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Heart Disease (Expert Forum)
PE or no Pe, that is the question!
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PE or no Pe, that is the question!
by unreal, Sep 03, 2004 12:00AM
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.
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.
Doctor's Answer
by CCF-M.D.-MJM, Sep 03, 2004 12:00AM
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.
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.
