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Pulmonary Embolism
March 2001

Q. In March, 1998 I had a pulmonary embolism as the result of a broken fibula (I was a pedestrian struck by a vehicle). I was on anti-coagulation medication for about 6 months after being released form the hospital. In speaking to my physician, he said I had an infarct on the lung which should not interfere with lung capacity but he did think I might have the potential for circulation problems in the lower legs later in life. What other complications might arise? Do you have any recommendations on preventive measures? I do not smoke, I do exercise. Any specialists I might see?

A. A common complication of a fracture leg is a pulmonary embolism. This is because after the fracture the blood in the leg does not circulate as well (exercise usually helps the blood circulate), and the pooling blood can form a clot. The clot can break off and travel through the heart to the lungs, thus resulting in a pulmonary embolism (an embolism is something that travels through the bloodstream; pulmonary refers to the fact that it lodges in the lungs). The pulmonary embolism causes a small portion of the lung to die (to have an infarct) because it blocks the blood supply to that part of the lung. Fortunately, your lung capacity far exceeds what you're likely to need in your life. For example, we can entirely remove one of your lungs and you can still function quite well.

For this reason, it is unlikely that your lungs will ever cause you a problem because of this pulmonary embolism. On the other hand, you are at a slightly higher risk of recurrent blood clots and pulmonary embolisms because of your past history. Therefore, if you are ever hospitalized or have another broken leg the doctors will probably want to give you medication to help prevent another blood clot.

Other than that, I would not be too concerned about other complications. Certainly you want to continue to exercise and not smoke. Both of these are incredibly important. If you choose to see another specialist, a pulmonary specialist is one that usually specializes in blood clots, though a hematologist (a blood specialist) is sometimes consulted.

The following page http://www.amg.gda.pl/MEDIC/pe.html is filled with links to resources about pulmonary embolisms. I was unable to find a Web site about pulmonary embolisms for the lay public.

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