Beware of Heart-Related Diseases: Diagnostic Warnings from Pulmonary Embolism to Migraines

Case Study

A 36-year-old man nearly died from a pulmonary embolism: A 36-year-old male patient suddenly experienced difficulty breathing and temporary syncope while swimming. He was brought to our hospital by his family and was ultimately diagnosed with a pulmonary embolism. Due to timely medical attention, the patient was out of danger after resuscitation. Examination revealed multiple thrombi in the lower extremities. The cause of the pulmonary embolism was a thrombus in the lower extremities detaching and blocking the pulmonary artery. Therefore, we implanted a "filter" in the patient's lower extremities to prevent the thrombus from detaching again and blocking the pulmonary artery. Simultaneously, the patient received thrombolytic therapy.

What is a Pulmonary Embolism: The most common type is pulmonary thromboembolism (PTE), a very dangerous and potentially fatal disease. It often results from a thrombus in the lower extremities detaching and blocking the pulmonary artery, causing severe respiratory distress, syncope, and even sudden death. Because this disease lacks characteristic clinical manifestations, clinical diagnosis is difficult and often leads to misdiagnosis or missed diagnosis.

Who is prone to pulmonary embolism:

1. Older adults: Studies show that the incidence increases with every 10-year age increase.

2. Women taking estrogen therapy or oral contraceptives;

3. Individuals with venous thrombosis;

4. Obese individuals;

5. Individuals who have undergone surgery, such as fracture surgery;

6. Pregnant women and women in the postpartum period;

7. Individuals with a long history of sedentary lifestyles;

8. Individuals with varicose veins.

How to prevent pulmonary embolism: Individuals with the above-mentioned underlying conditions should pay attention to monitoring for lower extremity thrombosis when using medications, such as by having regular vascular ultrasound examinations. Long-distance travelers, those flying, or those sitting for more than 6 hours should avoid wearing tight clothing on their lower limbs and waist to prevent dehydration and should frequently perform activities such as calf muscle contractions.

Case: A Near Misdiagnosis Due to Believing in Folk Remedies

Our outpatient clinic once treated a 56-year-old female patient whose main symptoms were frequent chest tightness and shortness of breath. She had consulted an elderly traditional Chinese medicine doctor, who diagnosed her with myocardial ischemia and coronary heart disease after pulse diagnosis. The doctor prescribed herbal medicine and told her about methods to improve blood circulation, such as patting her upper limbs. The patient followed the doctor's treatment, spending several thousand yuan, but her symptoms fluctuated, and she developed bruises and subcutaneous bleeding on her upper limbs. Without reviewing her medical history, one might mistake her for a victim of domestic violence; this was the result of the patting treatment causing subcutaneous hemorrhage.

After reviewing her medical history, conducting a physical examination, performing an electrocardiogram, echocardiogram, and psychological questionnaire at the outpatient clinic, Dr. Zhou concluded that the patient did not have sufficient evidence of myocardial ischemia or coronary heart disease, and that her symptoms were likely caused by excessive anxiety. He advised the patient to go home and observe. However, the patient refused, insisting on hospitalization for a thorough examination.

After admission and examinations including a coronary CT scan, coronary heart disease was ruled out. The patient's symptoms were considered to be caused by excessive anxiety and neurological dysfunction. The patient was happily discharged. Following Dr. Zhou's guidance, after daily aerobic exercise and sleep adjustments (non-drug treatments), the symptoms completely disappeared, and the patient is now enjoying a very pleasant life.

Based on this case, Dr. Zhou would like to offer the following advice to patients:

1. Although coronary heart disease and myocardial ischemia are relatively common, they do occur at a certain rate. Chest tightness does not necessarily indicate coronary heart disease.

2. Traditional Chinese medicine has a unique theoretical basis for the diagnosis and treatment of coronary heart disease. However, some "pseudo-TCM" practitioners promote superstition and folk remedies, and widely publicize online that Western medicine is a waste of money and involves unnecessary tests. They claim that they can tell how much blood vessels are blocked by pulse diagnosis, or even determine the specific level of uric acid in the blood through pulse diagnosis. Dr. Zhou strongly advises that anyone with an illness should consult a regular hospital for proper examination and treatment. Doctors will provide patients with appropriate examinations and treatment plans.

Case Study: Frequent Migraines May Also Be a Sign of Heart Disease

A 26-year-old female patient had been experiencing recurring migraines recently. She underwent examinations at various hospitals' neurology departments, including head MRI and cerebral angiography, but no problems were found. Medication provided only minor relief.

Through a friend's recommendation, she consulted Dr. Zhou. Dr. Zhou had the patient perform the Valsalva maneuver, and the patient suddenly experienced a migraine. Dr. Zhou then performed a transesophageal ultrasound, which revealed a congenital heart defect: patent foramen ovale (PFO).

Dr. Zhou reminds everyone, especially young people, that if you experience frequent migraines, it is crucial to have your heart checked, particularly for congenital heart disease.

There are three main reasons why PFO can cause migraines:

First, the shunting of blood from the right side of the heart to the left side can lead to brain hypoxia;

Second, increased serotonin levels;

Third, paradoxical microthrombus formation.

Studies show that 41% of migraines are actually associated with congenital heart disease, specifically PFO. Therefore, if you have a migraine that you can't find the cause of, you should definitely have your heart checked.