Understanding pulmonary embolism and its implications
A pulmonary embolism was the immediate cause of death for actor and comedian Catherine O’Hara. It’s a serious condition in which a blood clot lodges in the lungs, reports BritPanorama.
O’Hara’s sudden passing on January 30 at age 71 has drawn attention to a medical emergency that can unfold rapidly. This condition can strike individuals who otherwise appear healthy, with symptoms often mimicking other problems. Recognizing the warning signs is critical for timely intervention.
To explain what a pulmonary embolism is and who is most at risk, I spoke with wellness expert Dr. Leana Wen. Wen, an emergency physician and clinical associate professor at George Washington University, emphasizes the importance of understanding this condition.
CNN: What is a pulmonary embolism, and how does it develop?
Dr. Leana Wen: A pulmonary embolism (PE) occurs when a blood clot travels to the lungs, blocking one of the pulmonary arteries. Most often, the clot forms elsewhere — typically in the deep veins of the legs or pelvis — in a condition known as deep vein thrombosis. When part of that clot breaks off, it can travel through the bloodstream, pass through the right side of the heart, and become lodged in the pulmonary arteries.
When this blockage happens, blood flow necessary to pick up oxygen is hindered. The size and location of the clot can significantly affect oxygen delivery to the body and increase pressure on the heart. Large clots can obstruct major pulmonary arteries, leading to sudden cardiovascular collapse, while smaller clots may limit airflow and still strain heart function. Indeed, a PE is a potentially life-threatening emergency requiring prompt diagnosis and treatment.
CNN: What symptoms should people watch for, and which ones require immediate emergency care?
Wen: The most common symptoms include sudden shortness of breath, chest pain that worsens with deep breathing, and an unexplained rapid heart rate. Other signs can include coughing up blood and experiencing lightheadedness or fainting.
However, symptoms can vary. Some individuals may suddenly experience severe breathing difficulties, while others notice mild shortness of breath or vague chest discomfort. In some instances, the first symptom of a PE might be a sudden collapse.
Symptoms that require immediate medical attention include difficulty breathing, chest pain, fainting, or signs of shock, such as confusion and clammy skin. Given that a PE can deteriorate rapidly, it is crucial to seek emergency care if these symptoms arise.
CNN: Why can a pulmonary embolism affect people who appear otherwise healthy?
Wen: Blood clots tend to develop when three factors are present: slowed blood flow, injury to the lining of blood vessels, and an increased tendency for blood to clot. These factors may not be visibly apparent; thus, someone might seem healthy until a blood clot occurs. This unpredictability underlines the need for both clinicians and patients to recognize a PE and consider it a possibility during diagnosis.
Catherine O’Hara had a history of rectal cancer, which can elevate the risk of developing blood clots. Some studies indicate that pulmonary embolism is a significant cause of mortality among cancer patients, second only to the cancer itself.
CNN: Who is at highest risk for developing a PE?
Wen: Individuals with a history of blood clots are at a significantly higher risk of recurrence. Other high-risk groups include those over 60, individuals who have recently undergone major surgery, those who have been hospitalized or immobilized for extended periods, and people with certain medical conditions such as cancer, obesity, atrial fibrillation, and inherited blood clotting disorders.
CNN: How urgent is treatment, and what does treatment typically involve?
Wen: Pulmonary embolism is a medical emergency, and treatment should begin as soon as the diagnosis is made or strongly suspected. Anticoagulation, commonly referred to as blood thinners, is the primary treatment method, as these medications prevent clot growth and lower the likelihood of new clots forming.
In severe cases — such as when large clots lead to heart failure — more aggressive treatments may be required, including thrombolytic medications that dissolve clots or surgical interventions. Most patients will need anticoagulation for at least three months, depending on whether the clot was occasioned by a temporary risk factor or signifies an ongoing predisposition.
Preventive measures are crucial. Staying active and avoiding prolonged immobility are important strategies. During long travel, individuals should periodically stand and move their legs. People with known risk factors should consult their healthcare providers about preventive strategies before major operations or long journeys. Maintaining a healthy weight and refraining from smoking can also mitigate risk.
If someone experiences symptoms indicative of a pulmonary embolism, they should not hesitate to seek emergency medical evaluation. Early intervention remains vital for improving outcomes and can indeed be lifesaving.
