A pulmonary embolism can strike even the fittest of people and be caused by a long airline flight when someone hardly moves their legs.
Chuck Norris had been at his vacation home in Kauai, Hawaii, when a “medical emergency” occurred.
Soon after, he was in a hospital. Many speculate he had a heart attack, but apparently, he’d been talking and in “good spirits” at the hospital — which implies that at that time, he’d been medically stabilized.
We can logically deduce that there had been a second event at the hospital which caused Chuck Norris to pass.
Could that second event have been a pulmonary embolism, resulting from a deep vein thrombosis (DVT) in his leg — caused by his flight to Hawaii?
Stealth Killer
A DVT is one of those medical problems that sounds rare and dramatic, but the way it can unfold is sometimes surprisingly quiet and ordinary.
A classic setup begins with something millions of people do every year: a long flight.
Sitting for hours with limited leg movement can slow blood flow in the deep veins of the lower leg.
A person of advanced age, even healthy, would be more vulnerable to a blood clot during flight — even a shorter flight.
Airplane cabins have lower humidity and mild cabin-pressure changes, which can promote dehydration and thicker blood, which is why that same person wouldn’t be at DVT risk watching TV at home for a few hours.
In some people, that slowed circulation allows a clot to form. The clot may stay lodged in a calf vein at first, and that’s where the story often becomes deceptively calm.
For several days, the clot may not cause obvious symptoms. Some people feel nothing at all.
Others notice only mild discomfort — maybe a dull ache in the calf, a feeling of tightness, or tenderness that seems similar to a sore muscle from hiking or doing a sparring workout while on vacation.
Doing some martial arts sparring involves a lot of leg work, and the discomfort of a brewing DVT can easily masquerade as a typical “pulled” or overworked muscle. It can easily get shrugged off by the athlete.
Because those explanations are so common on a trip, the possibility of a blood clot rarely comes to mind.
Meanwhile, the clot can remain in the leg, sometimes growing slowly.
At some point, a small fragment can break loose and travel through the bloodstream to the lungs.
When that happens, it becomes a pulmonary embolism (PE).
A PE Can Kill in a Minute
Early symptoms of a PE can be subtle: mild shortness of breath, chest discomfort, lightheadedness or a sense that breathing suddenly feels harder than it should.
A pulmonary embolism can occur in a young fit athlete. In fact, tennis great Serena Williams had one in 2011.
When someone is 86, the milder symptoms of a small PE can be passed off by the individual as being from “getting old,” even if that individual feels young and is healthy and active.
However, a shortness of breath that’s not typical of their workout, and especially if coupled with a chest pain they’ve never had before, would be concerning enough to seek medical attention.
At the Emergency Room
When someone presents at the ER with shortness of breath and/or chest pain, a specific protocol takes place.
I’ve witnessed this same protocol over and over whenever my elderly mother went to the ER with a complaint of “shortness of breath.”
The protocol includes a blood draw for D-dimer. If it’s positive, this is suspicious for a blood clot somewhere in the body.
It was always positive for my mother, though she never actually had a blood clot (a positive result can have different causes in an elderly person).
But always, a positive D-dimer nets a CT scan of the chest to check for a blood clot in a lung (pulmonary embolism).
If you go to the ER with calf pain (or swelling or redness), this means an automatic ultrasound to check for a DVT. An ultrasound of the legs might reveal the DVT sitting in the calf veins.
Blood thinners are typically started right away to prevent the clot from growing and to reduce the risk of pieces breaking off and traveling to the lungs.
In most cases, treatment works and the clot stabilizes. But medicine is not perfect, and sometimes events move faster than treatment can control.
A Large PE Can Strike in a Flash
Even after a DVT has been identified and anticoagulation has begun, part of the clot can still detach.
If a larger portion breaks free and reaches the lungs, it can block major pulmonary arteries. This is known as a massive pulmonary embolism.
A massive PE can end up saddling the portion of the pulmonary artery that splits off (or bifurcates) into the two vessels that lead to each lung.
A saddle PE will completely block oxygenated blood from reaching the lungs. Death can quickly occur — even in a hospital setting while the patient is under observation for the DVT treatment.
Despite rapid medical response, a massive embolism can sometimes prove fatal within minutes.
It’s Speculation at this Point
When a celebrity of advanced age dies unexpectedly, the go-to speculation is a heart attack.
Heart attacks are very common, and it’s reflexive to conclude that the ticker in an 86-year-old just gave out, especially from sparring with someone shortly before the medical event that resulted in the hospital admission.
People are wondering, “How can someone so fit, who’s never had any health problems before, who’s had no issues with alcoholism, drug addiction, who’s a nonsmoker and of a healthy body weight — possibly have a heart attack, even at 86?”
Meanwhile, people who don’t work out much and may even be a little plump make it into their middle 90s.
A PE would explain Chuck Norris’s death far more than would a heart attack.
He had been physicallyo fit enough to conduct karate workouts well into his mid-80s, and had been into the physical fitness lifestyle all his life.
It’s normal for fans to speculate in forums, but we’re all going to have to wait for the cause of Chuck Norris’s death to be disclosed. Meanwhile, to learn how a DVT can lead to a fatal PE in just moments, check out the article below for which I interviewed a vascular surgeon.
