What are the early symptoms of pulmonary embolism?

Written by Chen Tian Hua
Cardiology
Updated on December 19, 2024
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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.

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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 Yuan Qing
Pulmonology
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Why do patients with pulmonary embolism feel sleepy?

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 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 Wang Li Bing
Intensive Care Medicine Department
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What are the symptoms of a pulmonary embolism warning sign?

Pulmonary embolism is also very common in clinical settings, mainly seen in patients who have been bedridden for a long time, undergone various major surgeries, suffered from long bone fractures, pregnancy, etc. In the early stages of pulmonary embolism, patients generally experience varying degrees of chest pain, hemoptysis, and difficulty breathing, among others. If pulmonary embolism is suspected and the patient's condition permits, a pulmonary artery CTA scan should be immediately carried out to further confirm the diagnosis of pulmonary embolism. If the pulmonary embolism has already caused circulatory disturbances, thrombolytic therapy should then be considered.

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Written by Yuan Qing
Pulmonology
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Is it good to place a filter for pulmonary embolism or not?

Whether it is good or not to place a filter for pulmonary embolism mainly depends on the cause of the pulmonary embolism and whether there are indications for placing a filter. Generally speaking, if pulmonary embolism is caused by the formation of blood clots in the lower limbs or the inferior vena cava, placing a filter can generally be beneficial. However, not all cases of lower limb venous thrombosis require a filter. Filters are usually only used for deep or large vein thromboses that are not suitable for thrombectomy or thrombolysis treatments. If a filter is placed under other conditions, it is very likely that thrombosis will re-form on the surface of the filter, potentially leading to some recurrent pulmonary embolisms or iatrogenic pulmonary embolisms. Therefore, the decision to place a filter is complex and requires a doctor to weigh the pros and cons before deciding whether or not to proceed.