In early June, Ms. Wang (pseudonym), who is 50 years old this year, accidentally injured her left lower limb. Although it was painful and her mobility was slightly restricted, she was still able to carry out daily activities. After resting at home for more than 10 days, she felt that the swelling in her left leg had worsened - this should have been a warning sign that could not be ignored! But it did not receive much attention. The next day, Ms. Wang suddenly experienced severe chest pain, followed by loss of consciousness, bluish lips, and stiff limbs! Life is at stake.
Ms. Wang was urgently sent to the Emergency Department of Tonglu Hospital, Hangzhou First People's Hospital by 120. The emergency team quickly joined the battle: tracheal intubation, mechanical ventilation, continuous chest compressions, use of rescue drugs... After about 9 minutes, Ms. Wang regained her spontaneous heartbeat!
Quick and accurate diagnosis is the key to saving lives! Emergency team urgently improves examination for Ms. Wang: 'Silent Killer' emerges: acute pulmonary embolism!
Pulmonary artery CTA: Clearly shows that both main and branch pulmonary arteries are blocked by a large amount of thrombus - diagnosed with acute large-area pulmonary embolism (PE). Cardiac ultrasound: right heart enlargement, tricuspid regurgitation - the heart is "overwhelmed" due to blocked pulmonary blood vessels! Lower limb venous ultrasound: Directly targeting the source of the disease - left lower limb popliteal vein thrombosis (deep vein thrombosis, DVT)!
Faced with pulmonary embolism that could potentially take another life at any moment, time is life! The emergency team decisively pumped thrombolytic drugs into the patient.
After successfully stabilizing vital signs in the emergency room, Ms. Wang was quickly transferred to the intensive care unit (ICU). After careful brain protection strategies, continuous renal replacement therapy, hemodynamic monitoring and other precise volume management by the intensive care medical team, targeted infusion of coagulation factors, respiratory support, standardized anticoagulation and other treatments, Ms. Wang has now regained consciousness and recovered well, and has been transferred to a general ward.
Ms. Wang's experience vividly outlines a deadly journey of blood clots.
Starting point (deep vein thrombosis): left lower limb trauma>restricted mobility>slow and stagnant blood flow>deep vein thrombosis (DVT) formation. Increased swelling in the legs is a key signal for the formation or enlargement of blood clots! Detachment and migration: thrombus detachment>flowing through the heart with blood>reaching the pulmonary artery. Endpoint (pulmonary embolism outbreak): Thrombotic obstruction of the main and branch of the pulmonary artery>Acute pulmonary embolism>Dyspnea, chest pain, syncope, cardiac arrest!
Experts from Tonglu Hospital, a hospital in Hangzhou, remind that limited mobility after trauma is one of the high-risk factors. Even if patients can still "walk" or "engage in daily activities", as long as the limb's mobility is significantly reduced or restricted due to trauma (fractures, sprains, soft tissue injuries, etc.), and blood flow velocity slows down, it is extremely easy to form blood clots! Swelling, pain, elevated skin temperature, and changes in skin color (redness or bluish purple) in the lower limbs (especially on one side), especially those that worsen or reappear on the basis of existing trauma, must be highly vigilant.
