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Six months or so before my PE, I noticed that my left left was a little larger than normal. I showed it to various friends, family members but didn't think it was a blood clot because I had no inflammation or redness. In July 2022, I noticed that suddenly when I walked across the room I had trouble catching my breath. I blamed it on allergies. The next day I not only couldn't catch my breath but was feeling like I was going to faint.
Went to emergency and told them I have heart disease (CAD) they immediately took me back. In triage they ran an EKG - within 10 minutes or so the doctor came in and said I was either having a heart attack or PE. They had already admitted me, if it was a heart attack I would undergo stints in the morning, or if PE they would perform the procedure to bust the clots (I didn't have to have it).
They immediately started me on Heparin and told me I would most likely be in the hospital a few days.
A CT scan determined blood clots in lung and 3 still in left leg. I responded very well to the Heparin and was switched to Eliquis the next day and dismissed.
The clots in lung were causing right heart strain which is the reason I felt like I would faint, the blood was not pumping to my heart the way it should.
I was seen by an ER doctor, Cardiologist and Pulmonologist immediately in the emergency room. I am being followed by both doctors and will be on Eliquis the rest of my life. Luckily, I take it with no issues.
They determined the cause of my clots was an estrogen cream I was using to help prevent UTI's. They took me off of it immediately.
Note: I was 75 at the time and in good shape. Healthy diet and exercise, good weight. The doctors told me that I could have died with the size of blood clot in my lung but for my strong body condition.

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Replies to "Six months or so before my PE, I noticed that my left left was a little..."

@ljchr you should find and read my recent post in lung health. My situation was very similar to yours except for the underlying cause. I have repeated most of what I posted here in case anyone else see this and has had DVT and PE eventsm I am a 69 year old male. In early December 2025, I had massive PE in both lungs, DVTs in both legs and right ventricle to left ventricle ratio of 1.5. I assume your heart issue was similar. I suspect my underlying cause is an undiagnosed autoimmune disease. I can't get my PCP or Specialist seen to agree and do further testing. When providing just facts and symptoms to AI, it comes back supporting my views, suspected causes, which appears to be forms of vasculitis and even recommend s specific further testing and medications to treat symptoms. Since my directors literally almost killed me, had I waited another 24 hours to go to ER in early December 2025, I was told I would likely not survived. I had an earlier unprovoked DVT in April 2025 in left leg, put on Eliquis for 90 days. 10 days after stopping I had a suspected DVT in right leg, an ultrasound was unable to confirm, but I was put back on Eliquis for another 90 days. By not keeping me on Eliquis after October 2025, I had the recurrence in December 2005.

@ljchr what was the name of your estrogen cream?