Lung Disease & Respiratory Health Center

Serena Williams' Pulmonary Embolism, Hematoma: FAQ

What are the symptoms of pulmonary embolism?

The most common symptoms are:

• Sudden shortness of breath
• Sharp chest pain that is worse when you cough or take a deep breath
• A cough that brings up pink, foamy mucus

Pulmonary embolism can also cause more general symptoms, such as feeling anxious or unwell, heavy sweating, feeling lightheaded or faint, or having a rapid heartbeat or palpitations. Such symptoms, particularly if sudden and severe, require immediate medical attention.

What is the treatment for pulmonary embolism?

Treatment for pulmonary embolism depends on the size of the clot blocking the lung artery and on the degree of blockage.

"When someone comes into the hospital with a suspected pulmonary embolism, we give oxygen. Then we start with blood thinner, heparin, to thin the blood enough to allow it to pass through the blockage," Shafazand says. "Then we do some testing, a CT angiogram, to look for the pulmonary embolism. We may also look at the veins in the leg through Doppler ultrasound."

If a severe pulmonary embolism is confirmed, more urgent treatment may be necessary.

"If the embolism is very severe and the patient is at risk of dying, with blood pressure dropping, there is a procedure called pulmonary embolectomy, where we go in through a vein [with a catheter] and make attempt at removal of the clot. This is done rarely," Shafazand says.

Another emergency treatment for pulmonary embolism -- also rarely done -- is to use the clot-busting drug tPA to open the clogged artery.

Did Williams undergo an embolectomy? That isn't yet known, but it's unlikely.

Williams did undergo a procedure. This may have been simply a diagnostic procedure to take a close look at her pulmonary embolism.

Another typical procedure in patients who have suffered a pulmonary embolism is to insert a filter into the major vein leading to the heart  -- an inferior vena cava (IVC) filter -- to catch any future clots that come along.

Why did Serena Williams have a hematoma? What is a hematoma?

People magazine reports that Williams suffered a hematoma from her treatment for pulmonary embolism.

A hematoma is a bruise -- a collection of blood beneath the skin from a leaky blood vessel.

"A hematoma could happen with any procedure where they have to enter vein or artery," Shafazand says. "If it is a large enough hematoma, it would be drained and if the artery beneath it is still leaking, it would be repaired."