What is the likelihood of pulmonary embolism recurrence over time in a 58 yr. old caucasion male when PE etiology is unknown including no evidence of deep vein thrombosis and subject is otherwise healthy?
Subject is seeking evidence to appeal denial of medical insurance coverage until 24 months have elapsed following treatment (heparin) for a pulmonary embolism. At this writing it has been 13 months since treatment was discontinued. Subject continues to be symptom free and participates in full range of physical activity.
Pulmonary embolism (PE) is a blood clot in an artery of the lungs. Without knowing where the PE have come from or what has caused them, it is not possible to speculate on the likelihood of recurrence over time. PE can occur without deep vein thrombosis (DVT). The clots can come from the pelvic veins or even from major blood vessels in the chest and around the shoulder.
The lack of recurrence in the 13 months since treatment was stopped is strong evidence of an unidentified one-time cause of PE. It also argues strongly against any chronic cause or predisposition to PE.
You might suggest to the insurance company that further testing be done at this time. This would include blood testing and imaging to show that there are no clots, PE or pulmonary hypertension. If all of these tests are normal, you have a strong argument that the PE was a one-time event and that you are not at increased risk for recurrence.
unfortunately, i cant remember the name of the genetic diagnosis, but i have heard of someone who had pe's from dvt's with an unknown cause.....its rare and prominent in males...ask your md or look up genetic causes for pe's and see what you hit.. just thought this might be something to look into.good luck
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