When Kristina Vogel arrived at the Berlin accident hospital on Saturday, April 13, 2024, she underwent emergency surgery a short time later. The reason: a pulmonary embolism. “If I had stayed at home one more day, it would probably have been my last day,” the former professional athlete wrote on Instagram two days after the operation.
A pulmonary embolism is life-threatening. This causes a blood clot to enter the lungs. “I didn’t feel well from Friday to Saturday,” Vogel writes. “My resting heart rate was too high. 120!” In an interview with “Bild”, she also talks about shortness of breath, nausea and pain over the chest, in the shoulder area and in the neck.
Typical signs of a pulmonary embolism are:
Shortness of breath Heart palpitations Pain when inhaling Coughing up blood Dizziness Fainting Chest pain Vogel took the warning signs seriously and made his way to the hospital. “A few hours later I was already on the operating table. Pulmonary embolism. Blood clots (thrombi) were removed or sucked out through a catheter,” describes Vogel. “It was life-threatening.”
How a pulmonary embolism occurs
Normally, our body transports oxygen-poor blood from the heart to the lungs via the pulmonary arteries. In the lungs, the arteries branch out into small branches that become ever finer and narrower and finally release the carbon dioxide from their blood through the alveoli. In return, the arteries absorb oxygen.
In patients with a pulmonary embolism, one or more arteries are blocked by a blood clot. The blood is no longer sufficiently enriched with oxygen, and oxygen exchange is therefore restricted. If it stops completely, the person affected dies.
Causes of a pulmonary embolism
A pulmonary embolism is usually caused by a deep thrombosis in the leg. “A blood clot can detach from leg vein thrombosis. The bloodstream transports it to the right heart, from where it is transported to the lungs,” explains Ulrich Hoffmann, head of the angiology department at the LMU Munich Clinic. In rare cases, air, fat, amniotic fluid or foreign bodies that have found their way into the vascular system can also cause a pulmonary embolism.
People with paraplegia like Kristina Vogel may have an increased risk of thrombosis, as these often arise from inactivity. In the case of Kristina Vogel, however, the doctors seem to rule out this connection. “In the meantime, the medical team is investigating the case. Where did the pulmonary embolism come from? My spinal cord injury probably has nothing to do with it,” explains Vogel on Instagram.
In addition to being confined to bed, other risk factors can include lung disease, pregnancy, coagulation disorders or cancer. “Tumors activate blood clotting. With the increase in tumor diseases in our aging society, the risk of pulmonary embolism also increases,” explains Hoffmann.
How do doctors recognize a pulmonary embolism?
Diagnosing a pulmonary embolism is often difficult, says the expert. If it is a blockage of a small pulmonary artery, it can even remain asymptomatic and undetected. The body’s own mechanisms help in this case and dissolve the blocked clot.
The symptoms are more severe the larger the portion of the lung that is cut off from the blood supply. “An acute pulmonary embolism is life-threatening. The right side of the heart has to use significantly more force to pump blood into the lungs. Right heart failure occurs. In patients with a severe, acute pulmonary embolism, the circulation can collapse,” explains Hoffmann.
Surgery is not necessary in every case. Blood thinners such as heparin can dissolve blood clots. “In a severe pulmonary embolism, the blood clot blocking the pulmonary artery is dissolved with a thrombolytic drug. The common drug for such reperfusion therapy in medicine is the fibrinolytic rt-PaA,” explains Hoffmann.
The patients then have to take medication that inhibits blood clotting and thus prevents new thrombosis formation for at least three to six months.