Workers who sit for a long time may suffer from cardiopulmonary embolism

Real points:

Young people who sit for long periods of time, stay in bed for long periods of time, or stand for long periods of time are prone to symptoms of lower extremity venous thrombosis, and the detachment of emboli may lead to pulmonary embolism. In addition, obesity is also one of the risk factors for pulmonary embolism. The most important thing to prevent pulmonary embolism is to move.

Verifier: Zeng Hanhua | Attending Physician of the Respiratory Department, Meizhou People's Hospital, Guangdong Province

According to media reports, a host in Shandong died of a sudden pulmonary embolism recently. The host was only 36 years old. Pulmonary embolism is related to blood clots. Many people think that this is a disease that only the elderly will get. In fact, more and more young people are suffering from pulmonary embolism. So what is pulmonary embolism? Why do seemingly healthy young people suffer from pulmonary embolism?

1. What is pulmonary embolism? What are the causes of pulmonary embolism?

Pulmonary embolism (PE) is a relatively common vascular emergency. Its main cause is the clinical manifestations caused by various "emboli" blocking the pulmonary artery system. In severe cases, it can directly lead to death, and it happens very suddenly. This is why many people who seem to be healthy suddenly die suddenly. Most of the reasons are related to embolism, and pulmonary embolism is one of the most common causes. Emboli that can block the lumen of blood vessels can be fat, tumors, amniotic fluid, air, blood clots, etc. The most common embolus is pulmonary thromboembolism caused by blood clots.

Any factor that can cause venous blood congestion, endothelial damage to the venous system, and hypercoagulable state of blood can be the cause of pulmonary embolism.

Some of these causes are primary risk factors, that is, caused by genetic mutations, such as factor V mutation, protein C deficiency, protein S deficiency and anticoagulant enzyme deficiency. If people under 40 years old have repeated thromboembolism, most of them have genetic factors. In addition to genetic factors, there can also be secondary risk factors, which mainly refer to acquired factors. For example, fractures, trauma, surgery, malignant tumors, oral contraceptives, obesity, etc.

After reading the above picture, some people may ask, why can daily activities such as bed rest and travel also cause pulmonary embolism? What is the relationship between fractures and pregnancy and pulmonary embolism? In fact, these are all common clinical triggers of pulmonary embolism. Let us explain them one by one:

Figure: Causes of pulmonary embolism Source: Zhong Nanshan's "Respiratory Medicine" 2nd Edition

Bed rest (generally speaking, continuous bed rest for more than three days) is common in people who have to stay in bed after surgery because they are afraid of pain from the surgery. There are also patients with cerebral infarction and severe lung disease who stay in bed for a long time because they cannot take care of themselves. Long-term bed rest can easily lead to thrombosis in the deep veins of the lower limbs, and the thrombus in the deep veins will break off and flow to the lungs with the blood flow, eventually leading to pulmonary embolism. If unexplained lower limb edema and pain occur, you need to pay attention to the possibility of lower limb vascular disease.

We also call long-distance air cargo and car travel "economy class syndrome" because in the economy class of the flight, the space for activities is relatively small, the lack of activities, the slow blood circulation in the lower limbs, coupled with the lack of water intake, the slow blood flow, it is easy to form blood clots, and eventually easily lead to pulmonary embolism. Similar situations often occur during the National Day and Spring Festival holidays, when long-distance car travel encounters traffic jams, because long periods of sitting lead to slow blood flow, etc., which induces pulmonary embolism.

Pregnancy/delivery: Pregnant women are a special group. During pregnancy, the placenta compresses the blood vessels, which slows down the blood flow and leads to the formation of blood clots. Especially in the late pregnancy, because the fetus is large, it is inconvenient to walk, the activity time is reduced, and the time spent in bed is increased, which increases the risk of thrombosis. In addition, during delivery, amniotic fluid enters the blood vessels and causes amniotic fluid embolism, which can lead to sudden death of the mother during delivery.

Fractures: Especially long bones, such as femoral fractures, because of damaged blood vessels (three major conditions for thrombosis: blood stasis, blood vessel wall damage, and hypercoagulable state), as well as the presence of adipose tissue, often cause fat to drip into the blood, leading to the formation of embolism. In addition, the pain of fractures and long bed rest make fracture patients prone to pulmonary embolism. There have even been tragedies of sudden death from pulmonary embolism due to fear of pain due to sprained feet, long-term bed rest or significantly reduced activity of the affected limb.

Cancer: This type of patients mainly has high blood viscosity, which is easy to form blood coagulation. A large number of cancer cells clump together to form cancer thrombi, which can cause blockage of pulmonary blood vessels and thus form pulmonary embolism.

2. Pulmonary embolism targets young people and is related to these bad living habits

In addition to a few cases of pulmonary embolism in young people due to primary factors, many are also related to acquired factors. For example, most young people like to play with their mobile phones for a long time, lie down like Ge You, or sit in front of the computer for a long time to type and write code. Sitting for a long time, lying in bed for a long time, or standing for a long time can easily cause lower limb venous thrombosis, and the thrombus will fall off and cause pulmonary embolism. Another factor is obesity, which can easily cause the blood to be in a hypercoagulable state. Once you sit for a long time, the venous blood will slow down, and you are not far from pulmonary embolism.

Pulmonary embolism can be asymptomatic or cause sudden death, which is closely related to the size and range of the blood vessels blocked by the embolus. The most common symptoms are: chest tightness, chest pain, shortness of breath, cyanosis of the lips, and some patients may also experience hemoptysis (bleeding from the respiratory organs below the throat (i.e., trachea, bronchi, or lung tissue) and discharged from the mouth through coughing). The most serious patients may directly faint, go into shock, or die suddenly. Therefore, if a person with the above risk factors suddenly experiences unexplained dyspnea, chest tightness, etc., the possibility of pulmonary embolism should be highly suspected.

3. To prevent pulmonary embolism, the most important thing is to move

Although pulmonary embolism is silent and aggressive, it is nothing to be afraid of if we take preventive measures. To prevent pulmonary embolism, the most important thing is to move! Reduce bad habits such as standing, sitting, and lying in bed for a long time, long-distance flights or long-distance travel, or even sitting at a desk for a long time. It is recommended to stand up every hour and move your body to promote blood circulation, drink more water, and reduce the intake of high-salt and high-fat foods. These measures can effectively prevent thrombosis, especially to minimize the possibility of pulmonary embolism.

Editor of this article: ambergchen