Pulmonary Embolism Patient Kristen Balla

When Kristen Balla, a resident of Richmond, Va., agreed to meet her best friend in Baltimore for a spur-of-the-moment reunion, she didn’t expect to also visit the emergency room a few blocks from where she was staying. Kristen, an avid runner, was unknowingly living with a pulmonary embolism – a dangerous blood clot in her lungs. It was her healthy, active lifestyle and her proximity to the University of Maryland Medical Center (UMMC), however, that ultimately ended up saving her life.

Kristen was training for her first Iron Man triathlon and went to see her primary care physician after noticing that she was having trouble breathing while exercising, a common symptom of a pulmonary embolism. Her doctor performed an echocardiogram and discovered that Kristen’s heart rate was unusually low. Kristen was advised to follow-up with a cardiologist for further tests, but was not under the impression that her low heart rate was anything to seriously worry about. During her training, she injured her leg with a "pulled muscle" and placed in a splint.

Kristen drove up to Baltimore just two days later. Aside from feeling unusually fatigued, Kristen had an enjoyable evening downtown catching up with her childhood friend. The next morning, however, Kristen’s condition worsened very quickly. Kristen lost consciousness in the hotel room where she and her friend were staying, and she was immediately transported via ambulance to the emergency room at UMMC.

The short drive to UMMC not only ensured a quick diagnosis, but also proper treatment of Kristen's rapidly deteriorating condition. Doctors immediately began running tests to determine what was causing Kristen to lose consciousness, but her heart was repeatedly stopping; she had to be resuscitated multiple times. Her condition was so critical that when the pulmonary embolism was discovered, she was rushed to the operating room.

A pulmonary embolism occurs when a blood clot breaks off from somewhere in the body, typically a deep vein thrombosis in the leg, and travels to the lungs, blocking circulation. These situations can occur without much warning and are considered life-threatening.

A pulmonary embolectomy was performed to remove the blood clot and restore her circulation. Surgery for pulmonary embolisms is often considered a last resort reserved for the most-severe, emergent cases. In Kristen’s case, time was of the essence, and surgeons needed to intervene quickly before it was too late.

Pulmonary embolectomy is a procedure performed in the operating room. It involves dividing the sternum (breastbone) and placing the heart on cardiopulmonary bypass (CPB).  CPB redirects blood away from the lungs and heart and uses an external machine to provide oxygen and pumping functions.  With minimal blood flowing through the heart, surgeons can make an incision in the pulmonary artery and directly remove the blood clot.  Afterwards, the artery is sewn closed.

If Kristen had been taken to another local hospital, her outcome might not have been as positive. UMMC is home to several cardiothoracic surgeons skilled enough to perform this life-saving surgery when life is on the line.

Kristen spent the next few months recovering in Michigan with her parents. Persistence and the help of cardiac therapy helped Kristen recover enough to go home to Virginia and resume a somewhat normal life. Kristen eased into everything. She started by going on walks, and then her walks turned into a combination of walking and jogging.

Kristen says that the biggest lesson she’s learned from the experience is to rely on others for help, even if you don’t necessarily want to. That includes physicians – she urges others to see a doctor when something doesn’t feel right. She had never heard of a pulmonary embolism before she was diagnosed with one and expects to rely on her doctors’ expertise more often in the future.

She is also extremely grateful for the support she received from family and friends throughout her entire recovery. On the first anniversary of her surgery, Kristen completed a half-Iron Man, and she had her own personal cheerleading section in the crowd.