PE or no Pe, that is the question!

Good morning!

To begin, thank you so much for this forum, it has truly been a lifesaver!  

I'll give a really quick synopsis:

April 2003 - Strep B Septecemia - PICC Line inserted - 12 - 24 hours from death when hospitalized. In for 3 weeks.

June 2003 - Pleurisy

July 2003 - PICC Line removed. ESR levels still slightly high but were low enough to remove line.

August 2003 - After serveral trips to the ER (small town hospital) was tested for PE.  No PE Symptoms. D-Dimer "slightly off".  BP 121/80, HR - normals, O2 - 99% on room air.  VQ Scan came back High Probability 2 defects in left lung, 1 in right lung.  Started on IV Heparin and Coumidan.

September 2003 - Had Spiral CT with contrast dye at large city hospital.  No signs of PE and great lung circulation. RELIEF at last!

December 2003 - Follow-up VQ at original hospital.  Result - No  change in PE's from August scan. Defects still present.

December 2003 (day after VQ) - Met with Hemo at a different large city hospital, did a D-Dimer and another CT with Dye.  Result - No PE present, D-Dimer normal, great lung circulation.


Did I ever have a PE to begin with? the Hemo really questions the diagnosis.  Your opinion would be greatly appreciated.

[CCF-M.D.-MJM]

Hello,

These are always very difficult questions and impossible to know for sure.  You certainly had some risk factors for deep vein thrombosis and pulmonary embolism--acute illness, likely not able to move around well for several weeks.  If a V/Q scan showed perfusion defects consistent with PE, I would probably complete a 6 month course of coumadin and stop.  I have to ask why did they check a V/Q scan if you weren't having any symptoms?  Certainly the CT scan calls the V/Q scan results into question, but there is really know way to know for sure at this point.  I think continuing 6 months of coumadin is the right thing to do.

I hope  you find yourself in better health now and I would not repeat the V/Q scan unless you have symptoms.

Good luck.