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

Written by Yuan Qing
Pulmonology
Updated on October 26, 2024
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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.

Other Voices

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Written by Wang Chun Mei
Pulmonology
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What should I do if I have pulmonary embolism and asthma?

Pulmonary embolism is a very common type of disease clinically, and its triggering factors are numerous and complex. For such patients, the main triggering factors are usually the detachment of thrombi from the pelvic deep veins and the lower limb deep veins, leading to pulmonary artery embolism. Therefore, the clinical symptoms that appear in these patients are mainly difficulty breathing, chest tightness, chest pain, and some patients may experience coughing, coughing up blood, shortness of breath, and even wheezing. Thus, for such patients, it is first necessary to clarify the cause of the disease, and then provide the patient with oxygen, thrombolysis, anticoagulation, and other symptomatic treatments. Usually, after effective symptomatic treatment, when the embolism location is effectively controlled, the symptoms of wheezing and air blockage that the patient experiences will also be significantly improved.

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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.

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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
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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 Chen Tian Hua
Cardiology
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What are the early symptoms of pulmonary embolism?

The early symptoms of pulmonary embolism are clinically diverse and often non-specific. Mild cases may not present any symptoms at all. Common symptoms include the following: 1. Unexplained difficulty in breathing; 2. Pain in the precordial region; 3. Some patients initially present with fainting as the first clinical symptom; 4. Some patients may also experience irritability, fear, or a near-death feeling; 5. Early symptoms can also include coughing, coughing up blood, and palpitations. Pulmonary embolism is a critical condition in clinical settings. Once it occurs, it is essential to go to the hospital promptly for an accurate diagnosis and to receive effective treatment to avoid severe clinical consequences.