Simultaneous Diagnosis of PE and CVT
Hello everyone, I am curious about the frequency of simultaneously experiencing a pulmonary embolism (PE) and cerebral venous thrombosis (CVT) when both conditions manifest their symptoms concurrently. I’m a 27-year-old female, standing at 5'2" and weighing 110 pounds. Three weeks ago, I received my PE diagnosis after an episode that led me to seek medical attention. The catalyst for my visit was an excruciating migraine, which was the most severe I have ever encountered, accompanied by an elevated heart rate and difficulty breathing. A CT scan of my brain revealed no abnormalities, but the lung CT confirmed the presence of a PE. Fast forward two weeks post-hospital discharge, and my migraine returned, exacerbating particularly when I reclined. I revisited the emergency room, and it turned out I had CVT all along, with the CT scan detecting a clot. What are the odds of this happening? How could the clot have been overlooked in the initial scan? My physician indicated that the oversight was likely due to the lack of sufficient contrast during the first imaging. I am left questioning whether my birth control could have played a role in this, or if it is possibly linked to a hereditary issue. I've undergone multiple genetic tests, all of which returned negative, but did have extremely low protein S levels. My doctor inquired about any history of miscarriages in my family, but there are none. Fortunately, I have not experienced any complications, though I am quite unsettled by this entire situation. It’s noteworthy that my PE presented atypically, as I lacked the classic symptoms, with no evidence of deep vein thrombosis (DVT). I am no longer taking birth control and am currently prescribed Xarelto, 15mg taken twice daily. I am not on any other medications and do not have chronic health issues, but I will be readmitted to the hospital soon.
Answers (1)
6/17/2025, 7:01:21 AM
OpenHealth AI
Experiencing both a pulmonary embolism (PE) and cerebral venous thrombosis (CVT) simultaneously is rare but not impossible. Each condition arises from clotting issues, which can sometimes occur together, especially in individuals who have underlying risk factors. I understand that this situation can be unsettling, especially considering the symptoms you experienced and the diagnostic challenges.
Explanation
While both PE and CVT are caused by blood clots, they typically occur in different circulation pathways. PE usually arises from clots in the legs (deep vein thrombosis, or DVT) that travel to the lungs, while CVT involves clots in the brain's venous system. The situations you faced—intense migraine and respiratory distress—can sometimes overlap in symptoms, leading to potential delays in diagnosis.
Your physician's note about initial imaging may help explain why the CVT was missed earlier; the use of contrast can significantly enhance imaging clarity and help identify clots. The low protein S levels you mentioned can be a risk factor for clotting disorders, which could contribute to both conditions, even without a familial history.
Next Steps
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Understand your condition: Follow up with your healthcare provider to discuss the results of your genetic tests and the implications of low protein S levels. You may want to explore further testing or evaluations for other clotting disorders.
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Monitor symptoms: Keep track of any new symptoms, especially headaches, visual changes, or unusual swelling in limbs, as these can provide valuable information to your healthcare team.
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Medication adherence: Ensure you are taking Xarelto as prescribed, and discuss any concerns or side effects with your doctor. Understanding how this medication works to prevent further clotting is essential.
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Lifestyle adjustments: Maintaining hydration, avoiding long periods of inactivity, and considering leg exercises can help with circulation. Discuss dietary considerations with a nutritionist if needed, focusing on a balanced diet that supports vascular health.
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Regular follow-ups: Schedule regular follow-ups with your healthcare provider to assess your response to treatment and overall risk for clotting events.
I can only imagine how stressful this experience has been for you, but with proper management and support, you can navigate this condition effectively. If you have any more specific questions or need further details about managing your health, please feel free to ask.
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