First, as described, these are fairly substantial clots on the basis of size, extension, and acute pulmonary hypertension with dilatation of the right heart. They are substantial, but not severe as would be the case with vascular collapse and/or respiratory failure. The size and extent of the emboli are such that complete lysis or resolution of the clot might be delayed or not occur, with resultant residual organized clot and increased resistance to flow in the pulmonary circulation. If a large enough residual, it could lead to chronic pulmonary hypertension, with chronic right heart strain and/or in some instances, shunting of blood (at the atrial level) from the right heart to the left heart through a patent foramen ovale. For all of the preceding reasons, and especially with the recent onset of chest pain, you should have a cardio-pulmonary reevaluation at this time, with a CT scan and an ECHO to assess pulmonary hypertension. It is possible that you coincidentally do have costochondritis. On the other hand, pulmonary hypertension can cause chest pain and right heart failure. If dilatation is more than mild it might compromise coronary artery circulation. In essence, you and your doctors will want to be sure that the pain truly is of musculoskeletal origin and not a reflection of compromised cardio-pulmonary function.
Your tiredness may just be a residual of your having experienced a powerful shock to your body and your sense of bodily integrity. Or, it could be a reflection of low cardiac output.
In essence, your second expression of concern is valid and should be taken seriously; at least seriously enough for your doctors to entertain the possibility that your chest pain may not be costochondritis. If they choose not to, you should request a second opinion.
Hi. Did I not provide the right information? I just wonder as I haven't had any replies and I tried to give sufficient information. Perhaps you could let me know.
Thanks so much for your informative reply. I will discuss your points with my doctor. Great service and very much appreciated. Thanks again.