Twisted Ankle Nearly Proves Fatal From Blood Clot
A woman in her late twenties nearly died from a blood clot in her lungs caused by prolonged immobility after a twisted ankle, a case that highlights how dangerous clots can form from seemingly minor injuries.
On July 6, Dr. Fiew posted a warning on Facebook about a patient who suffered a near-fatal condition from what seemed like a simple twisted ankle. The doctor was called in the middle of the night to examine a woman in her late twenties with normal vital signs, blood pressure, and oxygen levels who complained of heart palpitations and fatigue over two days. After initial examination revealed no obvious abnormalities, an EKG showed a slightly elevated heart rate at 100 beats per minute. However, emergency room doctors are trained to consider the most dangerous conditions first, as missing a critical diagnosis can be fatal.
While reviewing the EKG, the doctor noticed subtle details that raised suspicion this wasn't ordinary heart palpitations. When asked about immobility, the patient revealed she had fallen down the stairs a month earlier, spraining her ankle without fracture, and had barely walked since—mostly just getting up to use the bathroom. This detail connected the pieces. Additional blood tests showed abnormally high levels suggesting blood clots, prompting a CT scan of the lungs. The results confirmed acute pulmonary embolism.
The danger wasn't the ankle sprain itself, but prolonged immobility. When legs don't move much, blood flow slows, creating conditions for clots to form in leg veins. When a clot breaks free, it travels through the bloodstream and lodges in the lungs, blocking blood flow. The heart then works harder to pump blood through the obstruction. If the clot is large enough, the heart cannot handle the strain, blood pressure drops, consciousness fades, and cardiac arrest can occur within minutes.
The most frightening aspect of this condition is that many patients appear only mildly ill—some just tired, some with heart palpitations, some with shortness of breath. This patient walked into the emergency room on her own, spoke normally, and had normal oxygen levels. Had the doctor dismissed her as merely stressed or with normal tachycardia, she would have gone home with a life-threatening condition.
At-risk groups include: bedridden or nearly immobile patients, those on long flights or car rides, recent major surgery or fracture patients, pregnant women or recent mothers, oral contraceptive users (especially smokers), cancer patients, those with previous blood clots, and those with clotting disorders. Warning signs not to ignore include sudden fatigue, chest pain, and shortness of breath.
