Brief Answer:
it's most likely due the traumatic bone fracture only..

Detailed Answer:
Dear xxxxxxxxxxx, welcome to HCM..

I've gone through your query and understand your concern in this regard..

Now till date, medical researches which have done so far have shown an extremely rare incidence of fat embolism due to hyperlipidemia, same goes for the emergency physicians who have actually come across any case of fat embolism due to hyperlipidemia alone (regardless to say that Me too haven't come across any patients of this rare etiology yet)..

So it can safely be concluded that hyperlipidemia is not the likely cause here also, although you should note that hypertension and coronary artery disease is..but once again, hypertension alone causing fat embolism is quite rare scenario..

So most likely it's due to the traumatic fracture of the radius and ulna..now the cumulative adverse effect of hypertension and long standing coronary artery disease can certainly give rise to fat embolism (although you should know that fat-embolism itself is an unlikely condition which seldom happens )..

D-dimer is basically done to exclude other conditions rather than detection of embolism(even if it's positive still it's not a diagnostic test alone to detect any embolism)..the negative and/ normal predictive value of D-dimer carries more importance than positive value(in this case it's moderately elevated, so it's in between of negative and positive)..

LV-dysfunction is a secondary feature , the first and foremost findings to look for in a case of embolism in ECHO is the right sided cardiac features(i.e RA/RV/PA) to be specific, so the focus should be on those findings and not on these(which I believe the cardiologists and physicians must have done already)..

Now with all these being said, even though the presentation in any embolism (thrombo/fat embolism) case is quite acute , the prognosis and overall survival of the patients are generally quite good(depending on early detection and reaching the appropriate healthcare facilities)..


I've tried to make it as simple as possible for you to understand, let me know if anything's not clear..

Take Care
Kind Regards

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