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Q. My brother has been having pain on the left side of the chest. Kindly interpret his reports.

Answered by
Dr. Anshul Varshney
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Jul 01, 2015 and last reviewed on: Jan 11, 2019

Hello doctor,

My brother has been having these following symptoms:

Rapid heart beat. Severe headaches especially at nights. Pain on the left side of the chest. Occassional nausea. He went for a CT scan and part of the results is, ''A large filling defect is seen within the infrarenal inferior vena cava with no opacifications of the vessel. The vessel is enlarged measuring approximately 25mm in diameter. The visualized osseous structures and lung bases are unremarkable.'' What do these results mean? Please help.

Dr. Anshul Varshney

Critical Care Physician Diabetology General Medicine Internal Medicine Medical Gastroenterology Nephrology Pulmonology (Asthma Doctors) Rheumatology
#

Hi,

Welcome to icliniq.com.

The findings suggestive by his CT scan report goes in favor of Inferior Vena Cava (IVC) Thrombosis. Assessing the clotting and fibrinolytic systems are required. The investigations required are protein C, protein S, antithrombin III and anticardiolipin studies.

The goals of treatment are to manage the primary impact of the deep vein thrombosis (DVT) and the impact of embolization. Medical management can include anticoagulation therapy and thrombolytic agents. He definitely needs further investigations and work up.


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Thank you doctor,

What tests do you recommend to assess the clotting and fibrinolytic systems? A local cardiologist has suggested CT Venogram. This test is expensive, so I am just wondering is it really important to take this test? Is this a common or rare condition? Is it fully treatable perhaps by medicine or surgery?

Dr. Anshul Varshney

Critical Care Physician Diabetology General Medicine Internal Medicine Medical Gastroenterology Nephrology Pulmonology (Asthma Doctors) Rheumatology
#

Hi,

Welcome back to icliniq.com.

Yes, CT Venogram is required for the confirmation of the diagnosis. However, it is not a highly sensitive test. The tests I have mentioned are useful to diagnose the underlying cause of thrombosis.

This is very important to understand that we have to find out the cause to treat the condition. Prognosis depends on the severity of the disease.


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