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In May of this year I was diagnosed with the

DOCTOR OF THE MONTH - Sep 2017
Sep 2017
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In May of this year I was diagnosed with the pulmonary embolus in the right lung. Those findings were backed up by CT angiogram, x-ray, and a bunch of blood test.

Early in 2016 I was diagnosed with atrial fabulation which I underwent a ablation for and had a CT angiogram done prior to the ablation and all was clear, no clot or masses.

In October of this year I had a repeat CT angiogram to check my pulmonary veins for possible stenosis from the ablation done in 2016, thinking that might be where the blood clot came from per another Cardiologist. The results of the latest CT angiogram came back showing that the right middle lobe medial segmental pulmonary embolism had increased since May, and the right basilar subsegmental pulmonary embolism has decreased.

My question is I’ve been on anticoagulation therapy I have an appointment to see a hematologist because the doctors have said I have thick blood but I’m curious as to why the right middle lobe medial segmental pulmonary embolism has increased, and the right basilar subsegmemtal pulmonary embolism has decreased.

My history, 300 pounds I’m fat, walk the dogs 3-4 miles a day 6-7 days a week, had aflutter, afib which are under control, stroke in 2012, no residue effects, high blood pressure under control, sleep apnea and mild diastolic dis function of the heart.
Posted Fri, 1 Dec 2017 in Lung and Chest disorders
 
 
Answered by Dr. Kaushal Bhavsar 38 minutes later
Brief Answer:
There is no specific reason for this.

Detailed Answer:
Thanks for your question on Healthcare Magic.
I can understand your concern.
Honestly speaking, there is no specific reason why one clot is increased and one is decreasing.
But this is commonly seen with hypercoaguable states.
Common causes for this are
1. Protein C deficiency
2. Protein S deficiency
3. Anti thrombin 3 deficiency.
4. Hyperhomocysteinemia
So consult hematologist and discuss about these diseases.
You have to undergo blood reports for these diagnosis.
Please let me know if these reports are done in the past or not.
Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.
Above answer was peer-reviewed by
 
Follow-up: In May of this year I was diagnosed with the 1 hour later
Below are the following test results done in May 2017:

Protein C. 88 (70-130)
Protien S. 95 (65-160)
Antithrombin III. 80 (88-138)***
No Hyperhomopcysteinemia
Fibrinogen. 534 (190-400)
Factor V. 93 (40-150)
Lupus Anticogulant. Neg
Cardiolipin Antibody, IGG. Neg
Cardiolipin Antibody, IGM. Neg
Prothrombin Gene Mutation. Neg
Factor 2 Activity. 81 (40-150)
MRSA Admission. Neg
 
 
Answered by Dr. Kaushal Bhavsar 7 hours later
Brief Answer:
Do you have anti thrombin 3 deficiency?

Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
I have gone through the reports you have mentioned.
Your all reports are normal except Anti thrombin 3.
It is slightly lower.
Do you have anti thrombin 3 deficiency?
Have you rechecked this?
Please reply me answers of above asked questions, so that I can guide you better. I will be happy to help you further. Wish you good health. Thanks.
Above answer was peer-reviewed by
 
Follow-up: In May of this year I was diagnosed with the 22 minutes later
I don’t know if I have a AntiThrombin 3 deficiency.
I haven’t had my AntiThrombin 3 rechecked since 5/28/17 when I had the PE. I see the hematologist, waiting for an appointment, I’m sure they will order it. Or I can ask my primary care physician to order it.
 
 
Answered by Dr. Kaushal Bhavsar 5 minutes later
Brief Answer:
Does any of your family members have any such history?

Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
I can understand your concern.
Yes, you should definitely ask for rechecking anti thrombin 3 levels.
Does any of your family members have any such history (Pulmonary embolism or young stroke or heart attack)?
Please reply me answer of above asked question, so that I can guide you better. I will be happy to help you further. Wish you good health. Thanks.
Above answer was peer-reviewed by
 
Follow-up: In May of this year I was diagnosed with the 11 hours later
Not that I’m aware of, no history of AntiThrombin 3 deficiency, I guess I’m the lucky one.
 
 
Answered by Dr. Kaushal Bhavsar 2 hours later
Brief Answer:
Get it rechecked.

Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
I can understand your concern.
In my opinion, you should rechecked it first.
Hope I have solved your query. If you are not having further queries, then please close the conversation and rate my answer.
You can ask me directly on bit.ly/askdrkaushalbhavsar.
Wish you good health. Thanks.
Above answer was peer-reviewed by
 
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