Chest Pain and PEs

[eddie864]

My 24 year old fiance is 17 weeks pregnant with our first child together, although she has a little girl from a previous relationship so this is her second pregnancy.

Two weeks ago she told me she was a little breathless and getting crushing pain in the middle of her chest. So we went straight to her GP who suspected a Pulmonary Embolism and we were sent to the local A&E. She doesn't have the classic symptoms of a PE - just a little breathlessness when the pain is there and a faster than normal heart rate - so she had a chest X-Ray and eventually a V/Q lung scan. They also gave her one injection of a blood thinner. The X-Ray and scans didn't show anything and she was discharged. She is still getting this pain that comes and goes, without any noticeable cause. Today we went to the GP again who has given her antibiotics for bronchitis. I guess we will see how that is once the weeks course of Amoxicillin 500mg is done.

I am really concerned about the possible PE as I am aware that it can be life threatening or may cause other damage to my fiance and the baby. Has anyone got experience of blood clot problems through pregnancy, the symptoms and treatment?

Hi eddie I've had blood clots (pre pregnancy). Should say I'm not a doctor but have reasonable experience with this. From the tests she's had it would seem unlikely to me to be a PE and would most likely have been picked up from one of the scans and a blood platelet count.

I've injected blood thinners throughout my pregnancy for prevention of another clot, others take a higher dose for treatment. The drug is called heparin or Clexane and is safe during pregnancy as does not cross the placenta so don't worry about what they gave her.

My advice for what it's worth would be to monitor it obviously but wait until the antibiotics have kicked in. Pregnant ladies are immunosupressed meaning you are at risk of every bug going which could easily develop into bronchitis. Clots aren't always preventable during pg but keeping well hydrated, reasonable exercise (just some walking will do) and possibly compression stockings will all help.

Hope she feels better soon :)

Hi Eddie I'll preface this post with this is my peronal experience and I am not a Dr.. I had multiple bi-lateral PEs in my 3rd pregnancy. I thought I just had a chest infection or was perhaps having a panic attack. My oxygen sats were normal (usually much decreased with PE) my pulse was racing (and remained very high until after delivery of DC3). I was very breathless but had no pain, no coughing up blood or sense of doom. So not all the classic symptoms were there.

My GP amazingly spotted it and sent me to A+E, I was about 7 months pg and so once they had monitored me for a couple of hours after the first heparin injection they transferred me to a bigger hosp with a neonatal intensive care unit incase they needed to get the baby out in a hurry. At this point it was still a suspected but 'very unlikely' PE as my oxygen was fine.

Over the next week as an inpatient I had normal white blood count blood test - ruling out chest infection and a normal chest x-ray ruling out various other things! I also had ultrasound of my legs to see if they could find a DVT - which were again normal so 'very unlikely to be PE'I had a VQ scan after being in hosp for about a week with continuing raised pulse and breathlessness which came back showing areas of air flow but no blood flow in the upper and lower sections of my left lung and the centre section of my right lung. Classic PE damage.

As they didn't find clots in my legs it was suggested I had my clots in my groin or abdomen but we will never kniw for sure. I was medicated with daily heparin injections and after birth had 6 months of Warfarin. I was also advised not to get pg again!

If your partner's VQ scan came back negative then I don't think it can be a PE, but go back to the GP for advice. He/she should be able to to a simple blood count to see if it is an infection or not.

If in doubt get your partner to a Dr. My hosp consultant said 'if this is what we think it is (PE) then it is a 9 on my 1-10 seriousness score'.

Best of luck.

Thanks for your comments. I guess the hospital didn't find anything on the V/Q scan so they don't think it is a PE. We shall give the antibiotics some time but it is a worry. Along with her constant sickness, terrible tiredness, high ketones (because she can't keep much down sometimes) and general feeling of malaise now it's been a more interesting pregnancy than my last two and her last one.

Thanks again...