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Chest Pain And Low O2 Sats, Coughing Blood, Breathing Noises. Bronchoscopy Shows Abnormal Cells. What Can It Be ?
Question: Hello,
I have been having chest pain problems and low O2 sats for many years, I have seen many doctors and had many scans - I have started coughing up blood and having breathing noises, on a recent CT of abdomen they saw something possibly in the bottom of my lung - I have some symptoms that could prove to be heart related and a Bronchoscopy found non cancer lesions and washings produced some abnormal cells - my concern is that in the last 2-3 yrs I have had about 7 x plain chest xrays - 2 x Chest CT - 1 x Chest Spiral Angiogram - Another Chest Head and Abdo CT after a car accident - A normal abdo CT and 2 other CT's of chest - as well as a Gallium scan - most of these scans were done with the radioactive XXXXXXX - I dont want to have any more scans, but my doctor insists because of what was seen on the Abdo and because of the abnormal cells found in the washings from the bronchoscopy... I want a single scan to cover heart and lungs as there is some discussion to say I might have heart embolism - the docotr has ordered a CT PA with High Res reconstruction - each time I get these scans, the next doctor says "Oh you should have gotten "x" type of scan, these are not of use" - I am concerened about my radiaton exposure and I want to know if there is another type of scan I could do that covers everything, I dont want to have this scan for the Pulmonologist and find out I need another for a Cardiologist
I have been having chest pain problems and low O2 sats for many years, I have seen many doctors and had many scans - I have started coughing up blood and having breathing noises, on a recent CT of abdomen they saw something possibly in the bottom of my lung - I have some symptoms that could prove to be heart related and a Bronchoscopy found non cancer lesions and washings produced some abnormal cells - my concern is that in the last 2-3 yrs I have had about 7 x plain chest xrays - 2 x Chest CT - 1 x Chest Spiral Angiogram - Another Chest Head and Abdo CT after a car accident - A normal abdo CT and 2 other CT's of chest - as well as a Gallium scan - most of these scans were done with the radioactive XXXXXXX - I dont want to have any more scans, but my doctor insists because of what was seen on the Abdo and because of the abnormal cells found in the washings from the bronchoscopy... I want a single scan to cover heart and lungs as there is some discussion to say I might have heart embolism - the docotr has ordered a CT PA with High Res reconstruction - each time I get these scans, the next doctor says "Oh you should have gotten "x" type of scan, these are not of use" - I am concerened about my radiaton exposure and I want to know if there is another type of scan I could do that covers everything, I dont want to have this scan for the Pulmonologist and find out I need another for a Cardiologist
Hello,
Thanks for the query.
It does look like that you have undergone lot many CAT scans and that does amount to significant exposure to radiation.
If your doctor feels a need for a repeat scan, then may be it warrants a more priority then the risk of exposure to radiation. And as you aptly asked, one can do a Computed Tomography (CT) scan which will cover your heart and lungs in same sitting. Computed Tomography Pulmonary Angiogram (CT PA) will help us know whether you have heart and pulmonary vessel embolism and at the same time your lungs can be reformatted in a different algorithm without the need of rescan.
Another option that you can use is MAGNETIC RESONANCE PULMONARY ANGIOGRAPHY (MR PA) which has a sensitivity of 92%-100% and specificity of 62% for detection of pulmonary embolism; but again this modality is subject to availability. MR PA is 100% free of ionising radiations and hence risks of radiation are significantly low.
You can discuss about these options with your treating doctor.
Hope I have provided you with some useful information about your concern. Let me know if you have any further queries.
If your concern is addressed and you do not have any other queries, please close this discussion.
Wish you good health
Regards
Above answer was peer-reviewed by :
Dr. Prasad
Thank you - I heard about a "Triple Threat" scan, that needs to be done to match your heart beat, what is this scan?
Also, by having the CTPA and the High Res reconstruction together am I lessoning the quality of image by combining or reconstructing.
IE - I am about to have a combined CTPA with HR reconstruction to avoid extra radiation exposure - would I get better images if I did the two seperately -
IE 1 x CTPA and 1 x HR Chest CT
Also, by having the CTPA and the High Res reconstruction together am I lessoning the quality of image by combining or reconstructing.
IE - I am about to have a combined CTPA with HR reconstruction to avoid extra radiation exposure - would I get better images if I did the two seperately -
IE 1 x CTPA and 1 x HR Chest CT
Hi XXXXXXX
Thanks for writing back.
I am sorry I have no idea of "Triple Threat" scan.
And considering your clinical condition, a CTPA is the one which is more important and a reconstruction of those images using a different algorithm does give a diagnostic quality image of your lung parenchyma. I dont think you would have to undergo another CT scan to look at your lungs.
I hope this would help you, but do discuss with your treating physician and if possible with the radiologist before undergoing the CAT scan.
Regards
Thanks for writing back.
I am sorry I have no idea of "Triple Threat" scan.
And considering your clinical condition, a CTPA is the one which is more important and a reconstruction of those images using a different algorithm does give a diagnostic quality image of your lung parenchyma. I dont think you would have to undergo another CT scan to look at your lungs.
I hope this would help you, but do discuss with your treating physician and if possible with the radiologist before undergoing the CAT scan.
Regards
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Above answer was peer-reviewed by :
Dr. Aparna Kohli
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