Ask a doctor on the topic of Internal medicine

Pulmonary embolism?

October 10, 2015 | 15,00 EUR | answered by Dr. med. Frauke Gehring

Hello and thank you in advance for your time!

Yesterday, I received a referral to the hospital for suspected pulmonary embolism and was supposed to go there for an examination - but now I believe my primary care physician had an acute "almost-finishing-time attitude" and didn't want to work anymore, trying to pass on the responsibility...

Anyway, I don't want to go to the hospital unnecessarily (I'm afraid of hospitals), especially I don't want to have a CT or MRI and expose myself to radiation if in the end, nothing comes out of it... the chest X-ray taken yesterday showed no abnormalities... the radiologist only mentioned slight peribronchial infiltrations, which I don't really understand?! (Attached images).

Briefly, my symptoms:
- More than 1 year: occasional sharp pain behind the sternum - or between the shoulder blades (sometimes radiating to the right)
- More than 1 year: dizziness with and without double vision
- About 6 months: graying of individual hairs
- About 6 months: slight balance disorder when avoiding obstacles (body reacts somehow too slowly when suddenly a box or similar is on the ground)
- For about 4 weeks: Hair loss (definitely more than 100 a day...)
- For 1 week (after a flu-like infection): continuous pain on inhalation, wheezing on inhalation, cough with slight phlegm production (normal mucus, without pus or blood), shortness of breath because it hurts and I probably breathe shallowly
- For 2 days: headache, feeling of illness

Blood pressure and pulse are normal. EKG without abnormalities, lung test (short test by inhaling and exhaling on a device) at PCP normal. No fever (current temperature between 35.4 and 36.7).

Didn't receive antibiotics from the doctor, just painkillers and this referral to the hospital.

A pulmonary embolism is something that happens quickly, right? I can't carry that around for years... and just because I have a cough now, I don't know...

Nevertheless, I'm a little scared, the lungs don't feel pain, so as soon as it hurts it must be something "bigger". By the way, my father died of pancreatic cancer about two years ago... is that hereditary?! And how do you recognize something like that? I don't think you can see that on a lung X-ray...

I'm 27 years old and have been a smoker for 8 years.

Thank you in advance for your hopefully prompt response!

Dr. med. Frauke Gehring

Good day,

This does not actually fit with a pulmonary embolism, as that is indeed an acute event. I rather suspect that you have a prolonged bronchitis, likely due to smoking. I would strongly advise against smoking now, as bronchitis can often last three weeks or longer in smokers.

By the way, an MRI does not involve radiation exposure, but I consider it unnecessary.

Your primary care physician could perform a blood test (D-dimer) if they suspect an embolism. It would come back positive if that were the case. At the same time, they could take a blood sample to check for viruses or bacteria causing your illness. Antibiotics would help against bacteria, but not against viruses.

Pancreatic cancer is not hereditary. It is usually noticed through back pain that is not related to movement.

Wishing you a speedy recovery!

Warm regards, Dr. Höllering