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Bleeding and Clotting Disorders

Need for CT pulm angioram in bleeders

03/04/2008

Question:

I have a history of mild VonWillebrandts and chronic bronchitis/asthma. I had 2 major surgeries under general anesthesia a little over a year ago that was almost immediately followed by repeated bouts of severe bronchitis (new for me). I have recurrent sinus infection that precipitates the bronchitis. I have remained slightly dyspnic altho the asthma is now under much better control. CXR has shown a pulm nodule in apex of lung. CT scan without contrast diagnosed it as scar tissue. Now my pulmonologist wants CT pulm angiogram to R/O PE. Since I am a bleeder, I was doubtful that this could be and was wondering if this test is really needed. I am not confined to bed and have had no surgeries for a little over a year and do not notice any tenderness in my extremeties (aside from inflammatory type pains with my fibromyalgia). I do have a family history of mother with PE, grandmother (paternal) with DVT and grandfather (maternal) with DVT but again I seem to have tendencies for excessive bleeding (hematologist diagnosed as mild VonWillebrandts).

Is this test really necessary--is a bleeder at risk for PE? Thank you so much.

Answer:

While it is not possible to give direct medical advice with only limited information, I would tell you that even though you may have a bleeding tendency, it is still possible to develop a venous thrombotic event (pulm. embolus, DVT, etc.)

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Response by:

Spero R Cataland, MD Spero R Cataland, MD
Associate Professor of Clinical Internal Medicine
College of Medicine
The Ohio State University