Serena Williams’ Diagnosis: What’s a Pulmonary Embolism?

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People Magazine reports that Serena Williams underwent emergency treatment at Los Angeles’ Cedars-Sinai Medical Center on Monday for hematoma, a complication of earlier treatment for a blood clot discovered in her lung artery last week. On Sunday night, Williams was out attending Oscar parties, belying ongoing medical problems for the tennis star.

“Last week, Serena suffered from a pulmonary embolism which was discovered upon her return to L.A. She had been in New York for doctor appointments for the ongoing issues with her foot,” Williams’ spokeswoman, Nicole Chabot, told People. “Doctors are continuing to monitor her situation closely to avoid additional complications.”

Although Williams’ condition is not considered life threatening, it is the latest in a string of health complications that have kept her off the tennis court since winning Wimbledon on July 3, 2010. Shortly after that tournament, Williams injured her foot by stepping on glass at a restaurant in Milan. Williams underwent two surgeries to correct the unspecified foot injury.

Pulmonary embolism (PE), in which a blood clot blocks blood flow in the lung’s arteries, usually results from a clot that traveled to the lung from elsewhere in the body, typically from the veins of the leg. About 90% of pulmonary embolisms are caused by clots that originally form in the large veins deep within the leg, a condition called deep vein thrombosis (DVT). When such clots end up in the lung and block blood flow, it may kill some lung tissue and result in permanent damage, and can be life-threatening if left untreated. With prompt treatment, however, most patients recover fully.

PE is rare, but it can affect otherwise healthy people. Symptoms include unexplained shortness of breath, chest pain and bloody coughs. So what increases your risk?

Surgery. It is not yet known exactly what contributed to Serena Williams’ PE, but there are a number of risk factors mentioned in her publicist’s statement — including surgery. Williams underwent two surgeries for the injury to her right foot. Preparations for surgery itself, and being immobilized after surgery can increase the risk of clots. Higher risks are seen with major orthopedic surgeries like hip and knee replacement. Also, according to the National Heart Lung and Blood Institute, inflammation or injury to the lining of veins — because of surgery or the injury that prompted the operation — can contribute to clot formation and DVT.

Immobility. Staying motionless or sitting in a cramped position for long periods, like during a long car ride, airplane trip or after surgery, can increase the risk of clotting because the lack of motion may cause restricted and slow blood flow. Williams’ pulmonary embolism was discovered after she took a six-hour flight from New York to Los Angeles.

Hormone therapy. Hormone replacement therapy and some birth control pills can increase the risk of pulmonary embolism. That’s because the estrogen in these drugs can increase clotting factors in blood. (Note: we have no idea if Williams is taking any combination-hormone drugs.) The risk is higher for women who are overweight or smoke.

Other factors. A family history of blood clots or pulmonary embolism puts you at increased risk. PE risks also go up with age and with certain cancers, heart disease, pregnancy, smoking and being obese.

Williams is getting the medical attention she needs, but this is a good opportunity to learn about the risk factors and signs for PE, which kills between 60,000 and 200,000 Americans each year. That’s more than the number who die in car accidents.

For more information on pulmonary embolisms, check out the Mayo Clinic’s site. Also, the NHLBI has a useful animation that demonstrates how a blood clot travels to the lungs.

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