A 'hypothetical' question please

[Pesty]

I am interested in medial staff opinions and non medical staff opinions.

what would people recommend in the following situation.


Patient presents with chest pains ans shortness of breath

Patient is 66 with no known health issues and is in general good condition for age.

female non smoker, non drinker.

No previous chest or breathing complaints.

Patient had flown on a 16 hour flight 4 days previously.

if there are any doctors around what would you suggest. Also interested in non expert opinions just to see if my thinking is way off.

Thanks in advance.

[Pesty]

are you sure you are not a doctor?

[Pesty]

knk said:

Need to exclude PE, and get a troponin.

Can you elaborate on what a PE and Troponin are?

Ahh pulmonary embolism. May I ask how would you exclude that?

[Pesty]

thank you.

[Pesty]

sorry one more question

IF PE is a high risk. would Anticoagulant therapy be prescribed as a routine precaution or do you need to know for definite before treatment?

[Pesty]

Thanks.

I've been reading about PE but it might as well be greek.

Could DVT caused by the long plane journey lead to a heart attack?

[Pesty]

BlackVanDyke said:

Nearly lost my dad to pulmonary embolism twice (bad luck/clotting disorder) - been well educated about risks and causes since, so I'd at the very least expect a chest x-ray and possibly some sort of perfusion scan or other reliable diagnostic/rule-out tests. (not sure about what current standard of care is, my dad's stuff was in the 90s and early 00s so might have changed).

Hope the hypothetical patient is OK. If there's any concern that it really is pulmonary embolism then anybody caring for them will want to be pretty bloody vigilant and probably advocate quite strongly for testing as if/when a not-currently-too-bad PE goes 'wrong' it does so quickly and seriously.

Thank you

The patient was sent away with a diagnosis of anxiety attack.

The patient died early this morning.

The patient was my mother.

Ive been on here trying to take my mind off it. Because the more I think about it he more I realise I'm a wker who made the same mistake twice now.

she saved up for a once in a lifetime holiday. The only time she has ever put herself first. She worked full time and still looked after everybody else tirelessly.

And i took it all for granted like the i am. didn't even text to see if she got there safe or was enjoying herself.

[Pesty]

BlackVanDyke said:

Oh, christ. I'm so desperately sorry.

No, you're not a wker, .

thank you but really I am. never once showed any gratitude and she did everything for us. i dont do the touchy feely stuff never have it was all i could bring myself to say hello when she came around.

went through to the house and found an envelope with my daughters name on. she had bought her vouchers for driving lessons, she was not a wealthy woman.

we don't know if it was pe garbled phone call at 4 am from a nurse i think.

[Pesty]

JumboBeef said:

OK, can we just step back a bit please?


It is of course possible that there was a fk up. It is impossible to tell from what you have said and the talk of "heads rolling" at this stage is not helpful.

Can you find out more about her treatment for her breathlessness and if tests (ECG etc) where undertaken?

And, OP, please don't blame yourself for anything. I'm sure your mother wouldn't want it.

(I am a Paramedic).

Thank you.

The reason for thethread was to get some suggestions of possibilities so i mightbe able to ask questions. I will try to get an email address later so i can email the clinic. Not sure what that will achieve.

Communication is very difficult. In 4 days they will be in new zealand and i imagine i will be able to find out more then.


So far all i know is that she went to a c clinic and saw a dr a few hour later she died. I dont know exact timings or if any treatment was given. All i heard was she was told to rest because the doctor thought it was an anxiety attack.

She was not the sort to complain and would not have told us if she felt unwell so we wouldn't worry.

Edited by Pesty on Monday 18th February 12:58

[Pesty]

Thank you.

Any advice on how to break the news to my daughters.

They will be devistated she doted on them. My eldest gets back from college and my other is out dancing for another hour or so. I wanted to tell them together, they are both quite emotional.

[Pesty]

Well that just capped the day off nicely.

I shouldn't have had to tell the happiest go luckiest and most smiley 13 year old that her grandmother has died. My youngest is still quite sweet and innocent, I think this might be a rude awakening

She took her most weekends shopping despite our protests to stop spoiling the girl and she didn't need any new clothes. They went away on trips...


66 is no age, she will not see them graduate from college, maybe get married,maybe have children.

she was the proudest grandmother you could meet. I was trying to change my behaviour towards her (i am very anti social bordering on emotionally challenged) but thought I had years.

cant get in contact with anybody so no new info. probably will not hear anything for 4 days

[Pesty]

medical report confirms muliple PE

[Pesty]

thank you.

my kids are my world, its everybody else i can't deal with.

[Pesty]

Pesty said:

medical report confirms muliple PE

Well this is a turn up for the books. Over the last year I've gone into a&e twice with breathing problems and chest pains. They did an eeg and took blood and told me I was having a panic attack.... History repeats itself.


So two weeks ago it happens again. I turn Grey for two hours finally get some colour in my cheek and I'm left very breathless and a sharp pain in my chest for a fortnight.

Didn't bother going to a and e but after two weeks of not being a&be to walk to the end of the street and constant chest pains I think f it.

Lukily this hospital is a centre of excellence and did a ct scan find a large PE. It's possible this is a genetic thing and I will be on warfarin for the rest of my life.

So for the last three days here I sit and let me tell you hospitals are not fun

[Pesty]

JumboBeef said:

Sorry to hear that.

A couple of years ago, you were understandably upset at your mother's death due to misdiagnosis. Did you ever take the case forward?

I received an email from some official in NZ to say the coroners report was about to be finished. I replied back with my concerns about the treatment and being dismissed so easily with panic attack and she said she would keep the report open and pass the new info on to the coroner.

Heard nothing since.

It's been a tough few years, MIL is currently in a very bad way. I really don't think there is much point in perusing it. If the coroner in NZ doesn't think so and I believe they are quite a powerful,office over there then that's that.


I'm very happy with my treatment here in Stoke hospital. Just happy I'm not at my local ones. Thanks fk I've got the Internet though and they let me use the iPad.