March 3rd, 2011
08:20 AM ET

What Serena Williams' condition means

Tennis star Serena Williams has a serious health condition called pulmonary embolism that sent her to the hospital several times over the past week, her representative said.

She underwent surgery for a hematoma - when blood abnormally collects outside a blood vessel - resulting from this condition, the spokeswoman said.

Pulmonary embolism essentially refers to one or more blocked arteries in the lungs. This usually happens when a blood clot travels from another part of the body (often the legs) to the lungs, according to the Mayo Clinic. This can happen to people who are otherwise healthy, and can be life threatening. But taking anti-clotting medications quickly can reduce the chance of it being fatal.

Symptoms often include sudden and unexplained shortness of breath, chest pain and a cough. This cough can produce sputum with blood. If you have these symptoms suddenly, seek medical attention immediately.

Pulmonary embolism can also cause these symptoms, says the Mayo Clinic:

*Leg swelling
*Clammy or bluish-colored skin
*Excessive sweating
*Rapid or irregular heartbeat
*Weak pulse
*Lightheadedness or fainting

Medications include anticoagulants and clot dissolvers. The condition may also require surgery to remove the clots with a catheter, or a vein filter.

A 2008 study found that the incidence of pulmonary embolism was about 63 per 100,000 patients in 2001. Because of earlier diagnosis, that there has been a trend of more of this condition seen, but a lower severity of illness and fewer in-hospital deaths resulting from it, the study found.

Your risk of developing blood clots in the legs, which can travel to the lungs, goes up if you are sitting for a very long time, such as on a plane or in a car. Preventive steps include taking a walk once in awhile, exercising while you sit, wearing support stockings, and drinking a lot of fluids.

Read more from the CNN Health Library

soundoff (44 Responses)
  1. linda

    I wish u good luck n god bless

    March 3, 2011 at 08:59 | Report abuse | Reply
  2. mee

    Our prayers r with u for a heallthy speedy recovery!

    March 3, 2011 at 09:25 | Report abuse | Reply
  3. JLUV


    March 3, 2011 at 09:52 | Report abuse | Reply
  4. Gary

    Serena I am a huge fan of yours and I love to see you play. I hope you have a full recovery and I'll be praying that you not only do you finish having a great career, But that your health improves altogether.

    March 3, 2011 at 12:05 | Report abuse | Reply
  5. keith

    get well soon we luv u

    March 3, 2011 at 12:11 | Report abuse | Reply
  6. Yeah

    When a person gets this, provided they live thru it and the clot doesnt break loose and go to the heart or the brain, you spend a week in a hospital bed with a heparin IV and off you go. Welcome to the world of coumadin.
    /been there, done that twice
    Hope youre ok

    March 3, 2011 at 13:25 | Report abuse | Reply
  7. Julie Labrouste

    5% of all North Americans have a genetic blood disorder called, "Factor V Leiden", which greatly increases the risk of blood clot related events. However, despite the severity of this matter, the vast majority of people with Factor V Leiden never know anything about this until they actually suffer a deep vein thrombosis, or embolism, all of which could cause INSTEAD DEATH. So why doesn't the American Medical Association, et al, insist that everybody be tested for this genetic disorder? O.o Furthermore, why isn't Factor V Leiden even mentioned in this article either? O.o I don't know why not, but it sounds GALACTICALLY STUPID not to even test people UNTIL they survive such an event or after they drop dead to establish the probable cause. In 2005 I had a deep vein thrombosis in my right thigh, which really hurts by the way. They told me about my having Factor V Leiden, which I, like most of you, NEVER EVEN HEARD OF! Now I'm on blood thinners and being checked MONTHLY to make sure my PT/INR (lab test) is good, but only AFTER a DVT! O.O The AMA needs to pull its head out and start insisting that this be tested for instead of IDIOTICALLY waiting for a blood-clot event to occur.

    March 3, 2011 at 14:38 | Report abuse | Reply
    • DocCat

      Julie- You raise interesting points, but I have to take exception to some of what you propose. First of all, your estimate of the prevalence of the Factor V Leiden mutation is a bit high. Second, if you perform the assay as a screening test on the entire population, you are talking about performing a very expensive test on 350 million people. Where does the money come from to do that? And if you find it in an asymptomatic person, does that mean you should treat them with anticoagulants? A significant percentage of people with the mutation do not have a clotting event. What if you put an asymptomatic person with the mutation on coumadin and they suffered a fatal bleed in the brain? Finally, the AMA has nothing to do with establishing public health policy, or passing legislation.

      March 3, 2011 at 20:23 | Report abuse |
    • Tom

      I agree with Julie's comment regarding the prevalence of FVL being 5%. Here is some information from the leading blood clot/blood clot disorder patient advocacy organization here in the U.S. (www.stoptheclot.org):

      It is estimated that about 5% (1 out of 20) of Caucasians (white people) have factor V Leiden, and it is more common in individuals of European ancestry. In the United States, approximately 1-2% (1 in 100 to 1 in 50) of African Americans, Hispanic Americans and Native Americans also have the mutation. Factor V Leiden is rare in Asians."

      March 4, 2011 at 15:32 | Report abuse |
    • JackAttack

      I'd just like to point out that such a small percentage of people "have" Factor V Leiden because very few people a) know what it is/that it exists and b) actually get tested for it. There are also people who have one gene mutation (heterozygous) and those that have both genes mutated. 1 in 1,000 people in the GENERAL POPULATION will get some sort of blood clot. People with one mutated gene have a 1 in 125 to 1 in 250 chance while people with BOTH genes have a 1 in 12 chance. Women can get blood clots when pregnant, from birth control, etc etc and if they have Factor V are even MORE likely to get a blood clot that could potentially kill them. While yes it would be expensive for everyone in the USofA to get tested, more people need to made aware of this disease. Especially those who are doing a lot of traveling – flying on planes or sitting on buses or trains or in cars for long periods of time, like Serena did, is worse for people with Factor V. This gene mutation was only discovered in 1994. More people need to made aware of it. While it may not affect as many non-Caucasians, people should still be made aware of it.
      'Body of Proof' actually had a nice episode about it this week – and 'House' mentions it a lot in passing as a diagnoses, but it is never the underlying cause (of course, because it's House and it needs to be something 'exotic')....
      If you are worried that your parent or someone had a DVT and could have had Factor V, get tested! Or take precautions!!! It is serious!

      April 20, 2011 at 22:01 | Report abuse |
  8. Rod Mersereau

    Because major blood clotting events are so often fatal, a relatively new clinical decision aid has been created to help rule out pulmonary embolism in low-risk patients who clinically present P.E.'s classic symptoms like "shortness of breath", "rapid heartbeat", and "wheezing."

    It's called the Pulmonary Embolism Rule-out Criteria or PERC score and it includes eight criteria:

    1[ No exogenous estrogen? i.e is patient on COPD's [ Combined Oral Contraceptive Pills]?
    2] Age less than 50 years old?
    3] Heart rate less than 100 beats per minute?
    4] Oxygen saturation on room air less than 94%?
    5] No prior personal or family history of deep vein thrombosis or pulmonary embolism? [e.g..thrombophilia; see "Factor V Leiden" in above comment]
    6] No recent trauma or surgery?
    7] No hemoptysis? i.e spitting or coughing up blood?
    8] No clinical signs suggesting deep vein thrombosis?

    If the answer to ANY of these questions is YES, then the well-known "d-dimer" blood coagulation test should be done IMMEDIATELY. Should the results be "normal"[ i.e. within reference levels] a P.E. can almost always be ruled out.
    If they are not, further testing is called for.

    In Serena's case, it would be highly relevant to determine whether she was on the "pill'" or not, and, if she was, what kind?

    March 3, 2011 at 16:01 | Report abuse | Reply
    • DocCat

      Many scoring systems have been validated, including the Well's Criteria, the modified Well's Criteria, the Geneva score, the PERC score. I find them to be mildly helpful, but I'm not sold on the D-dimer test. I think it's pretty worthless. Yes, if it's negative, you've excluded the disease (theoretically), but I've never seen a negative one. They're always above the reference range, so you might as well skipped it and just imaged the patient in the first place and saved some time.

      March 3, 2011 at 20:26 | Report abuse |
  9. LIZ

    It is amazing how many people go undiagnosed until they end up on the autopsy table, like my 14 year old son did on October 30 2010. Most people don't realize that Factor V Leiden is hereditary along with other clotting disorders. Please people get yourself checked and your kids. It was to late for my son ,but beleave me if i had known what i know now he would have been checked along time ago. The symptoms of PE's also mimic URI, plurisy, pneumonia. If there is a family history of blood clots or any blood disorder get checked. Bottom line. I am so glad serena is alive to tell her story.

    March 3, 2011 at 18:09 | Report abuse | Reply
  10. clean up tennis

    My old grandpa is afraid of pulmonary embolism. He is overweight and sedentary. Why isn't CNN saying that a pulmonary embolism is RARE in an active young woman? And that many performance enhancing drugs do increase the risk of pulmonary embolism? Well, they do, and Serena has arms that look like a male body-builder.
    Oh, check out the blog " tennis has a steroid problem".

    March 3, 2011 at 20:14 | Report abuse | Reply
    • Ms. R

      People keep saying or suggesting that Serena is taking steroids or some form of performance enhancement pills without any validity, or kinowledge to back up such claims. I have been watching both men and women tennis for years, and know that Serena has always been built the way she is now. I have a young niece who is muscular as well, and she has never used performance enhancement pills. There are at least 2-3 other female players who are built muscular as well, but no one ever comment on their body type. To me, it shows that these ladies work out a lot to stay on top of their game. Also, one has to realize that one's body type is often times hereditary in most cases. I'm not saying that performance drugs are not used by professional tennis players-I don't know that it is, so, therefore I am not pointing the finger at anyone. One thing for sure is that Serena Williams (with or without drugs) is a gifted and talented professional tennis player. The talent she has cannot be learned–it is God given. My prayers are for her complete recovery, and if she decides to play tennis again that will be good, but if not, then she and her doctors knows best. HER HEALTH COMES FIRST.

      March 5, 2011 at 20:46 | Report abuse |
    • KDavis

      Clearly, you know nothing about the *other* causes of pulmonary embolism. You jump to the cause that paints Serena Williams in a negative light. From another article: "the truth is, deep vein thrombosis can happen to anyone. And since Williams had just undergone surgery, her risk was increased.

      Deep vein thrombosis (DVT) leading to a pulmonary embolism can occur at any age. Of course there are risk factors like clotting disorders, taking birth control pills, prolonged immobility, smoking, family history and being overweight.

      Surgery is actually one of the leading causes of problem blood clots because it is possible for tissue debris to enter the bloodstream and form a clot. Since Williams had surgery on her foot, it’s fair to assume that she was ordered by her doctors to stay off it and remain immobile. Add to that, she was flying back and forth on a plane, and her risk just increased even more."

      Read more: http://www.foxnews.com/health/2011/03/02/serena-williams-pulmonary-embolism/#ixzz1Xmg3QbrG

      September 12, 2011 at 19:32 | Report abuse |
  11. footdronline

    Serena Williams Undergoes Treatment for a Pulmonary Embolism. Read more at http://footdronline.com/blog.html

    March 3, 2011 at 22:38 | Report abuse | Reply
    • DJ

      Ummm.....the comments saying Serena looks the same as she always has are just ridiculous. Serena isn't just bulked up, she is grotesquely bulked up. This not remotely normal for any woman athlete (can anyone point to any other female athlete who looks the same?). She actually looked female when she started and looks anything but now.

      Let's not sugar-coat it. Lance Armstrong was doping, and Serena is just as certainly doping. It has greatly diminshed tennis and will continue to do so until there are random and unannounced drug tests.

      August 30, 2011 at 23:04 | Report abuse |
  12. Rod Mersereau

    I take from your response, DogCat, that you're an experienced physician.
    I am not.
    I'm merely the father of a healthy daughter, age 26, who lost her life to a massive pulmonary embolism – COCP-induced.
    Yes, of course, the D-dimer test's high sensitivity is only exceeded by it's poor specificity and is therefore plagued by false positives. However, going to imaging tests directly in all cases can have deleterious consequences all their own if they involve things like intravenous contrast dye or a significant amount of radiation.
    Surely, Doctor, it is a matter of degree.
    In my daughter's case, D-dimer at E.R. admission and autopsy was MORE THAN TEN TIMES reference levels – unlikely to be a "false positive."
    Personally, I devoutly wish my daughter's physician had ordered a D-dimer out of her office.
    We would have LOVED to then take our chances with dyes and radiation.

    March 3, 2011 at 23:27 | Report abuse | Reply
    • LIZ

      My son was active at 14 years old. He ran in the Junior Olympics Reginals in colorado this past summer and was on the freshman football team. He had no symptoms of a PE until he was takin to the ER and later DX'd (at autopsy) with a massive bilateral pulminary embolism at 14 years old. Yes it does happen to young people. I am so sorry for your loss.

      March 4, 2011 at 11:56 | Report abuse |
  13. BeenThere

    Ms Williams' PE isn't that unusual.

    Athlete + leg surgery + air travel can be an accident waiting to happen.

    She shouldn't have had a clot. The fact that she did means that her doctors weren't paying attention to her risk factors.

    If she's lucky, she'll be on anti-coagulants for a few months, and then go on and entertain her fans as if nothing had happened.

    Get well soon, Serena!

    March 4, 2011 at 00:40 | Report abuse | Reply
    • DocCat

      "Her doctors weren't paying attention to her risk factors..." Did her doctors miss her diagnosis? I didn't read anything in the article about her diagnosis being missed.

      March 4, 2011 at 08:07 | Report abuse |
  14. Christine

    Serena....Please take care of yourself. Best wishes and Best health to you.

    March 4, 2011 at 00:42 | Report abuse | Reply
  15. Tom

    With April being National DVT Awareness Month I am surprised that it takes for a famous athlete to draw attention to what is a potentially deadly medical condition. This is why organizations like the National Blood Clot Alliance was created. They are a patient advocacy organization funded through a collaberative grant by the U.S. Centers for Disease Control and Prevention (CDC) to help raise awareness.

    From CDC statistics, more people die each year in the U.S. from blood clots then from the combined numbers of deaths from Automobile Accidents, Breast Cancere and AIDS. Yet it is one of the least heard about medical conditions. Estimates suggest that 350,000 to 600,000 Americans have a DVT or PE each year, and that at least 100,000 people die as a result.

    March 4, 2011 at 13:29 | Report abuse | Reply
  16. Vera

    Alcohol increases one's risk of contracting breast cancer. Take a look at this article: http://www.breasthealthandhealing.com/media/archives/StabroekNewsCancerCampaign011210.html

    March 4, 2011 at 14:46 | Report abuse | Reply
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