Elizabeth Simms was 27 years old and about 31 weeks pregnant when she suddenly noticed the first signs of what turned out to be a life-threatening medical emergency.
She had woken up one morning in May of 2022 to change her daughter when she felt a "bear hug around me," Simms, now 30 and a stay-at-home mom of four in Greenville, Kentucky, tells TODAY.com.
"It was so tight and my heart was pounding," she recalls. "I started shaking."
Then a mom of three, Simms knew this wasn't a normal pregnancy symptom. But she describes having "two sides" arguing inside of her at that moment.
On one hand, "I thought I was dying," she says. But at the same time, Simms also felt like she might be just having a panic attack and tried to calm herself down.
"I wasn't going to (call the doctor) because I'm stubborn," she says with a laugh. "I don't go to doctors. I was like, I just need a nap."
But she did text her husband to ask him to come home. "And when he walked in and saw me, he said, 'No, we're getting a diaper bag and you're going to the emergency room,'" she recalls.
It Turned Out to Be a Life-Saving Decision
At their local community hospital, ER doctors immediately recognized that Simms could be experiencing a pulmonary embolism, a condition in which a blood clot gets lodged in the arteries of the lungs.
She was rushed to a larger regional hospital where the situation became "crazy" and "chaotic," Simms recalls, and she began to recognize the severity of her condition.
With a pulmonary embolism, the blood clot can block oxygen from getting to the parts of the lung that are "downstream" from the clot, Dr. Alexander Lin, an OB-GYN at Northwestern Medicine Palos Hospital, tells TODAY.com.
Often, a person's pulmonary embolism first starts as a blood clot in the vein of the leg, explains Lin, who was not involved in caring for Simms. "The clot can break off and then shoot up into the lungs and cause a pulmonary embolism," he explains.
Imaging tests revealed that, in addition to large clots in multiple parts of her lungs, Simms had what's called a saddle pulmonary embolism. This happens when the blood clot is lodged in between the lungs — right at the point where the main artery splits into left and right branches, Lin says.
A pulmonary embolism is always a medical emergency because it can lead to a heart attack or stroke, and it can be life-threatening if not treated fast enough. The location and size of the clot Simms had made it even more of a threat.
Her doctors made the decision to use a technique called a computer-assisted vacuum thrombectomy to remove the clot.
She felt like a weight had been lifted off her chest within minutes of finishing the procedure and realized just how long it had been since she'd been able to take a deep breath. "The whole time I thought I was just big and pregnant and out of breath," Simms says.
After three days in the hospital, Simms was able to go home.
A Few Weeks Later, Simms Gave Birth to a Healthy Son
It can be challenging to navigate delivery in a patient with a pulmonary embolism, Lin explains, due to the need for blood thinners. Often, it requires careful timing so that the patient is off those medications for 24 hours before she needs an epidural, and then they're restarted about eight to 12 hours after delivery.
While there was a chance that Simms would need an emergency C-section, she was ultimately able to give birth safely and according to her original plans just a few weeks later.
"We went in at 38 weeks, and that boy was ready to come out. I scared him or something," she laughs. After just one push, she gave birth to "the kindest boy," she says.
Now, Simms is sharing her story to help other people recognize their symptoms quickly — and to take them seriously, she says. Simms also wants to set a good example for her kids, and knows they won't wait to help if they experience something similar "five years or 50 years from now."
Pulmonary Embolism Symptoms
Pregnancy makes blood clots, including pulmonary embolisms, more likely for multiple reasons, Lin explains. These include more proteins in blood that make it clot more easily, as well as reduced mobility later in pregnancy.
It’s partly a way that “nature helps us” to prevent hemorrhaging during delivery, he says. But that also means that later in pregnancy and in the weeks following delivery, people are at a higher risk for clots.
Some people have other risk factors, like obesity or genetic risks, that also make blood clots more likely, Lin says.
According to Lin, some of the early signs of a pulmonary embolism can include:
- Shortness of breath, or feeling like you can't catch your breath
- Chest pain or heaviness
- Cough, possibly coughing up blood
- Leg pain or swelling, especially if only in one leg
One challenge, Lin says, is that "a lot of the symptoms that people get with pulmonary embolism are also common symptoms in pregnancy."
So it's not unusual for patients to dismiss their early symptoms, maybe out of a sense of optimism, he says. "Whether it's the patient or the doctor, you don't want something bad to be happening, or you can't believe that something bad is happening to yourself," he explains.
But a pulmonary embolism can be fatal, Lin says, so it's crucial to recognize the signs and to notify your doctor if you feel like something isn't quite right.
Of course, chest discomfort doesn’t always mean blood clots, Simm says. “But I wish I could just scream at everyone: If you feel your body is doing something different, don't wait."
