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Does A Normal Lung Perfusion Scan With A Normal Xray

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Posted on Sat, 9 May 2020
Question: does a normal lung perfusion scan with a normal xray rule out a PE.THe ventilation part of test wasn't done because of the corona virus here in NY.. Have of dvt in upper extremity rifgt brachial vein from a picc line since Dec 13rh.Not able to do blood thinners tried 3 weeks in Dec of eliquis and a day on xarrelto couldn't tolerate side effects.Male 57 174 lbs,eat healthy.
doctor
Answered by Dr. Dr. Jolanda (1 hour later)
Brief Answer:
Yes, it's the first choice of examination in suspected patients

Detailed Answer:
Hello and welcome to 'Ask A Doctor' service.

I can understand your concern,

Yes, a lung perfusion scan is the examination of choice in patients suspected of pulmonary embolism. If you don't have signs and symptoms such as acute breathlessness, chest pain or less commonly cough then, in my opinion, the probability of having PE is low even if you have DVT. However, you should wear elastic stocks, try to move the extremities frequently.

On the contrary, if you have the above signs and symptoms you should absolutely do an Angio CT scan of the chest to exclude pulmonary embolism. Please discuss this with your doctor.

Hope to have been helpful

Dr. Jolanda



Above answer was peer-reviewed by : Dr. Arnab Banerjee
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Follow up: Dr. Dr. Jolanda (4 hours later)
Can't do angio ct due to allergic reaction to contrast XXXXXXX .Been getting chest pain and shortness of breath that's why the perfusion part of vq scan was done with a chest xray.
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Follow up: Dr. Dr. Jolanda (1 minute later)
The dvt is in the right arm in the brachial vein.
doctor
Answered by Dr. Dr. Jolanda (6 hours later)
Brief Answer:
Continue discussion

Detailed Answer:
Hi again

In such patients with contrast allergy we do a premedication with steroids IV one day before the chest CT in close consultation with alergologist specialist . As you explain the situation and according to the perfusion scan it doesn't seem to me you have PE. However in my opinion you should take LMWH regardless side effects . Nevertheless it's your treating doctor to decide exactly which is the best option for you.

Regards
Dr.Jolanda
Above answer was peer-reviewed by : Dr. Kampana
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Answered by
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Dr. Dr. Jolanda

Pulmonologist

Practicing since :2003

Answered : 2904 Questions

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Does A Normal Lung Perfusion Scan With A Normal Xray

Brief Answer: Yes, it's the first choice of examination in suspected patients Detailed Answer: Hello and welcome to 'Ask A Doctor' service. I can understand your concern, Yes, a lung perfusion scan is the examination of choice in patients suspected of pulmonary embolism. If you don't have signs and symptoms such as acute breathlessness, chest pain or less commonly cough then, in my opinion, the probability of having PE is low even if you have DVT. However, you should wear elastic stocks, try to move the extremities frequently. On the contrary, if you have the above signs and symptoms you should absolutely do an Angio CT scan of the chest to exclude pulmonary embolism. Please discuss this with your doctor. Hope to have been helpful Dr. Jolanda