pain after embolectomy

[leannel80]

i'm trying to figure out why i am continuing to have severe chest pain 7 months after i had a 7 inch long blood clot removed from my pulmonary artery.  it formed while i was on bed rest with my twins, and immediately after i was closed up from my c-section i went into cardiac arrest because it had gone into my lungs, then artery.  they did open heart surgery to remove it, and i don't know if it is because i pick up my twins all the time, and they lay on my chest, but i often have severe chest pain, and recently had another ct with contrast to rule out another clot, which there wasn't one, but my doctor wants me to see a pain specialist, but i have no health insurance, but can't stand the pain much more.

anyhone have any ideas?  

[Bhupinder Kaur, MD]

Hello,

CT with contrast is a good test for fiding out if there is any blood clot,but I feel that MRA(magnetic resonance angiography) or color Doppler to be more accurate than CT. But if the CT scan is showing that there is no clot,then a big clot like the earlier one must have been ruled out.The chest pain that you are having may be due to some other reason.

I feel that this kind of pain can be due to pulmonary infarction(death of the tissue) due to pulmonary emboli compromising the blood flow to the part, damage to the pleura lining the lungs or due to damage to the intercostals nerves due to emboli or due to surgery.

All these possibilities definitely need to be discussed and evaluated by a respiratory physician or a pain specialist.Pls get it done.

Hope it helps.Take care and regards.

[Dr. Kokil Mathur]

Hi

Thanks for the post.

Chest pain could be due to several causes, heart attack being one of them. What is more important is how long the pain lasts, the position of the pain, if the pain radiates or not and the frequency of the episodes. Were you free of pain for the 7 months? Please describe the pain a bit more for us to understand it better. Does it pain even when you are at rest or some movement brings it or do you feel it on pressing a certain area?

After open heart surgery, some pain and discomfort is expected, especially in the chest bone. Lifting up your twins will certainly be a strain for you, so early after surgery. There could be pain due to costochondritis that is inflammation of the rib-chest bone joint. Sometimes there is another clot in the blood vessels of heart causing pain to come on and off, especially with exertion. This is more easily confirmed by an angiography. Embolus in the lung causing chest pain has been ruled out by CT in your case.

Another thing I not sure of is why open heart surgery was done. Did you have a thrombus in the heart too or an embolism?

This needs a more detailed investigation. It is difficult to comment beyond this without examining and various tests. Please let me know if there is any thing else and do keep me posted. Take care!