Hello.
Thank you for your query at DoctorSpring.com.
I understand your concern and agitation as a mother. I am glad to know that your daughter is doing well now.
Pulmonary embolism is something rare and I would not consider it as the first diagnosis in a 20 year old female with her symptoms.
Of course, a history of hormone therapy will make it more likely. The prediction score changes with that history. However, it would still not be the first diagnosis on a list of differentials.
Pain is a subjective symptom and the pain scale is not a standard tool for coming to any diagnosis.
And I will not blame the doctor who did not want to expose a young female to unnecessary radiation in the first step of management.
As to the damage to the lung (pulmonary infarct) cannot be quantified now. However, it will be quite small as the lung has a dual blood supply. There is nothing much to worry about in the long term.
I assume you might have received adequate treatment and advice on prophylaxis.
I would like to repeat it and suggest prophylaxis againt thrombosis for a minimum of 3 months.
Also, a follow up Ventilation/Perfusion (V/Q) scan after 2 weeks needs to be done to precisely quantify the damage to the lung.
I hope this was helpful.
Please feel free to ask further questions or clarifications if needed.
Regards,
Dr. Jacob George P,
MD, IDCCM, FCCP.