Pulmonary embolism (PE) is the third most serious emergency in the cardiovascular system after myocardial infarction and cerebrovascular accident, which causes thousands of deaths every year due to insufficient clinical awareness. In recent years, the widespread use of new examination techniques and the full attention of clinicians have greatly improved the diagnosis and treatment of this disease, bringing a boon to the majority of patients with pulmonary embolism. Lei Zhidan, Department of Radiology, Henan Provincial People’s Hospital
However, in clinical work, due to many factors such as clinicians’ inexperience or backward examination technology, some patients with atypical pulmonary embolism are not diagnosed and treated in time, thus losing the best time for treatment, which brings great physical and mental pain to patients, and at the same time losing a lot of financial resources, human resources, material resources, health and even life. Whenever I see these, I feel very painful and saddened! So, as medical workers, what can we do to avoid the loss of these patients with atypical pulmonary embolism?
Summarizing the diagnosis and treatment process of more than 60 cases of atypical pulmonary embolism patients diagnosed by my hands, I think the following points should be worthy of reference: 1. The majority of medical workers should continuously learn and summarize the lessons learned, and should enhance the understanding of atypical pulmonary embolism in addition to fully recognizing the manifestations of typical pulmonary embolism. 2. Patients with atypical clinical symptoms and signs, when taking active symptomatic treatment is not satisfactory D-dimer detection and imaging should be done promptly.3. Imaging workers should recognize the direct signs of pulmonary embolism and also fully recognize the indirect signs of pulmonary embolism, because the indirect signs can often be used as differential diagnosis and suggest the initial diagnosis of pulmonary embolism. For example: protrusion of pulmonary artery segment, enlargement of right ventricle, dilatation of jugular/ventricular vein, formation of collateral circulation, change of lung volume, change of lung density, change of lung texture and infarct signs of lung, etc. 4. The majority of medical workers should be extremely enthusiastic, careful, patient and highly responsible!
Hopefully, in the near future, due to the continuous improvement of diagnosis and treatment technology and the increasing knowledge and experience of medical workers, the diagnosis and treatment of atypical pulmonary embolism will be further improved, thus greatly reducing misdiagnosis, missed diagnosis and delayed diagnosis, and truly bringing gospel to the majority of patients with pulmonary embolism!