PULMONARY HYPERTENSION
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Pulmonary embolism?
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by Bozley04, May 02, 2012
I am a 19 year old female and have been experiencing chest problems for the last three weeks or so. It started with a mild but sudden shortness of breath, and since then I have experienced painin my left shoulder and in my chest when breathing in. This went for a few days and then over the weekend I experienced a sharp pain when breathing deeply in a localized area to the right of my chest. I went to the doctor who said it was unlikely a pulmonary embolism as I have no risk factors and my breathing sounded fine when he listened. Since my appointment on Monday I have not experienced chest pain when breathing in, except very mildly after stretching etc. Does pain from pulmonary embolisms come and go like this or would it be much more constant and severe? Is it likely that what I have experienced could be the result of a pulmonary embolism?
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by Jonathan D. Rich, MDBlank, May 03, 2012
Hello and welcome to the forum:

Although this is a pulmonary hypertension forum, I would be happy to briefly answer your question about pulmonary embolism.

To be honest with you, I am a bit puzzled by the doctor's response.  He is correct in that other causes of your symptoms are more likely than a PE but your symptoms could also have been caused by a PE and "listening" to a patient can not make or exclude the diagnosis.

The fact that your symptoms have fairly quickly dissipated make a PE less likely though PEs can come in all shapes and sizes and sometimes a very small PE can have minimal symptoms (sometimes they can even occur without any symptoms at all!).  PE pain, though, should not be impacted by stretching.

If your pain goes away completely soon and does not recur, I would move on and not worry about it (was probably not a PE given how much more common so many other things are--muscle strain, mild inflammation of the lining of your lung that has no long term consequence, etc).

However, if your symptoms do not resolve or worsen, I would re-address this with a doctor that your trust.  You should have a history, physical exam, and probably a CXR.  If all of that is negative, then a further evaluation (possibly including a scan to look for PE might be reasonable).

But please know that overall, the chance that you had a PE is very small.

Best,

Dr. Rich
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