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    Tamar Braxton's Blood Clots: Expert Q&A

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    By Brenda Goodman
    WebMD Health News

    Tamar Braxton stunned fans on Wednesday when she announced she’d be leaving Dancing With The Stars because of blood clots called pulmonary emboli in her lungs.

    “I woke up to a mirror and saw myself this morning and that makes me the winner because that almost wasn’t the case,” the 38-year-old singer wrote in a Facebook post.

    Blood clots that travel to the lungs—usually after they form in veins in the legs—are dangerous. In about one-third of cases, a pulmonary embolism is fatal, studies have shown.

    Long stretches of inactivity—traveling on a long plane flight or sitting in front of a computer for hours—are a known risk for developing these kinds of clots. But with a busy DWTS rehearsal schedule and a concert tour (also now canceled), being sedentary wouldn’t seem to explain the clots in Braxton’s case.

    To find out how young, active people wind up with these scary clots, we reached out to Gustavo Heresi, MD. He’s a doctor who specializes in removing blood clots from the lungs at the Cleveland Clinic.

    WebMD: How do you get blood clots in your lungs when you’re a younger, active person?

    Heresi: Being sedentary is a risk, but it’s just one factor. Others include inflammatory disorders, cancer, smoking, and even some genetic abnormalities which cause the blood to clot more easily or hinder the body’s ability to remove clots. Some of these causes are less common, but they certainly need to be considered when an otherwise young and healthy person develops these kinds of blood clots.

    WebMD: There’s a theory that elite athletes might be at greater risk for these clots because they’re so fit that their heart rate and blood pressure are low, so their blood flow is slower and more likely to form clots. They’re at greater risk for dehydration because they’re working out a lot, and they’re on and off planes all the time as they’re traveling to events. Is that a crazy idea, or is there some truth to the idea that being very fit increases a person’s risk?

    Heresi: That is something that hasn’t been clearly proven to be a risk factor. I am aware of some early studies that point toward that, specifically in professional basketball players. There have been a few cases in recent years of prominent professional basketball players developing blood clots in the lungs. There appears to be some early signals that they could be at higher than average risk for pulmonary clots, but that’s early evidence.

    WebMD: Braxton is young, in her late 30s. How common is it to get these kinds of clots in this age group?

    Heresi: Certainly, we tend to see blood clots in older people with several underlying risk factors,especially obesity, being sedentary, and as I said, other underlying medical conditions like heart failure and cancer. I would say it’s less common to see blood clots in otherwise healthy individuals.

    That being said, blood clots in younger individuals are not unheard of. We do see a fair amount of these cases. Pulmonary embolism is certainly widely prevalent and an under-recognized disease, so it’s not surprising to see this happen in young individuals.

    In healthy young women, one also needs to consider the possibility of birth control. Birth control pills are known to increase the risk for blood clots.

    WebMD: Doctors initially thought Braxton had pneumonia. Is it easy to miss this diagnosis?

    Heresi: That’s one of the challenges with diagnosing pulmonary embolism or blood clots to the lungs. The signs and symptoms are pretty nonspecific. The typical presenting symptoms are shortness of breath and some degree of chest discomfort. Lots of other things can cause those.

    WebMD: How do blood clots get into the lungs?

    Heresi: The most common situation is that the blood clots develop in the lower extremities. This is called deep vein thrombosis. About half of the time, when you have clots in the legs, 50% of those will break off and travel to the lungs.

    WebMD: What are the symptoms should people be aware of?

    Heresi: Symptoms of a leg clot include discomfort and swelling in a leg and sometimes changes in the color of the skin, especially if it’s just one leg. If these symptoms are isolated to just one side, but not the other, that should prompt you to seek medical attention because certainly a blood clot is a possibility. [You should seek help] even if you’re not having any shortness of breath or chest pain, since about half of these clots will break off and travel to the lungs.

    WebMD: You said this is an under-recognized condition. Can you tell us more about that?

    Heresi: Pulmonary embolism is one of the leading causes of death in this country. The estimates are not entirely precise, but the most recent numbers suggest that [there are] 500,000 to up to 900,000 cases of blood clots in the legs or lungs every year in this country. About 100,000 people will not survive those episodes. Because of a lack of specific symptoms and signs, it’s something that frequently gets missed.

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