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
-
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.
-
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.
-
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.
-
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.
-
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.
Related Questions
Persistent Itching of Left Nipple for One Month
For roughly a month now, I have experienced itching primarily on the lower section of my left nipple. Initially, I was at a loss to explain it, as I noticed no visible abnormalities. I suspected the issue might be due to body hair, so I simply trimmed it and moved on. This morning, however, the itch returned. While lathering up in the shower, I noticed the sensation again and decided to examine it more closely. To my surprise, I detected a darker area in the spot that had been causing the irritation. While I wouldn’t fuss if it disappeared, the ongoing nature of this itching is concerning. My attempts to understand the problem led me down a worrying path online, as I stumbled upon images related to "male breast cancer," which just heightened my anxiety regarding the situation. Which type of specialist should I consult about this issue? Would a gynecologist be the right choice?
Should I consult a healthcare professional about this?
I’m a 6-foot tall individual weighing 225 pounds and assigned male at birth. For the past three years, I’ve been experiencing a persistent issue that occurs monthly. About once a month, I start to experience abdominal pain that can last anywhere from several days to a couple of weeks. Coinciding with this discomfort, I also suffer from flare-ups of discomfort in my right leg, some in my left leg, and additional back pain. Furthermore, I endure significant bowel problems, which necessitate frequent re-cleaning throughout the day. My primary concern lies in the fact that I notice slight bleeding during this time; while there are no obvious signs in my stool, there are traces when I check the toilet paper. Interestingly, this situation seems to intensify during the summer months for some unexplained reason. I’ve previously consulted my primary care physician and visited various specialists, but after three years of uncertainty, I still lack a clear diagnosis. I’m left wondering if this is simply an unsolvable medical puzzle I must endure, or if it’s worth seeking further advice from a doctor. I'm hesitant to engage in the cycle of undergoing costly tests only to return home without answers. Additionally, I have been managing diabetes for nine years and have been on hormone replacement therapy for the last five years, along with occasional pain relief medication for migraine attacks that arise periodically.
Unidentified Skin Condition
I’m a 30-year-old female, standing 163 cm tall and weighing 65 kg. I’m reaching out for assistance in identifying this skin condition I’ve been experiencing. After visiting my general practitioner, I was left with no clear answers. They prescribed Rozex Gel and Prednisolone Cream, and I have also attempted to use ketoconazole antifungal cream, but nothing has effectively addressed the issue. This rash has persisted for the past eight months, presenting as weepy and crusty, and it is quite painful. Currently, it is extremely inflamed and I’m feeling quite desperate for relief. I am considering asking for a referral to a dermatologist, but I thought it might be beneficial to see if anyone here has suggestions that could possibly help me resolve this distressing problem. It not only looks terrible, but it feels just as bad!
Numbness in Left Side of Face Upon Waking
I’m a 26-year-old woman, standing at 5 feet 1 inch and weighing 105 pounds. I don’t smoke but occasionally enjoy a drink. My current medications include Zoloft at 125 mg and Wellbutrin at 300 mg. Last night, I went to bed around 11 PM but was awakened at 2 AM by my cat's antics. Upon waking, I realized that the left side of my face felt oddly numb, reminiscent of the sensation you get after a dental numbing shot. The numbness seems to extend from half of my lips and involves my tongue somewhat, radiating towards my ear and up to my nose. I’m not experiencing any additional symptoms such as a headache or toothache. I’m wondering if this warrants a visit to urgent care tomorrow morning or if it can wait until after my work hours. Any advice?
Seeking Insights on Unexplained Symptoms
At 26 years old, I find myself grappling with a perplexing set of symptoms that began when I was 25. Initially weighing around 70 kg, I've now increased to 80 kg at a height of 1.80 meters. The onset occurred in July 2024, when I experienced an unsettling sinking sensation in my left foot. It appeared out of nowhere during an otherwise typical week. It felt as if the ground beneath my foot was giving way. By the following month, these sensations intensified, bringing along severe headaches and a similar sinking feeling affecting both of my feet, my hips, and my head. After spending several days in the hospital, where they conducted a series of tests, including a nerve examination using a spinning machine, I was deemed to have perfect health, with all my levels showing normal readings. While the intensity of my headaches decreased from excruciating to mild, my condition remained a mystery. I frequently visited my doctor, who referred me back to the hospital for various tests; yet, despite thorough examinations, nothing abnormal was detected. My most recent check-up in January assessed my vision and hearing, both of which were also normal. Consequently, I've stopped pursuing further medical assessments, as numerous tests have yielded no concerning results. Despite this, I continue to experience the troublesome sensations. Specifically, when standing or moving, I feel as though the ground is collapsing beneath me. This feeling also arises in my hips and lower back when I sit on firm surfaces, such as the toilet after showering, where I need to sit to dry off. It occurs during lateral or forward movements of my hips. When lying down, crossing my legs, or shifting the top foot, the sensation reappears. Moreover, when the feeling intensifies, if my left foot is the one affected, I also feel a corresponding sinking sensation on the left side of my head. It’s akin to the sensation of an elevator abruptly stopping after descending. I've tried various relaxation techniques and medications for anxiety, but none have provided any relief so far.