Pulmonary thromboembolism

[rts3486]

After 4 weeks, I was diagnosed with an acute pulmonary thrombo-embolism.  I did not have the typical symptoms, but pain started after I breathed in 'CS' gas during an accidental discharge. I also had pertussis earlier in the year.  My pain always started btw the scapulas, and as my respiration increased from very mild exercise, the pain radiated across my scapulas, to my chest, down my arms to my elbows, and across my lower jaw.  I never had problems breathing;  only the pain.  The pain would shortly stop after I stopped whatever I was doing, to include walking.  I also have mild degenerative cervical vertebrae.  My heart was thoroughly examined and all is well.  My doctor prescribed an anti-coagulant, which after two days has lowered the pain, but my doctor insists the pain is not caused by the embolism.  I know the type of pain I have from the cervical vertebrae, and what I have is not the same.  Any idea what is a possible cause of the pain?

[rts3486]

Thank-you for your response.  I have been seeing a pulmonologist, who prescribed the anit-coagulant.  I have had doppler echo-cardiograms for my heart and legs, both which were negative.  I have had CT scans of the thorax and vertebrae, which revealed the blood clot in my lung, and mild degenerative issues with the C vertebrae, which I was already aware of.  Nonetheless, my pulmonologist recommended I visit an orthopedic dr., whom I will be visiting next week, as he said the pain is not a result of the clot.  The pain persists, and I will likely be taking an MRI.  This is like nothing I have had before, and I have inquired of many people for any similar issues, to no avail.  I also am impatient about waiting to get off of the anti-coagulant as it makes me very fatigued.

[David Tinkelman, M.D.]

Contrary to what you might believe, the pain you describe is very likely to be caused, either by nerve compression in one or more cervical vertebrae or,  originating in your heart.  The latter diagnosis  is consistent with the pain of coronary artery disease, and you will likely need further testing.  CS gas has been reported to cause disease, not just of the lungs, but also of the heart and liver.  I agree that, given your description of the pain, it is not a pain that is characteristic of pulmonary thrombo-embolism.

Given that your doctors have not decided on a definite diagnosis, this might be a good time for you and them to arrange for a second opinion, preferably with a heart specialist or a lung specialist.

Good luck