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What is a Bilateral Pulmonary Embolism? What causes it? How is it treated?

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A pulmonary embolism is a clot in the veins of one or both lungs.

As a very recent survivor of bi-lateral pulmonary emboli- one blood clot in each lung at the same time I can tell you that the symptoms mimic other disorders and a true diagnoses can be easily over looked. I thought my onset of shortness of breath was from the high altitude. Then I attributed it to extreme anxiety although I did not suffer from any anxiety disorders. I had a leg cramp. The onset of syncope (fainting) and shortness of breath lead me to believe I was having a heart attack. I passed out and remained unconcious for almost 12 hours. This time included treatment by paramedics and a full work up in the ER. It is life threatening. The first words from the ER physician were, "If you survive."

Five days in the hospital and 3 full weeks after discharge I am still not back to normal. At 53 years old, I have no previous medical history of any kind. An extremely long trip in a car, ( over 24 hours of straight driving) without being able to move, a leg cramp and extreme dehydration were the culprits. I will remain on blood thinning therapy for the next 3 to 6 months and will most likely have to take a 325mg aspirin every day for the rest of my life.

I would recommend testing for a pulmonary embolism before anything. Hope this helps your inquiry.
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I have bilateral PE but I had DVT and PE just recently. It took a year of Warfarin and my clots were reabsorbed. 1 month later and I could not breathe. Wated 2 days before going in and now they tell me I am a lifer for blood thinners.

I can't imagine clots forming that quickly but they did. it is nothing to fool with and I will never wait again if I run short of breath. They told me they were huge; one on each lung.
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I had bilateral pulmonary embolisms as well. I don't know how many there were, I just know that the surgeon said that there were too many too spread out for him to be comfortable with using surgery over heparin to remove them. Especially since the right side of my heart was rubbing up against at least one, causing it to swell up and start "leaking" as the ER doc put it.

My symptoms started about a week before I went to the ER. I was trying to walk to the bus stop when I felt a sudden pain from my chest to the top of my mouth, along with shortness of breath. I actually had to sit on the ground and beg my body to get back up in time to catch the bus. 5 days later I started not being able to walk more than 5 steps without needing to sit down. The day before I went to the ER, my fiance practically had to drag me into the apartment because my legs gave out from under me. 

When I finally got to the ER, the triage nurse took my vitals and my heart rate was up in the 140's, my hands and feet were freezing, and my blood oxygenation levels were at 90 and struggling. They got me to a bed, hooked me up to some oxygen, and began the testing process. They sped things up after I threw up (despite all the anti-nausea meds they were putting in the IV) and passed out for a minute. They gave me an Echo and that's where they got the information on how bad my heart was. Though my fiance was there, they still had to get my permission for using the heparin over the surgery option. 

I ended up spending about 10 days in the hospital, 3 of them with an oxygen mask. I've been out for a week now, and I'm still recovering. I'm going in for weekly blood tests as I am on Coumadin, and if my primary doc has any say I'll be on it the rest of my life. Still no definite cause. I'd been on birth control too long for it to be the definite cause. I have a sedentary job, but I walk at least 15-30 minutes a day. I deed have bilateral DVT, but again, no idea what caused it. No long rides, no dehydration, no clue.

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HI, REALLY SERIOUS. I THOUGHT I WAS HAVING A PANIC ATTACK AS I HAD JUST BEEN ATTACKED BY A MEMBER OF STAFF WITH BI-POLAR DISOREDER (BEWARE OF 'BI's)  THE CONDITION WAS NOT RECOGNISED BY THE LOCAL TEACHING HOSPITAL ALTHOUGH MY GP REFERRED ME TWICE. MY BPE WAS REFERRED TO AS A 'BARN DOOR' BY A&E. I WAS ON OXYGEN FOR 5 WEEKS AND OFF WORK FOR 14 WEEKS. I LOST SOME OF MY HAIR AND SOME OF MY WITS FOR A WHILE. IF YOU HAVE ALOVED ONE SUFFERING FROM THIS PLEASE BE THERE FOR THEM - THEY ARE LUCKY TO SURVIVE. MY GP WANTED ME TO SUE THE NHS OVER MIS-DIAGNOSIS. 7 YEARS LATER AND STILL SUFFERING SOME OF THE CONSEQUENCES, I WISH THAT I HAD.

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Just returned home from the hospital.  Diagnosis is Critical Bilateral Pulmonary Embli. Very slight symptoms in SOB that I attributed it to another diagnosis problem so I tolerated the SOB for quite a while.  Then this last week it became dangerous with unable to walk a few steps without sitting down.  So now, I go to the hospital.  Dr. says, "glad you came".  My B/P 154/111, Resp. 107, Sat 78.  I didn't know that this was the last minute before critical death would set in.  Moral of this is, listen to your body.  It gives off serious signs before it says, "I can't take anymore". I put up with it because when I sat or laid down for a few minutes the symptoms went away.  So then I thought I was ok.  Wrong.  Listen

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I too developed a PE last year. I also have colitis. The two can be related. I am very active...runner, biking, hiking, P90X. Extremely active and healthy. Twice now I sudden had shortness of breath. The first time a few years ago I suddenly was struggling to breath. Within about ten days it did go away before the doctors found out what the problem was. Then again, March of 2012, all of a sudden I couldn't breath. I went from running 20 km to not being able to run across the street. I couldn't walk a flight of stairs without stopping. My doctor sent me for many, many tests, then referred me to a pulmonary specialist. He didn't take me seriously, but did agree to send me for an exercise test. My blood oxygen level dropped 81 within 6 minutes and the test was shut down. My specialist then took me seriously and sent me for a lung scan. I was shocked! I told him coincidentally both times I had just finished having a colitis flare-up. Because he intially didn't take me seriously he didn't remember me telling him that and arguing that it has to be related, until he re-read his notes. He said I presented too healthy to have something so serious. So.......please keep in mind. If you have colitis you have a higher risk of developing a PE. I had to inject heparin into my stomach for the first month and now I'm on Warfarin. My Pulmonary specialist and Colitis specialist disagree on whether I should be a lifer on warfarin or not. Having said that, a person I know just died from a bilateral PE. I have decided I'm a lifer.
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Following a knee replacement operation in August 2013 my exercises were going very well. Then I developed shortness of breath and a calf pain that effetively put my exercises on hold. Shortly after this I had severe addominal pain and A&E gave me morphine and sent me home. My GP said that these symptoms sounded like Pulmonary Embolism and he gave me a blood test that involved a small device that would/would not indicate blood clots. He said I had none. My partner was not happy about this and we returned to my GP. He was a bit more thorough and was very sure sure I did not have blood clots.

Another pain attack occurred while I was talking to my GP on the telephone. I went to the Walk In Centre of the hospital this time and they thought it might be Gall Stones. I was admitted to the Emergency Assessment Unit for two days and they couldn't find anything. On both visits my oxegen levels were low and I was asked by nurses to take a few deep breaths to get it above 95. I was discharged. A third attack meant another visit to A&E and after morphine I was sent home. I returned at 5am and spent 12 hours on a trolley. During this time a nurse noted my low oxegen level and wheeled me to the resusitation dept where they decided that this was now a major problem. A Junior Doctor told me that he was sure I had PEs on my lungs and kidneys (hence the pain) and that CT scans would be carried out. By the end of the day I was admitted to a ward. Following a CT scan on my upper body only they found PEs. I was put on Clexanne and Warfarin. I had a Doppler scan and a DVT was found in my recently operated knee. They didn't take a scan of my lower body until a few days later. They 'think' I had thickening of the walls to my Lower Bowel and said that they thought it was lymphoma (I had to tell my family this), this meant that I would have an operation to remove the offending bit and make good. However, as I was on Clexanne and Warfarin I would have to suspend this and have have a filter inserted into a major vein (via my neck) to trap any errant blood clots that might find their way to my heart. This procedure (carried out the morning before the  the main op) was dependant on my blood being thick enough to allow the opration to be carried out safely. Unfortunately I was given clexanne in error the same morning - nevertheless both operations went ahead. The main operation (keyhole) showed nothing was wrong and everything was in good condition (some good news at least). So an invasive operation that I did not need; the filter was removed a few days later.

The Consultant advised that everything had been checked and investigated and that he had no other plans for me and that I would be discharged. My partner grilled the Consultant and he made some errors in his replies that suggested that he ust wasn't interested.  However, despite being emphatic that he had no further plans for me I would have another CT scan of my lower body where nothing was found...a radiologist suggested that he'd like an ultra sound of my spleen, again nothing found. On my discharge (after 3 weeks and 2 days) the Consultant suggested that the pain may have been PEs finding their way up from my DVT in my adominal area. Now that's pretty much as the Junior Doctor suggested without any scans and based just on information from me, my recent history and the oxegen levels at the time. 

I'm off Clexanne now and just taking Warfarin. I spoke to the Nurse at my clinic (no confidence in my GP) about when the pain from my calf will go so that I can walk properly, she said when the DVT has disapeared. So, I seem OK now, just waiting to complete the 6 month Warfarin course so that I can have a Thrombophillia scan.

I have left out some information but that really relates to the way the hospital in North Essex is run...its now under Special Measures!

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Hi - Was interested to read of your experience/s as to be honest I too am the victim of so many errors and mis-diagnosis regardingclots on both lungs......for FIVE months (after being discharged from hospital with Severe Chronic Ulcerative Colitis during which I developed a dull ache in my left calf which the consultant could not find anything really wr9ong by feeling it etc) my legs had lost all power and I couldnt walk a couple of steps without having to lie or sit down and as the months passed I became seriously breathless and couldnt even take two steps without gasping. Respiratory GP diagnosed it to be WIND (history of thrombosis in my family....maternal grandmother died from it and my mother surivived a heart attack brought on by a clot at the heart)..then I saw a cardiac consultant privately as my breathing was very frightening...he said it was due to side effects of medication for my colitis..less than two days later i was in re-suss whereby a CT scan (and a very smart doctor) diagnosed clots on both lungs. Home three weeks now and on warfarin but pain still in three places in left leg so have insisted on a ultrasound scan of my leg as I have had enough of being panned off as when I was in the hospital originally I was supposed to have these extra tests to find out where the clots were coming from and i never heard tell of them again so I am not taking any risks. Still I can't even walk a short distance without becoming short of breath and have been on 7mg warfarin now for one month (with the occasional fluctuation in keeping with weekly LNR)...anyway I can't wait till next week to have my leg scan as I dont know whether I should be exercising or bed rest as it is only the latter which eases the dull pain whereby I was told it was best to keep mobile .......
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I recently was diagnosed with massive bilateral pulmonary emboli which were almost blocking all of the blood to my lungs. I had been feeling bad for a month but couldn't put my finger on what was wrong. I just felt bad and exhausted all of the time. I had purchased an oximeter during a bout of pnuemonia so I decided to check my blood oxygen level. When the reading came back in the lower 70's I thought something must be wrong with the device. I tested it on my wife and it came back at 98 which from my understanding is normal. I called my pulmonologist to try to get my appointment moved up. When I told them the reading they told me to call 911 for an ambulance. At the hospital they ended up in admitting me an ran a CT scan with contrast in addition to other tests. I had not even got back in the bed when the nurse came in and said they were moving me to the Heart Centet which was in an adjacent building. All she would tell me was I had huge pulmonary embolism in both lungs which was blocking most if the oxygen going to my lungs. I wasn't in my room five minutes before they took me in for surgery. They has bumped other patients off the schedule to make room. In the pre-op room the interventional radiologist explained they were going to be making an incision in both groins and inserting a device through the arteries up into my lungs. These sonic devices (EKOS) would break up the clots and at the same time it would spray heparin on the clots to assist with the breaking of the clots. At first I was told I would be given a local and general anathesia but at the procedure started my oxygen level fell into the 60's so they decided not to give me the general anesthesia. I was very scarred as just a few hours earlier I was working in my garden. My wife didn't come to the hospital as she had been sick with a bad cough. I had never felt lonelier. I thought I was going to die and there was no one there who was even waiting for me. The procedure lasted at an hour and I was transferred to the Cardiac Crital Care Unit at the Heart Center. I was told I had to lay completely flat for 24 hours and they would then take me back to the surgery room to check on the progress. I was told the sonic devices had broken up the majority of the clots but there was still considerable amount left. They said this would dissolve over time with additional heparin and warfarin. They also installed vena cava filters in the arteries on both sides. I stayed 5 more days in the CCICU and then transferred to a room on the cardiac floor for three more days. They gave me instructions for taking warfarin and set me up with a clinic for testing my INR. They also had an oxgen generator delivered to the house and I was instructed to use it at night as my oxygen levels were dropping into the lower 80's at night. I will say I was treated very well while at the hospital and I couldn't have asked for any better care. I was under the impression I could go back to normal activities but the next day I worked in the garden for less than an hour and had to go back inside the house as I was having extreme fatigue and shortness of breath. My oxygen level was in the lower 80's again. I have several appointments next week including a hematologist and my primary care doctor. If I had not read the post on this site I would have probably gone back to the emergency room as I thought I had new clots but from what I have read it takes months to recover especially since I had massive bi-lateral PEs. I was told by several doctors I was lucky to have survived. Your thoughts?
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I'm a 47 yo male and was diagnosed with  Submassive bilateral pulmonary emboli.  I had minor knee surgery to repair a torn memiscus and remove some arthritis.  Went for a follow-up with my sergeon 9 days later I had a little swelling in my calf, nothing major and he told me that was expected after what he did.

4 days later I called him and said that my calf is very swollen and it hurts when I stop walking, right away they told me to take a 325mg aspirin and scheduled an untrasound which was negative for DVT.  So he wrote a script for PT thinking maybe that would help.

The PT was a little reluctant to do anything but since the sergeon said all was ok they started with a little leg massage and some exercises.  I went for 5 sessions in a week and a half with the swelling coming and going.  Finally a month after the surgery I was at work coming back from getting a drink, I staggered and nearly passed out.  Got back to my desk and was breathing very heavily so I decided to go to medical.  When I walked in I said I don't feel well and the nurse said you don't look well you are gray, so they had me lie down, gave me oxygen.  My pulse-ox (??) was 90 and my heart rate at 154, they didnt know what was going on so the called 911.

In the ER 15 minutes later they couldn't determine a cause so I went in for a CAT Scan.  I should have known something was up when the technician said I need to find his doctor NOW.  I was told that I had multiple clots in BOTH lungs and I needed to go to surgery to ahve a vena cava (??) filter installed.  After that I was in the ICU for 2 days while they administered TPA (clot buster) to break up the clots.  After that was started on heprin.  I spent 12 days in the hospital and currently on coumadin for the next 6 to 8 months (so I am told).

Other than the swelling and calf pain I had no other warnings of the impendng doom other than the fact that my son asked me that morning when driving him to school "dad why are you breathing so hard"  I didn't really notice but he did.

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I had a tummy tuck and breast reduction together and within a week of the surgery I suffered a bilateral massive pulmonary embolism. Since I was on Percocet for pain, I didn't feel any pain; but I did feel dizzy and like a fish out of the water subsequently I fainted due to lack of oxygen. When I arrived to the ER they Dr.s ordered a CT scan and an eco cardiogram, both tests came back showing ....both lungs full of clots and two big clots on each side blocking the main arteries , strain on the right ventricular cavity of the heart and right lung suffered a infarct. I was immediately admitted to the hospital where they performed a new procedure through my Aorta to both of my arteries of the lung and busted the clots and placed a filter in my main artery. After that I was on direct drip to my lungs with this medicine. Two days later they retrieved the lines and 30 days later they took out the filter. Im presently taking Xarelto and so far is working fine. Im worry that and possibly I will never be the same; but Im lucky to be alive. Even the doctors were amazed that I survived this. Im thankful to God for giving me a chance to stay, the doctors for not giving up on me, and my loves ones for always being there for me.
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How are you feeling now? I discovered bilateral pulmonary embolisms post at day 11. I am now 10 weeks post op and on Coumadin. I am leaving a lot out but I would love to share. 

 ***this post is edited by moderator *** *** private e-mails not allowed*** Please read our Terms of Use

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Do you take the pain meds while on the xeralto?
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I am thrilled to be alive. Recently I was having chest pain and shortness of breath. Due to other medical conditions I explained it away. Fortunately my family did not. Let me also say I have a high pain tolerance so felt it was a spasm. Ended up being life-flighted to hospital. Given excellent care and now recuperating from massive bilateral pulmonary embolisms. While testing for cause, a different type of mass was found and surgery is scheduled for time when embolisms will be more stable.
Listen to your body and don't self-diagnose. It may save your life. I am a walking miracle, so I am told and after reading your posts - you are too!
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