Sign-in to Ask A Doctor - 24x7
OR
Sign in with Google
Looking For Another Opinion Here. Had A Dvt In Right
Question: looking for another opinion here. Had a Dvt in right upper arm brachial vein Dec 14 . Was on blood thinners 3 weeks couldn't tolerate side effects came off doc tried another couldn't tolerate either. Been having chest pain radiating to back short of breath went to hospital d dimer normal .Perfusion only lung scan and chest xray performed both normal. ventilation part of test not done due to covid 19 in NY. Was told no PE from perfusion only scan normal chest xray and normal d dimer.. Still very symptomatic here chest pain radiating to back short of breath and extreme fatigue. Primary Doc won't try another blood thinners per these tests.Also had cardiac workup all fine. Does a normal perfusion only scan with normal chest xray and normal d dimer 100 percent rule out pe?If so what could be causing these symptoms at 5 month post diagnose of dvt.
Brief Answer:
Get done CT Pulmonary Angiography.
Detailed Answer:
Thanks for your question on Ask a doctor forum.
I can understand your concern.
I have gone through the detailed history you have given.
100% confirmatory investigation for Pulmonary embolism is CT Pulmonary Angiography.
If this is normal, we can be sure about not having Pulmonary embolism.
In 0.1% cases D dimer, chest x ray, ventilatory scan are normal still patient has Pulmonary embolism.
So in 99.9% cases normal D dimer, chest x ray and ventilatory scan, Pulmonary embolism possibility is very very less.
So in your case, I don't think you have Pulmonary embolism.
But if you really want to be double sure about not having Pulmonary embolism, you need to get done CT Pulmonary Angiography.
These symptoms can be seen with stress and anxiety.
So better to consult psychiatrist in person and find out stressor in your life and start anxiolytic drugs.
Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.
Get done CT Pulmonary Angiography.
Detailed Answer:
Thanks for your question on Ask a doctor forum.
I can understand your concern.
I have gone through the detailed history you have given.
100% confirmatory investigation for Pulmonary embolism is CT Pulmonary Angiography.
If this is normal, we can be sure about not having Pulmonary embolism.
In 0.1% cases D dimer, chest x ray, ventilatory scan are normal still patient has Pulmonary embolism.
So in 99.9% cases normal D dimer, chest x ray and ventilatory scan, Pulmonary embolism possibility is very very less.
So in your case, I don't think you have Pulmonary embolism.
But if you really want to be double sure about not having Pulmonary embolism, you need to get done CT Pulmonary Angiography.
These symptoms can be seen with stress and anxiety.
So better to consult psychiatrist in person and find out stressor in your life and start anxiolytic drugs.
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 :
Dr. Raju A.T
Answered by
Get personalised answers from verified doctor in minutes across 80+ specialties
