What began as a routine recovery following surgery to repair a sports injury led to the discovery of a life-threatening pulmonary embolism.
As a former college athlete and an avid lacrosse player, Caitlin Pluta is no stranger to sports injuries.
“I played lacrosse for a small Division 1 school in New York. During undergrad, I had quite a few ankle injuries. Over the years, I had physical therapy in an attempt to rehab it, but it wasn’t working so I ended up needing surgery,” says Pluta, now a second-year occupational therapy student at Thomas Jefferson University.
In August 2021, Pluta had surgery to repair a torn ligament in her ankle. Following surgery, she was partially immobilized with a cast up to her knee. Her recovery progressed as normal—that is until weeks later, when she started having trouble breathing.
It started in September. I remember it like it was yesterday. I woke up and kept feeling like I couldn’t breathe, and I also had some tightness in my chest. – Caitlin Pluta
She initially thought she was experiencing anxiety. However, when her symptoms persisted, she called her mom who urged her to seek medical attention.
“After talking to my mom, I went to a local pharmacy that has a minute clinic. The pharmacy is maybe 200 feet from my apartment, but in traveling just that short distance, I felt like I was going to pass out,” says Pluta.
The doctor at the clinic took Pluta’s vitals. Her pulse-ox level (the measurement of how efficiently blood is carrying oxygen to the extremities) was so low that she was told to go to the hospital right away. In the emergency department at Thomas Jefferson University Hospital, Pluta’s vitals were taken, and her pulse-ox was still low. She underwent an ECG, an ultrasound of her heart and a chest CT, which ultimately confirmed her diagnosis: a pulmonary embolism.
“A pulmonary embolism occurs when a thrombus, also known as a blood clot, becomes trapped in the pulmonary arteries blocking blood flow to the lungs. It usually arises from a blood clot in the deep venous system of the lower extremity, a condition known as deep vein thrombosis,” says interventional radiologist Dr. Carin Gonsalves.
Risk factors for pulmonary embolism can include heart disease, chronic obstructive pulmonary disease (COPD), cancer, smoking, obesity, oral contraceptives, pregnancy and certain genetic conditions. Surgery and prolonged immobility can also lead to an increased risk of clot formation. At the time of her diagnosis, Pluta was wearing a knee-high cast that limited her mobility as she recovered from ankle surgery.
“Caitlin’s pulmonary embolism developed following her ankle surgery due to prolonged immobilization of her leg. Her case was not unique, but unusual, given that Caitlin is young and athletic without any major health issues,” says Dr. Gonsalves.
Dr. Gonsalves is co-founder and co-director of the Pulmonary Embolism Response Team (PERT), which is comprised of physicians in interventional radiology, pulmonary critical care and vascular medicine. When an inpatient or patient in the emergency department is a suspected pulmonary embolism, a PERT Alert is called and specialists convene to quickly and safely determine the best course of treatment.
“In Caitlin’s case, she had what we refer to as a massive pulmonary embolism, which can be fatal in a high percentage of people,” says Dr. Gonsalves.
Pluta’s case was so severe that she required immediate intervention.
“I was being prepped for surgery and I started to panic as I began to process just how serious this all was. One of the nurses who was there with me was so helpful and reassuring. She held my hand and helped me to calm down,” says Pluta.
Due to the severity of her pulmonary embolism, there was concern about the strain that general anesthesia would have on her heart. For that reason, she was given pain medication but was awake for the entire procedure.
Pluta underwent catheter-directed suction thrombectomy. The minimally-invasive procedure took less than two hours and involved using a catheter to go up through Pluta’s heart and into her lungs to remove the clots.
“During the procedure, we removed a significant amount of the clot from Catlin’s pulmonary arteries and she immediately noticed a difference right on the procedure table. Her chest pain went away and her shortness of breath began to improve. In addition, her heart rate decreased and her blood pressure and pulmonary artery pressures both normalized,” says Dr. Gonsalves.
After surgery, Pluta spent a couple of days in the Medical Intensive Care Unit. She was discharged from the hospital after just three days and it took about a month for her lungs to feel completely back to normal.
“The fact that I’m young and pretty healthy—especially being an athlete for much of my life—my doctors told me that definitely helped in my recovery,” says Pluta.
Now as she reflects back on the near-fatal experience, she can breathe a sigh of relief.
“Looking back, I’m so glad that my mom urged me to seek care. Having this surgery literally saved my life,” says Pluta. “If I kept writing off my symptoms and I didn’t get to the hospital when I did, I can’t imagine what would have happened.”