signs. The disease primarily arises from venous thrombi in the venous system, which travel with the venous blood back to the right heart, and then with the blood flow from the right heart back to the aorta. If the thrombus is relatively large, it can easily become lodged in the pulmonary artery, forming a pulmonary embolism. The symptoms of pulmonary embolism can range from mild to severe. Based on the patient's symptoms and vital signs, pulmonary embolism is categorized into low risk, intermediate risk, and high risk. Low and intermediate risk typically indicate that the patient's vital signs are relatively stable, with normal blood pressure, heart rate, and pulse oximetry saturation. In severe cases, patients may exhibit noticeable symptoms such as coughing up blood, difficulty breathing, low blood pressure, shock, and oliguria. These represent the more severe cases of pulmonary embolism.

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Written by An Yong Peng
Pulmonology
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Can I eat lamb if I have pulmonary embolism?

Patients with pulmonary embolism can appropriately eat mutton, as it is acceptable in their case. For pulmonary embolism, it is advocated to follow a light diet, avoiding spicy, irritating food, and excessively greasy food to prevent aggravating the gastrointestinal burden of the patient. Additionally, it is acceptable for patients with pulmonary embolism to consume some meat, as long as it is not fatty meat. Once diagnosed with pulmonary embolism, patients should receive active treatment, which often requires anticoagulant therapy. If the condition is not too severe, simple anticoagulant treatment may allow the patient’s condition to recover. However, if the pulmonary embolism is more severe, thrombolytic therapy may be necessary. After thrombolytic treatment, vascular anticoagulant therapy is given to manage the patient's condition.