Taipei City Government

Recently, a breast cancer patient at Zhongxing Branch of Taipei City Hospital who underwent chemotherapy and radiotherapy after surgery, felt shortness of breath. She was immediately sent to the emergency room where she was detected with low blood oxygen. After undergoing a chest CT scan, it was discovered that thrombus had formed on the pulmonary arteries on both sides, and she was diagnosed with acute pulmonary embolism. After receiving subcutaneous anticoagulant treatment, oral anticoagulants were used to control the disease, and the condition finally stabilized.
Acute pulmonary embolism is one of the three main fatal cardiovascular diseases (acute myocardial infarction, aortic dissection and acute pulmonary embolism). Blockage in a pulmonary artery occurs due to thrombus, gas or amniotic fluid, obstructing blood flow to the lungs for gaseous exchange. In severe cases, it may even result in shock.
Dr. Chen Guan-Yu, Director of Cardiology at Zhongxing Branch, said the main causes of pulmonary embolism is usually deep vein thrombosis (DVT), which is mainly due to prolonged stationary position of the limbs, varicose veins, and long period of sitting, standing or lying in bed. Other dangerous factors include congenital coagulation disorders, after surgery, pregnancy, oral contraceptives, smoking, obesity, central venous catheter, malignant tumor, etc., which could cause symptoms such as difficulty in breathing, chest pain, cough, coughing up blood, or even shock.
Dr. Chen stated, pulmonary embolism is difficult to diagnose and has a high fatality rate. Clinically, D-dimer test, echocardiography, pulmonary ventilation/perfusion scan, CT scan and angiography could be used to assist in determination and confirmation. Once confirmed, it should be treated with anticoagulants according to the condition. In more severe conditions, the patients should be treated with thrombolytic agent, cardiac catheterization, or even undergo surgical thrombectomy.