HomeAnswersPulmonology (Asthma Doctors)pulmonary embolismKindly analyze the recent CT scan and suggest whether I have PE.

Does my CT scan show pulmonary embolism?

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The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

Medically reviewed by

Dr. K. Shobana

Published At January 20, 2021
Reviewed AtJanuary 29, 2024

Patient's Query

Hi doctor,

I was diagnosed with pulmonary embolism (PE) before three months. I am taking Eliquis for now. Last night, I had some complications and went to the emergency for having a low heart rate, dizziness, chest pain, and shortness of breath. They retested again using a computed tomography (CT) scan with contrast. They told me that the PE is gone and I need to continue taking medicines until I consult the hematologist. I have some questions regarding the findings observed in the CT. On the CT report, there is no pulmonary embolism and the pulmonary arteries were patent within normal limits and it is unremarkable. The lower neck was normal. The chest wall was normal and the central airways were patent. There is no lymphadenopathy. A triangular-shaped soft tissue density anterosuperior mediastinum compatible with residual thymic tissue was seen. The thoracic aorta was within normal limits and it was patent. The heart was not enlarged without pericardial effusion. The lungs showed minimal curvilinear bands subsegmental atelectasis versus scarring of the lateral left lower lobe. The remaining lungs were clear. The upper abdomen and bones were normal

Hi,

Welcome to icliniq.com. I can understand your concern. According to your statement, you are suffering from dizziness, chest pain, shortness of breath, and low heart rate. According to the HRCT (high resolution computed tomography) of the chest, minimal curvilinear bands subsegmental atelectasis versus scarring lateral left lower lobe was seen. You have a history of pulmonary embolism. The thymus occupies the anterior mediastinum near 40 years or at the age of 40 years. The thymus is almost replaced with fat and only residual nodular density of tissue remains. The slightly poor contrast opacification thoracic aorta results from an artifact or due to previously treated pulmonary embolism. But "without acute thoracic aortic abnormality " indicates that there is no pulmonary embolism is now. The subsegmental atelectasis indicates that there is a slight or mild involving less than one bronchopulmonary by atelectasis. The scarring lateral left lower lobe means that there can be a development of fibrosis on that particular area of lungs where the lung tissue became scarred, damaged, and thickened.

Patient's Query

Thank you doctor,

I am attaching the first computed tomography (CT) scan reports.

Hi,

Welcome back to icliniq.com. CT (computed tomography) pulmonary angiography (CTPA) is the gold standard test or investigation of pulmonary embolism and it has revealed that there is a partially occlusive vascular filling defect in the right lower lobe with posterior basal segmental branch compatible with acute pulmonary embolism. The vascular filling defect in the right lower lobe at the posterior basal segmental branch of the pulmonary artery indicates pulmonary embolism on that particular branch of the pulmonary artery and on that particular area. A pulmonary embolism is a blockage of an artery in the lungs by any substance. So, according to the CTPA report, a partial blockage was found in the right lower lobe at the posterior basal segmental branch of the pulmonary artery that is caused due to pulmonary embolism on that particular area and particular branch of the pulmonary artery. In your latest HRCT (high resolution computed tomography) of the Chest, there are no abnormalities found on the right lower lobe and so your pulmonary embolism has got subsided.

Patient's Query

Thank you doctor,

Why was the scarring not observed in the first computed tomography (CT)?

Hi,

Welcome back to icliniq.com. CTPA (CT pulmonary angiogram) is a special CT (computed tomography) scan that is used to diagnose blood clots or pulmonary embolism. CTPA takes only the pictures of blood vessels that run from the heart to the lungs. CTPA with contrast means that contrast is infused into the body to visualize the whole passage of blood supply or blood vessels on the inner path or lumen to detect any suspected blockage. CTPA is only related to the blood vessels and blood supply of the lungs and not used for the whole lungs. But CT scan is a special type of X-ray that produces cross-sectional images of the different parts of the lungs. For this reason, your scarring was not detected on CTPA and it was detected on the CT chest taken recently.

Patient's Query

Thank you doctor,

You are amazing. Thank you doctor.

Hi,

Welcome back to icliniq.com. Now, you should know some simple measures to stop the further process of fibrosis. You are taking Eliquis and it contains Apixaban. It is used to prevent blood clots. Do not stop taking this medication without the doctor's permission. Your recent computed tomography (CT) chest has shown subsegmental atelectasis versus scarring or fibrosis lateral left lower lobe but it is minimal and so do not be worried. If you suffer from cough, shortness of breath, or respiratory difficulties, then you can take bronchodilators like Salbutamol after consulting your pulmonologist. If you do not have any other symptoms, then you do not need to take any medications. You have to practice breathing exercises using an incentive spirometer. Even you can blow balloons at home daily. These breathing exercises will help you to expand your lungs and you will be able to breathe more deeply and fully. It protects you from developing further atelectasis. You can also consult a physiotherapist who is a specialist in breathing exercises.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Muhammad Zubayer Alam
Dr. Muhammad Zubayer Alam

Pulmonology (Asthma Doctors)

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