She did originally go into hospital but they sent her home saying she had a chest infection despite her recently having DVT and the fact that blood clots and strokes seem fairly common in the family Careless of them not to do any checks.
I just want to make sure she has begun treatment fairly quickly. In terms of the significance of the PE, the key factor is heart strain, this can be determined by an echocardiogram. Im sure that the main treatment of blood thinners would have been started. Has she had an echocardiogram, was there any evidence of heart strain?
I am I was disgnosed with a PE in my main artery this past August. I also have many small clots in my lungs. They hospitalized me and gave me heparin drip a d put a filter in. I also was in A fib. I take Eliquis and Metoprolol. What could it be? I also have rheumatoid arthritis a d take Enbrel and methotrexate and I have this horrible sore mouth and throat. I had a clot in one if the 4 chambers if my heart and 2 massive clots on my lungs.
Was told I had a PE. Spent 9 days on the cardiology ward. Am home now taking warfarin. Still getting a sharp pain when I take a deep breath on my left hand side. I cannot walk very far. Lost my confidence. Just do not feel myself. Can anyone tell me what recovery time I can expect.
My PE was 6 weeks ago. Just feel tired, week and depressed. Just would like some idea of how long I will feel like this? The pain is likely secondary to pulmonary infarction, this should improve over the next few weeks.
Given that you had likely atrial thrombus you did well to get through it all and the recovery may take a little while. Did you have any use of clot busting medication or procedures? I also experienced sharp chest pain and was diagnosed with pleurisy; it comes and go but it worse with deep breaths and when it is super cold. Perhaps ask your doc about pleurisy.
I too had a deep depression, anxiety, fatigue for almost six months after the first incident but I no longer take any anti-anxiety or depression meds. You and your body have been through a lot; give yourself to heal both mentally and physically.
I wish you a happy and healthy ! I appreciate this article. Both times she was prescribed Eliquis by vascular doctor. She saw vascular doctor after 3 months on Eliquis and both times was discharged as the clots in her legs had dissolved. However, less than 2 weeks after she was advised to discontinue Eliquis, for the second DVT, which she did, she experienced shortness of breath, chest cough and weakness. A trip to PCP and she was prescribed an anti- biotic to treat possible pneumonia, but later a drop in O2 level, we were sent to ER where she was diagnosed with PE and blood clots in both legs and admitted to ICMU of hospital.
She was given shots of anti-coagulant while there and prescribed double dose of Eliquis for first week, then resumed normal dose, same as she took to treat previous DVT. She is now on O2, Level 2. Two weeks from diagnosis, she saw pulmonary doctor for post hospitalization followup. Her PCP, pulmonary and hematologist specialist all concur she must remain on Eliquis the rest of her life.
My question for you is how unusual is it that she developed PE and DVT within two weeks of discontinuing Eliquis after taking it for 3 months? It is my understanding that no matter the cause of the blood clotting, the treatment is the same.
Doctors wanted to do blood test to determine if this is due to blood clotting disorder, specifically genetic. I said no, no more tests or doctor visits than absolutely necessary. I welcome any comments and appreciate your time.
She resides in a wonderful assisted living facility. My greatest desire is she does not suffer. I would not advise genetic testing. You are correct in that the treatment will stay the same regardless, if this is a big clot then life long blood thinning medication.
Thank you for your reply. She had multiple clots in both lungs, 1 particularly large. If we decided to stop Eliquis we understand the result will most likely be death. I am currently hospitalized for significant PE in both lungs near pulmonary artery. Several DVT were found throughout left leg and thigh. I have transitioned today from Lovenox to Xarelto and home tomorrow after a 5 day stay. My wife is concerned that especially the PE will move and re-block.
Thank you in advance Eric. In general although there is a theoretical risk of clot breaking off, the standard treatment once past the initial phase of PE is blood thinner.
In general patients do well once treated, the clot in the lungs often disappears relatively fast. In my experience, on follow up imaging, the clot is often gone. Blood thinner is a successful treatment. Is chest pressure a symptom of a PE? I was diagnosed with a PE last week after a month of misdiagnosis.
I am now on Xarelto. The chest pains are still there, but they are lessening. The worst part, is the chest pressure. I have immense pressure on my chest and diaphragm, making it difficult to breathe. Is this a normal symptom? How long will these symptoms last? I am extremely uncomfortable. I would go and seek an urgent medical opinion if you have had a recent PE and are having symptoms that concern you.
I was recently prescribed multiple courses of prednisone by my dermatologist for an id response and rash on lower leg. I have since read that glucocorticoids should not be prescribed to patients with a history of thrombosis. How dangerous is prednisone for people with such a history, and if so, are the warnings adequate? I have asked four physicians, including a close relative, and none were aware of any precaution. Thank you for your article. In January of , I had bronchitis, then an ear infection that led to vertigo.
I felt ill off and on for two months. I had a pulmonary embolism getting my hair washed and styled. I passed out and stopped breathing. It stopped, started again, etc. I started that strained snoring breathing, but stopped breathing again. One of the ladies hit me in the chest very hard, and I came to. A clot was found in my lung, and then ultrasound found the origin in my left ankle. I had IV blood thinners for several days and not allowed up for four days.
I went home with eliquis which I took for six months. I did not need further treatment. I continue to take daily aspirin. Here is my problem, it is now late December of , and my energy level has not returned to normal. My heart and lungs are fine. From October of to May of , it all I could do to get out of bed and teach.
I would collapse when getting home, fighting to stay awake until I drove the five minutes to my driveway. Summer arrived, and I could hardly do anything. I am feeling less exhausted, but after any exertion, I have to sleep for two or three hours, or I feel I will fall down from exhaustion.
I do one or two spin classes per month for this reason. I eat well, take supplements, and last week begged for and received a vitamin B-twelve injection. I was prescribed raloxifene, but my oncologist had me stop it because it gave me severe hives. Any ideas would be greatly appreciated. The hematologist told me to keep taking warfarin as I do 2 years now, from right after the PE or stop spinning classes.
No other cause or risk factor found. My father was admitted to the hospital to ight with PE and strain on the right side of the hear that was visible from the CT scan the hospital performed. Back so try is that this is the 4 case of PE in a 3 year span. Second time the thought his blood levels were skewed. The third time they had no idea, as blood levels were normal and PET scan was clean. Soon after my father went to a different hematologist and they found out the clotting factors were not right not sure of the details.
Anyway he was recently taken off his eloquis to have a biopsy done. Today he was to start the meds aging but began experiencing shortness of breath. This bring us to today. With the strain on the heart.
They have begun to give the clothes busting meds, but how does this affect him long term? Will this shorten his life span? It depends on a lot of factors, what is the official read of his ct scan, what is the acute clot burden, what is the chronic clot burden, what is his pulmonary artery pressure, and what is the state of his right ventricle.
Also in the setting of recurrent clots, in the future is there a role for ivc filter when he has to stop his blood thinner. These are the key points you need to discuss. They felt sure it was due to my BiEst and Prometrium that I have taken daily for the last 13 yrs; I am 63 yrs old. I had no signs of DVT and they never checked for that. I had signs of pulmonary hypertension and some Rt ventricular enlargement.
I was given 2 days of IV Heparin and then put onto Xarelto for 3 mo. I was sent home on oxygen at 3L. My GP thinks 3mo of anticoags may not be enough and that 6 mo may be indicated. Could my clots have just formed in the lungs? Is it likely I will need longer on anticoags? Would being on ASA 81mg when off the anticoags, for the rest of my life be advisable? Interesting questions and should be addressed on a case by case basis, without knowing a lot more about your case its hard to comment.
If there was right ventricular strain and no clear cause identified, i personally would never stop anticoagulation prior to 6 months. A full evaluation for underlying causes and recurrent risk needs to be performed. Your pulmonary artery pressures and right heart function needs to be monitored also. Your clots started in your legs and travelled to your lungs. An ultrasound of the legs needs to be done if you never had one. They are sending him home today on eliquis 10mg twice daily.
My concern is that he has had two attacks last night of the very similar under rib pain that brought him in here, very excruciating, to the point he can barely breathe. He has one doctor. Or is the pain an indicator that something needs to be looked at? I have no idea. Pleural pain can be common, it is sharp in nature and caused by a process known as pulmonary infarction whereby the damaged lung tissue is responsible for the pain.
He is on the blood thinner which is good. I suggest he see a Dr to ensure his vital signs and clinical status is stable. You have nothing to lose by being cautious. My mother had a very bad knee and her doctor determined a knee replacement was necessary.
They send us to our house doctor for testing and medical release. She had EKG and Echo done and all the other important test. Shortly before the surgery we went to the doctor who sent her for pre-checking at the hospital next door.
On October 24th she had the knee replacement done. The surgery went well and she started rehab in the hospital next day. On the 26th the day she was released she even received first place as best recovered patient by the rehabilitation staff.
Two days after she was released, a nurse came by and removed the medical nerve blocker that was still inserted through her vein in the leg. On Saturday 29th, the physical therapist came to the house and started her treatment. We asked her multiple times about the danger of blood clots and she said, yes the swellings are normal on the leg.
My mother had no pain in the area of the surgery and where the stitches are but she complained about pain behind the knee and above the knee front and back of leg.
Otherwise she was progressing along. On Monday 31st Halloween the physical therapist came again and she said again that the swellings are normal and told us to have her lift the leg when lying down.
The leg should be higher than the heart. My mother woke up around 6am, went to the bathroom and after she entered the living room she started breathing heavy, she turned white, she felt she had to throw up, etc…. They then shockingly asked us if we wanted her to go to the hospital. Not take her. When they took her with my wife in the front seat, they drove normal. Then all the sudden my wife realizes they are doing CPR in the back and they put the sirens on.
When arriving at the hospital … they determined she was already gone for 7 minutes and they brought her back and stabilized her. They said she had a heart attack.
They increased the blood thinner and with time her situation got worse and worse and she started bleeding from the kidneys, lungs and at the end from the mouth.
Because her body refused the fluids she started swelling everywhere including the face. At the end the doctors told us to get ready. My mother died on November 2nd at am. A woman that was healthy all her life who had a successful knee replacement went within hours from healthy to dead. Where the medications prescribed the correct ones? In Germany everyone gets shots for preventing of blood clots.
Why over here only Aspirin???? This is the biggest question we have. My moms story is almost identical, but she was very quickly taken from us the morning after her full knee replacement surgery. Her heart rate was being monitored through the night as it was going astronomically High then really low — reading everywhere points to the fact they should not have moved her but ultrasounded or at least looked for clots! We are heartbroken and lost the best mom and Grammie ever.
We are at a huge loss and forever will be. My husband has prostrate cancer with bone mets! He has just been diagnosed with 2 small blood clots in his lungs after a routine CT scan, he had no symptoms at all We have a very special family holiday booked which entails a 4 hour flight in 2 and half weeks time!
Our consultant has said that the risk is minimal and he has told us to go away and enjoy our holiday, he said he will be fine and the injections he is getting every day willl minimise the risk for him! I would love a second opinion please. Hi Alison, it would be irresponsible of me to provide you with an opinion not having seen details of the case and not having directly assessed him.
In terms of clinical significance, 2 small clots, that are being treated appropriately should not pose a problem. It looks like your consultant feels you can go and as long as you are comfortable with his opinion and understand press and cons a decision can be made.
Im assuming the injections are lovenox, which will serve to treat the clots and prevent recurrence. My neurologidst put me on Tegretal……too strong for me. He left on vacation, my primary care dr was out of town on vacation. Went to emergency room 3 times…… More drugs and pain killers.
Finally pain was unbelievable. Called primary dr and his fill in dr answered. He understood, put me on steroids and calmed down some.
Changed neurologist….. She put me on chewable drug that slowly calmed me……saw a surgeon……more meds. Primary dr came back , got me to his office, did d-dimmer. Sent me immediately to ER that could do Doppler. God got me there and they immediately started work.. D-dimmer was Ran Doppler, ct scan , shot for blood thinner, oxygen and off to hospital. Was in hospital for 2 weeks. Had substantial blood clot go through right side heart and into both lungs.
Breathing is not perfect, but I am still alive and will be on warfarin rest of life. God saved this 74 year for some reason. My sons were told I might not make it. What happened to your trigeminal neuralgia? Was there a link between the two other than you being in bed for a couple of weeks?
My husband died suddenly of a pulmonary embolism, but none was seen in his autopsy. Why not? Is this common? Does it mean that the clot dissolved before his autopsy which was a couple of days after his death? Please give me any thoughts or information that you can. My father is He takes junior aspirin daily. Fairly active and was diagnosed with a PE in each lung.
Protein S and C and factor V came back negative. I was started on Xarelto and was told I need to be on it for at least 6 months if not life. My question would be is do I need to be scanned or checked for any cancers? If so what scans? Thank you! Depends on many factors, and would need a full discussion and consultation in each case, however in general only age appropriate cancer screening is advised in those with otherwise unremarkable screening.
I would like to know if you systolic number is high, can it make it feel like the house is spinning when I lay down at night and also, can it make you feel very unstable on your feet? I will be still, then resume walking.
At night when I go to bed, I will lay down on my back and then it feels like the whole house is spinning. To stop the feeling, I will turn over and lay on my left side. I do have a history of heart problems. I had a heart attack in and two stents put in place. Also have congestive heart failure problems. I am diabetic, over weight, inactive because of bulging disc in my back and in remission from Leukemia.
Every time they have done a echo exam to check my heart they have not seen a strain and every thing functioning fine. Do my chances look good? Do pregnant women survive this? Yes pregnant women survive this, it just needs to be handled appropriately.
You will need to be on appropriate blood thinner. Thank you very much Dr. Mustafa is there way to help the body eat the blood clot besides being on the blood thinners? Yes, tumors, particularly if malignant lead to hyper coagulable states that predispose to clot formation. Hi my mom 82 had hip surgery in august, 2 weeks after she end up have a pe that was busted using catheter therapy. Clot was busted and she is on the road to recovery, additional test for clots have been done and came back negative.
She is on eliquis and metoprolol for heart rate. She has both a cardiologist and pulmonary specialist. Her oxygen levels are 98 when she does the 6 minute test with slight breathlessness after the 6 minute test. Should we be very worry. The fact that here pressure went down is good I think but I think her age makes recovery slower for her.
I guess my question is how long does it take for lung pressure to normalize after having a pe? Pulmonary dr did say if her pressure was decreasing he would just watch but the fact she had 2 echo with level same he wants to do more test. When i perform the catheter treatment for PE on select patients i typically check the pressure the next morning through the catheters and if the treatment has been successful then i typically see the reduction has already occurred by that time.
Was there a prior echo in the past that documented her baseline? Im not sure why heart cath is being repeated or how it would change management, but that is something to discuss with your treating team so you get a better understanding of their thought process.
Yes, this was most excellent in letting me know what I was up against. I was told that I had a Massive Pulmonary Embolism, and that it was very serious. My Doctor said I was a very Lucky Man. He said, This Kills People.
Then, I called my brother, and told him I needed to go to the hospital, and in the car, as I was getting in, I passed out. I guess they were Massive. That was January 1sr, That Night, and I went Home, The 5th of January, and am walking, and trying to help things along, but, I walked 3 miles, or maybe 4, yesterday, and I was so exhausted.
I just slept, and slept, and slept, and my mother said, maybe you should slow down a little bit. That was a really scary thing for me, though, because when that Doctor came in, and said I had Clots in both my lungs, he looked at the Floor, and I thought I was a Dead Man for sure. I had an accident late December where a pallet jack trolley offloaded its contents onto the lower backs of both legs.
An MRI determined a significant meniscus tear. But my gut instincts said that I might have a blood clot. I was transfered to hospital, released the next day on Xarelto 20mgs. I remained on this for 12 months and wore a compression stocking for 2 years. I now take 1 or 2 aged Kyolic garlic tablets daily for peace of mind. My situation has been complicated by the diagnosis of CRPS 6 months post accident, which mimics multiple symptoms of dvt.
Can you advise if I am worrying needlessly or is it true that once you have had pulmonary emboli, with or without dvt you have a greater chance of having another one. Duration of anticoagulation after PE should be personalized on a case by case basis and risks vs.
Patients that have had an embolic event are in general considered to be at greater risk of a repeat event. In those that are at significant risk with ongoing factors such as lack of mobility, no clear provoking factor and such, i will often discuss extended duration of anticoagulation. In those that are at risk from blood thinner, such as those that have easy bleeding or significant complication there is a more compelling case to stop it.
I suggest you discuss the risks vs. In April of my daughter, 14 yo at the time, had multiple PE in both lungs. There was no evidence of a DVT. She is very active, plays soccer year around and is not overweight. My daughter was on Lovenox for 8 weeks until the clots dissolved. She is back to playing soccer and has no further problems. The mutation itself has long been considered a risk factor for thrombosis however the studies looking at population have led to conflicting results, i think most would say that in the setting of having the mutation its best to avoid triggers such as the BCP.
Thank you for this informative article. In December, I was diagnosed with a multiple clot burden, a DVT in my upper right calf and after being misdiagnosed 2 x I continued to work out thinking I just had a bad cold later Bronchitis. I have led a healthy Life, workout daily, follow a good sound nutrition program and docs believe I developed a DVT the result of 2 broken ankles and developing MRSA which left me with bad Lymphedema for 11 mos.
In 3 weeks my two left clots dissolved via aggressive Heparin and Coumadin therapies. Lovanox Injections 4 a day in stomach and pills twice a day. I was released after 12 days. Sadly had suffered 5 large lung infarcts leaving my right lung beat up.
Readmitted for 7 more days. My Arterial Blood Gas was Every workout I did prior to December was aerobic swimming, cycling running.
Never was much for just walking. Had to convert from a racehorse to a snail. Not easy for we active types. I am 54 and rarely ill so you can imagine the utter shock of all of this. On day 49 of my recovery I had bad chest pain and headaches and felt dizzy. All while sitting so I grew worried. Back to ER was there 10 hrs. More good news 3 clots in Right lung are gone!! CT of brain showed no bleed, no clot, no aneurysm.
CT of chest showed fluid build up. I left feeling relieved but concerned about fluid. Any ideas what the cause would be. Docs want to rule out Congestive Heart Failure.
Would that be possible to stay so asymptomatic til now?? I want to wean myself off Oxygen and get back to swimming. Meeting with Cardiologist and Neurologist in the next two weeks. My mom was hospitazed last monday with extreme chest pain and shortness of breath they found out only today why…. Hello Dr. Mustafa, This article is really helpful. My Sister had a severe leg pain ,so sge went to doctor and they confirmed thats its a DVT.
The did all kinds of test and found found that she also has clots in the lungs. After a week,Doctor told my sister that they are going to reduce the dose to 5mg per day after 1 week. So my question is,Which type of PE my Sister fall into?
Is it massive or submassive or Lower Risk. Is she in the right direction,? I am a 58 year old female who has had 2 pulmonary emboli events, the first in with also DVTs, the second in after being off coumadin for 2 months due to hemorrhage.
I was found to have the mthfr mutation. I was followed by a hematologist and cardiologist at that time and forward. I was switched from coumadin to Xarelto in I fell July and injured my left knee ultimately ending up with reduction of activity and partial bedrest, hospitalization for cellulitis in the affected leg and septicemia with extended IV antibiotics and PICC line at home.
Since this event my legs have started hurting again with swelling off and on, my shortness of breath is back and worsening. I am having some chest discomfort as well. My initial diagnosis in was delayed by my doctor attributing my leg pain and shortness of breath at that time to my arthritis and asthma.
My current physician is attributing my symptoms to decreased physical conditioning due to the extended reduction of activity and hospitalization, etc I recently experienced. Should I be concerned that due to the reduction of activity and illness I had, that I actually am experiencing PEs again? My paternal grandmother and paternal aunt both died of clotting events. With those symptoms returning i think that recurrent events need to be ruled out and you need to get advice from a physician familiar with this without delay.
My mum had a stroke last July, she recently had a fall and has been diagnosed with a small bleed on her brain. CT scan has revealed she has a small blood clot on her lung. She is 81 years old and had a bad chest infection for the last month.
She is currently still in hospital and last night we were told that she cannot have any operation such as inserting a mesh to stop the DVT in her leg sending showers of blood to the clot in her lung. She cannot have any clot busting thinners due to the bled on her brain. Basically they have told us there is nothing they can do! I am distraught at being told this by the staff nurse of the word.
This information was relayed to us from my mums consultant via the senior nurse and just feel debated to be told in this day in age of pioneering medicine they have given up and want to simply send her home. They also told us if my mum had a massive heart attack they would not do CPR as her chances of survival would be so slim.
I could not believe what I was being told. Any advice? My mom was diagnosed with pulmonary embolism after taking birth control for a ovarian cyst. She has been on blood thinners for 6 months but she is still getting chest pains. A blood clot in a leg vein may cause swelling, pain, warmth and tenderness in the affected area.
Although anyone can develop blood clots and subsequent pulmonary embolism, certain factors can increase your risk. You're at higher risk if you or any of your family members have had venous blood clots or pulmonary embolism in the past.
About one-third of people with undiagnosed and untreated pulmonary embolism don't survive. When the condition is diagnosed and treated promptly, however, that number drops dramatically. Pulmonary embolism can also lead to pulmonary hypertension, a condition in which the blood pressure in your lungs and in the right side of the heart is too high.
When you have obstructions in the arteries inside your lungs, your heart must work harder to push blood through those vessels, which increases blood pressure and eventually weakens your heart. In rare cases, small emboli occur frequently and develop over time, resulting in chronic pulmonary hypertension, also known as chronic thromboembolic pulmonary hypertension.
Preventing clots in the deep veins in your legs deep vein thrombosis will help prevent pulmonary embolism. For this reason, most hospitals are aggressive about taking measures to prevent blood clots, including:.
The risk of blood clots developing while traveling is low, but increases as long-haul travel increases. If you have risk factors for blood clots and you're concerned about travel, talk with your doctor.
Mayo Clinic does not endorse companies or products. Advertising revenue supports our not-for-profit mission. This content does not have an English version. This content does not have an Arabic version. Overview Pulmonary embolism Open pop-up dialog box Close.
Pulmonary embolism Pulmonary embolism PE occurs when a blood clot gets lodged in an artery in the lung, blocking blood flow to part of the lung. Request an Appointment at Mayo Clinic. Blood clot in leg vein Open pop-up dialog box Close. Blood clot in leg vein A blood clot in a leg vein may cause swelling, pain, warmth and tenderness in the affected area. Share on: Facebook Twitter. Show references Venous thromboembolism.
So what's a patient to do? There are some descriptors of symptoms you can keep on the lookout for: A charlie horse that will not go away no matter what you do A pulled muscle accompanied by uneven swelling An unexplained pressure or pain in your chest According to Dr. Madsen, f you have any of these symptoms, go get an ultrasound or a CT scan at the ER as soon as possible. Don't wait to schedule it a week or two out. He explains anecdotally that if a young person comes into the ER experiencing sudden cardiac arrest, pulmonary embolism is the first thing he thinks of.
If these symptoms hit you or a loved one, do not wait to seek treatment. Stacy Johnson explains that pulmonary embolisms can be caused by a long list of potential risk factors including: Long, sustained airplane flights Undergoing surgery Injury Cancer Diabetes Smoking Age Testosterone supplements Genetics does play a role in some cases of pulmonary embolism.
There has been a lot of research during the s and early s looking into a potential genetic or familial link and risk of forming PE. There are multiple genes and mutations that have been shown to increase a person's chance of forming blood clots. Several of the current at-home genetics tests even screen for some of these mutations. However, there is no way to apply these genetic findings clinically. Recent studies have identified as many as different genes involved in the clotting cascade process and potential 5, mutations that can increase or decrease a person's chance of forming a dangerous clot.
Considering most DNA tests only test for five or fewer of these mutations, it's important to realize that a negative result will only give a false sense of security. If you've heard of the terrible "rat-poison" that used to be prescribed, rest assured those days are long behind us.
Physicians stratify the risks of each PE patient, both before and after treatment. They identify the severity of the clot, what level of risk it presented, potential recurring causes, etc. This stratification informs the type of treatment and after-care a patient can expect. For lower-risk patients, the PE can be treated with a blood thinner medication and sent home either the same day or after a few days of observation in the hospital.
After treatment of the embolism, patients can expect a certain level of after-care depending on the same type of risk assessment they had for treatment. Patients with a low risk of forming another clot can expect to take blood-thinning medication for just a few months after treatment.
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