Mentions of other substances as cause for PEs can be found if you google it. It's not as common a cause for a PE, as a DVT, but possible. Here are just a few references to it:

http://www.clevelandclinicmeded.com/medicalpubs/diseasemanagement/pulmonary/pulmonary-embolism/

http://www.mayoclinic.com/health/pulmonary-embolism/DS00429/DSECTION=causes

http://www.nhlbi.nih.gov/health/health-topics/topics/pe/causes.html

Thank you. Not common, I'm sure---- but as you said---possible.

hi, I'm one of those who had massive, bi-lateral PEs, but no DVT. Not only was the doppler repeated twice, by a tech and by the radiologist, but our hospital has some of the newest imagery equipment. Also, I had absolutely no symptoms of a DVT.

I was told it was very rare to have clots form in the lungs this way and that's one of the reasons they're still investigating what may have caused the PE.

@Danielle,
Did they perform the ultrasound at your pelvis or upper extremities?
My ultrasounds were never done at those points, so no matter how great the equipment was------they wouldn't have seen them there. (But my DVTs were found in my legs, the most common and often the only place they look for DVTs so that wasn't a problem for me.)

Another thing---- I never had symptoms of a DVT, at least not symptoms other speak of. No pain or swelling or redness in the legs. My first 'hint' was pain in my lungs, coughing that doubled me over with pain Thanks to a numbnuts doctor all that was ignored until I wound up in the ER (where I had been taken by the ambulance after I'd called 911 from home!)

The fact they didn't find a DVT doesn't have to mean you didn't have one. I mean, even if they checked the most common places for DVT (your legs) it doesn't rule out the possibility of a clot originating in another part of your body which wasn't investigated. Like pelvic clots are particularly bad about embolizing, but they also usually take more than a doppler to find. I'm not presuming to know exactly which testing you had, Danielle, but most people don't end up getting a huge workup looking for where the DVT originated when basically the treatment for your PE will cover that too.

I think the most common "other substance" embolism is actually an air embolism, but any of those do take pretty special circumstances to get, and I would doubt it being too common a cause of PE-presenting patients with no identified DVT and I think a person who had a different type of embolism would be aware that it was that and not a blood clot, so I doubt there's been any confusion on that point. I mean, if it weren't a blood clot I doubt they even would need the 'normal' PE treatment.

Personally, I would imagine that like many things, there's a pretty big combination of these above mentioned reasons which account for the people who aren't diagnosed with DVT as well.

Agreed. .

Also DVTs in the upper extremities are far less likely to travel to your lungs vs lower extremity PEs. I've had both types of DVTs. .

Interestingly, the Cleveland Clinic site does mention cement., but it's in reference to polymethylmethacrylate cement,which is used in orthopedic surgeries, like hip replacements. So I suspect that must be the cement reference mentioned in the other discussion about whether cement is a possible cause for PEs.

They did check for a pelvic PE, but not upper extremities because it is likely to cause a PE.

The research I consulted was specifically about cement dust, more specifically, silica containing cement dust from construction site. From the way they explained where the silica dust may originate from, there likely is some in our building: they've been drilling cement, foundations, drywall as they're evergreening the building while it is mostly empy (only the 1st and 21 to 26th floors are currently occupied. We occupy from the 21st to 26th and they're currently working on the 24th and 25th. I'm on the 23rd.

When I had my PEs, they were work on the 22nd and was on the 23rd and the main lobby, where I had to go through several times a day.

Oh, and they're very confident that mine were blood clots, not other substances.

I have never experienced DVT either - my PEs were discovered 2 months after I had a gallbladder surgery with a post-op bleed, and went on the pill soon after.

Interesting. I had no symptoms of a DVT nor was any found when I was diagnosed with my PE's. I did have pain in the chest down my right arm, shortness of breath, nausea and sweating. I called the insurance nurse and she instructed me to chew an aspirin and call 911. The paramedics didn't think it was any thing serious but a few hours later after blood test and a CT the ER doctor was admitting for multiple PE's. In the end I found out I tested for Leiden Factor V. This scared me because over the years I have had many surgeries, not to mention three children.

No DVT for me either. I have repeated that question several times to different doctors. Just multiple bilateral PEs. For me they decided it was a clotting disorder, not one of the named ones though. Interestingly enough, I was clotting a lot from IV sites during four months leading up to the PEs. So I saw a hematologist and my d-dimer was elevated at that time. I imagine my PEs must have been forming. I did ask about chronic clotting as well but apparently there would be heart damage with that. This last time in December I did have a DVT so I know what that feels like now. I see the hematologist again this Friday so I hope to learn something new. She thinks maybe inflammation is part of the picture for me especially given my muscle and joint pain that responds to steroids.

The last ultrasound tech told me clots can come and go in the legs and not have symptoms and still travel and it can happen very fast. A year ago, I had no symptoms of a DVT and yet, they found one. I've actually had several DVTs that did not turn into PE and then I'm on my 4th set of PEs. And nobody knows why. However, they all agree that we just need to take the proper precautions to not have any more. I think that sometimes it just is and we have to deal with it. I've given up trying to figure out the "why". I just want to move on with life.

I had PEs symptoms for a month or two before I ever had the DVT symptoms. So I suspect I had a DVT well before my PE symptoms. Had someone considered that I might have had a PE when I first complained of sob and what not, and been treated right away, I wonder if my DVT symptoms would have ever appeared at all.

I had multiple bi-lateral PE with no determined cause. While I was in the hospital they did ultrasounds on pelvis, legs and arms with no DVT's found. I also did not have any dvt symtoms, had no surgeries and have had no other blood abnormalities show up since. I had the PE symtoms for about 5 days before going to the emergency room because they got much worse (sob, chest pain, and inability to walk more than 20 feet without being exhausted). I was in good shape at the time so I assumed I was getting the flu or something. On wargarin for life now, 2 years and counting.

Hm. Interesting.

I had no symptoms of a DVT prior to my PE and there was nothing found in my legs when I was in the hospital. Nobody ever mentioned it, so I'm just now finding out that this is considered strange.