Medical Author: Melissa Conrad Stöppler, MD
Medical Editor: William C. Shiel Jr., MD, FACP, FACR
Whenever a young and healthy athlete gets sick, it always gets the attention of the press. The news is even more dramatic when the condition can be life-threatening, as in the case of Serena Williams, who reportedly developed a pulmonary embolism in late February 2011. While it is possible to recover fully from a pulmonary embolism, it is indeed a serious condition and requires serious medications. In addition, Ms. Williams also reportedly required treatment for a hematoma, a collection of clotted blood that forms outside of a blood vessel.
A pulmonary embolism (PE) happens when a blood clot (thrombus) forms in one of the body's large veins (known as deep vein thrombosis or DVT), breaks off, and travels (embolizes) in the circulatory system back to the heart and out into the arteries that carry blood to the lungs to load up oxygen. There the clot in the lungs (embolus) then clogs the artery that provides blood supply to part of the lung, preventing the normal exchange of oxygen and carbon dioxide. It also reduces the blood supply to the lung tissue itself. Lung tissue can die (infarct) if circulation is impaired.
Essentially anything that increases the potential for blood clots to form in the veins can increase your chances of developing a pulmonary embolus. While some medications and chronic medical problems can increase the tendency of blood to clot, even those who are healthy and fit can be at risk for pulmonary embolism due to prolonged immobilization (as with extended car or plane travel or hospitalization and bed rest) or circumstances that damage the blood vessel walls, making a clot more likely to form. Surgery and trauma to the leg are examples of conditions that can make a vein more likely to clot.
Sudden chest pain and shortness of breath are the main symptoms of pulmonary embolism, but coughing may also occur. The pain is usually worse when taking a breath (known as pleurisy). The affected individual may have signs such as a blue-tinged discoloration of the skin and feel lightheaded or weak. In severe cases, the heart stops beating and sudden death results. Fortunately, treatment for pulmonary embolism is available, and most patients survive when appropriately diagnosed and treated with anti-clotting drugs. A higher incidence of death from pulmonary embolism occurs in patients who are older, have other underlying illnesses, or have a delay in diagnosis.
Williams' other condition, a hematoma, is not typically a life-threatening condition if it is located outside of the brain. A hematoma forms when blood collects in a location outside of the veins or arteries. This occurs when a vessel wall is damaged, allowing the leaking of blood. The blood vessel damage also increases the risk of blood clotting inside the vein, leading to an increased chance of a pulmonary embolism. As noted above, trauma and surgery are examples of potential causes of blood vessel damage that could lead to both pulmonary embolism and hematoma.