Pulmonary Embolism Support Group
By far the most common form of pulmonary embolism is a thromboembolism, which occurs when a blood clot, generally a venous thrombus, becomes dislodged from its site of formation and embolizes to the arterial blood supply of one of the lungs. Symptoms may include difficulty breathing, pain during breathing, and more rarely circulatory instability and death.
Some people have reported that they had no (found) DVT but did develop a pulmonary embolism.
One article, published in Journal Watch General Medicine November 24, 2009:
http://general-medicine.jwatch.org/cgi/content/full/2009/1124/6
snip:
"The authors offer four possible explanations: (
1) inadequate sensitivity of imaging studies for DVT;
(2) clots originating in the upper extremities, which were not studied here;
(3) complete embolization of thrombi from peripheral veins, leaving no detectable DVT upon imaging; and (
4) de novo clot formation in the pulmonary circulation.
The authors seem to favor the fourth explanation for many trauma patients, although this theory is unproven."
end snip
An interesting article in the American College of Emergency Physicians both agrees and then raises some dissenting points.
http://www.acep.org/MobileArticle.aspx?id=47233&coll_id=613&parentid=740
[I think that fat globules and perhaps other 'foreign objects' have also been suggested ]
One article, published in Journal Watch General Medicine November 24, 2009:
http://general-medicine.jwatch.org/cgi/content/full/2009/1124/6
snip:
"The authors offer four possible explanations: (
1) inadequate sensitivity of imaging studies for DVT;
(2) clots originating in the upper extremities, which were not studied here;
(3) complete embolization of thrombi from peripheral veins, leaving no detectable DVT upon imaging; and (
4) de novo clot formation in the pulmonary circulation.
The authors seem to favor the fourth explanation for many trauma patients, although this theory is unproven."
end snip
An interesting article in the American College of Emergency Physicians both agrees and then raises some dissenting points.
http://www.acep.org/MobileArticle.aspx?id=47233&coll_id=613&parentid=740
[I think that fat globules and perhaps other 'foreign objects' have also been suggested ]
Do be aware that BC without estrogen has also been linked to clots, although estrogen is generally considered the main culprit. I got my second DVT five weeks after starting on a progesterone-only (no estrogen) BC. I wasn't on warfarin at the time, of course.
I'm not saying that you shouldn't take it, just that you should make sure you're comfortable with the risks. Some docs are fine with BC with hormones as long as you're on warfarin. Some feel comfortable prescribing estrogen-free BC to a previous clotter (although the warnings for these types of BC still often say not to take if you've clotted before). Some docs will tell you to stay away from any and all BC that contains any type of hormone.
Again, it's up to you what risks you're comfortable with and all of us have different things that we're OK with as we try to sort all this out. Just make sure to keep yourself educated and read the warnings that come with ANY new med.
Thank you for following up, yes I realize the risks are still there, although potentially slightly reduced. I have an issue with heavy monthly bleeding (hence the BC), so I'm working with a gyno to look into other possibilities go forward. The decision was to keep me on something for now while I'm taking the anti-coagulants, but my haematologist has said I need to be off BC entirely by the time I finish the anti-coags. It certainly is something trying to put together all the pieces with the limitations being imposed by the anti-coagulants.
They believe that my PE's were caused by birth control.
I wish you well.