Does pain in chest indicate pulmonary embolism?

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Posted on Mon, 5 Jan 2015 in Lung and Chest disorders
Question: Hello,

I have been recently having pain in my chest and after doing a little research on the internet, symptoms pointed towards a PE. However, when I told my physician about the pain, he asked for a D-Dimer blood test and a doppler of my legs to rule out DVT. Both returned negative and were well in the reference range. I was then asked to undergo a Holter, Echo and Stree Echo which were negative for any abnormalities and I was given a thumbs up. My physician then asked me to undergo a Thyroid Function Test which diagnosed I was suffering from Throid and prescribed Eltroxin. I was also asked to undego tests for Vitamin b12 which were below the reference range and since (past 1 week) I have been put on Mecobal Plus (Mecobalamin) and Vitamin D3 supplements.

However, over the past few days, I have been having intermitent pain (sometimes stabbing and occassionaly dull) in my chest, between the shoulder blades and also in my back. My oxygen saturation as of today is between 96-98%. I have also had inlfamation in my neck which my physician diagnosed as Pharyngitis and asked me to undergo a Doppler on my neck to rule out an aneurysm. The results were ok but the inflamation has been growing since and despite taking paracemtol, I don't see much of an improvement.

My conern is, is the chest pain in anyway a PE? Or anything to do with a clot or anyway linked to the inflamation in my neck? Although my results so far seem to be in the green, I am concerned about the pain which sometimes knocks the wind out of me and leaves me short for breath.

I have also had a cough past 3 weeks. Is there any test or procedure to completely rule out PE? Its been on my mind all along.

Also, could the pain in my chest have anything to do with the cough? Any help here would be most appreciated.

Thanks!
doctor
Answered by Dr. Kaushal Bhavsar 31 minutes later
Brief Answer:
no need to worry for pulmonary embolism ( PE ).

Detailed Answer:
Hello dear, thanks for your question on HCM.
In my opinion you should not worry about pulmonary embolism ( PE ).
There are so many negative markers in your case to exclude possibility of pulmonary embolism. Like
1. Age. PE is uncommon in young age.
2. Normal D-Dimer
3. Normal 2D Echo
4. Normal saturation.
So no need to worry for pulmonary embolism. But if you want to rule out 100% then get done CT PULMONARY ANGIOGRAPHY. As this is the investigation of choice for the diagnosis of PE. So if this comes negative then PE can surely ruled out.
Pharyngitis is upper Respiratory tract infection ( URTI ). If not treated properly can lead to Lower respiratory tract infection ( LRTI ). And LRTI can cause cough and chest pain.
So possibility of LRTI should be ruled out in your case. So get done chest x ray to rule out this.
So in my opinion your chest pain, breathlessness and cough can be due to LRTI and not due to PE.
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. Vinay Bhardwaj
doctor
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Follow up: Dr. Kaushal Bhavsar 9 hours later
Thanks for your answer. I'm unfortunately allergic to the contrast XXXXXXX used during a CTA. Can a CT scan or MRI without the XXXXXXX be effective in ruling out PE?
doctor
Answered by Dr. Kaushal Bhavsar 10 minutes later
Brief Answer:
Yes, MRI is effective.

Detailed Answer:
Hello dear, thanks for your follow up question.

Both CT and MRI are useful in rule out pulmonary embolism (PE ), But not as accurate as with contrast.
But it will give you accurate result than d dimer and chest x ray.
So if you want to rule out PE without contrast than MRI will be slight more beneficial than CT.

Hope I have solved your query.
If you are not having further queries, please close the conversation and rate the answer.
Wish you good health.
Thanks.

Above answer was peer-reviewed by : Dr. Bhagyalaxmi Nalaparaju
doctor
Answered by
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Dr. Kaushal Bhavsar

Pulmonologist

Practicing since :2008

Answered : 14628 Questions

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