Last week, it was confirmed that beloved actress and comedian Catherine O’Hara died from a pulmonary embolism, according to her death certificate. TMZ was first to report the news. This left many wondering, what exactly is a pulmonary embolism? What are the symptoms? Who is at risk?
What is a Pulmonary Embolism?
In general, a pulmonary embolism (PE) refers to a blood clot that restricts or stops the flow of blood in a blood vessel somewhere in the body. When it occurs in the brain, for example, it can cause a stroke. A pulmonary embolism is one that occurs in the arteries that supply blood to the lungs. The clot often starts in a deep vein in the leg, also known as a deep vein thrombosis (DVT).
A PE is considered a medical emergency because it disrupts critical blood flow and oxygen levels in your lungs.
As USA Today reports, O’Hara, 71, died within mere hours of the onset of symptoms, the document reads. According to the death certificate, the fact that the actress had also been diagnosed with and was battling rectal cancer – a known contributor to causing PE – was also a factor.
What are the Symptoms?
Most are unaware that a pulmonary embolism is one of the most common heart and blood vessel conditions in the world, according to the Cleveland Clinic, with about 900,000 people a year in the United States experiencing one.
Though symptoms can vary based on clot size and underlying conditions. According to the Mayo Clinic, common signs include shortness of breath, chest pain and fainting. Sometimes blockages in the blood vessels are caused by other substances such as fat from broken bones, part of a tumor, or air bubbles, the Clinic added. Here’s the full list:
- Shortness of breath, even when resting
- Chest pain, which may be sharp and worse when taking a deep breath
- Fainting (syncope), caused by a sudden drop in blood pressure or heart rate
- Coughing, which may include blood-streaked mucus
- Irregular heartbeat
- Unexplained dizziness
- Legs that are swollen or painful
One of the challenges in getting an early or timely diagnosis of pulmonary embolism is that milder symptoms are often disregarded as being related to aging, an oncoming cold or simply being tired. Often, by the time symptoms become severe, the situation has become an emergency.
“Without quick treatment, a pulmonary embolism can cause heart or lung damage and even death,” the Cleveland Clinic notes. “About 33% of people with a pulmonary embolism die before they get a diagnosis and treatment.”
Who is At Risk?
Anyone can develop clots that lead to a pulmonary embolism, the Mayo Clinic says, but certain factors can increase your risk.
Those factors include a history of blood clots; medical conditions like heart disease, certain cancers, surgery, clotting disorders and COVID-19. Extended periods of inactivity, including bed rest and long trips, can also increase your risk. Other factors are smoking, being overweight, supplemental estrogen and pregnancy.
Medical professionals use blood tests and other scans to diagnose a pulmonary embolism, the clinic adds, and can treat them in a number of ways depending on the severity, including said blood thinners or other therapies and procedures.
The Colorectal Cancer Connection
O’Hara also was dealing with rectal cancer, which may have factored into her embolism and the speed with which it was identified. Cancer itself increases the risk for clotting in the body, with about 15 percent of cancer patients developing a blood clot in their veins. This may be, in part, because colorectal cancer induces a hypercoagulable state, where cancer cells, particularly in advanced stages, release proteins like tissue factor that make the blood stickier and more prone to clotting.
This is further complicated by sedentary tendencies during treatment. A person who is spending more time in bed is more likely to develop clots in their leg veins. And finally, if you are being treated for cancer – with chemotherapy, for example – you may experiences periods where you feel exhausted or under the weather. As a result, you may be more likely to dismiss early warning signs.
How to Diagnose and Treat Blood Clots
According to Orlando Health, the tricky thing about blood clots is that there is no way to diagnose one without some form of advanced imaging. They are usually found with a CT scanner, an imaging machine that uses multiple X-rays to create detailed images of the inside of your body. To get a scan, you either need to seek help after recognizing early symptoms of a pulmonary embolism, or have the clot noticed during a scan for some other issue.
If a clot is identified in time, treatment usually removes it before it becomes dangerous. Treatment usually starts with blood thinners or anti-clotting medications. These may be injected or taken by mouth and may take days or weeks to clear the clot. In extreme cases, more powerful medications – known as clot dissolvers – may be injected into the vein.
In rare instances, the clot may be too large and too dangerous to tackle with medication. Your doctor can use a catheter – a thin tube threaded through your vein – to reach the clot and pull it out.
If the clot has already migrated to your lungs, as a pulmonary embolism, there is the risk of damage to your lungs, even after the clot is removed. In some instances, this can cause breathing difficulty going forward. And even after the clot is gone, your doctor may suggest that you continue taking blood thinners to reduce the risk of a recurrence.
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