She Beats Life-Threatening Pulmonary Embolism Thanks to Her ‘Guardian Angel’ at Baptist Health Miami Cardiac & Vascular Institute

Mariana De Leon, 45, mother of three sons, ages 11, 18 and 21, decided to undergo genetic testing because her mother had a history of breast cancer and was diagnosed with ovarian cancer in 2020. Then Ms. De Leon learned she had a mutation to the BRCA1 gene and made a choice to undergo a double mastectomy and a radical hysterectomy. That’s because a BRCA1 mutation raises the risks of both breast and ovarian cancers.

But following her final surgery, she started having an array of sudden and disabling symptoms.

(Watch video: Hear from patient Mariana De Leon and Alex Powell, M.D., who specializes in diagnostic radiology and vascular interventional radiology at Baptist Health Miami Cardiac & Vascular Institute.)

“Then everything started with problems -- shortness of breath, hot flashes,” recalls Ms. De Leon, who moved to South Florida from Venezuela ten years ago. “Everyone told me, ‘Don't worry about it. Everything is fine. It’s that you're anxious because your mom with the cancer (and) you with the double mastectomy.’ No. I knew that something was wrong. So, I decided to go to the ER … and they performed a lot of tests, and they told me that I was having a pulmonary embolism, a massive one.”

And then, she adds, “Dr. Powell, my guardian angel, appeared and explained everything to me.” She’s referring to Alex Powell, M.D., who specializes in diagnostic radiology and vascular interventional radiology at Baptist Health Miami Cardiac & Vascular Institute.

A pulmonary embolism is a blood clot that typically forms in the veins somewhere else in the body, such as the legs or the pelvis, said Dr. Powell.

Alex Powell, M.D., who specializes in diagnostic radiology and vascular interventional radiology at Miami Cardiac & Vascular Institute.

“The reason a pulmonary embolism can be quite dangerous is: When it travels to the pulmonary arteries, it blocks blood flows,” explains Dr. Powell. “That results in a decrease in your body's ability to oxygenate the blood. But, more importantly, it acts as a dam and the heart has to pump harder and harder to try to bypass that blood clot. When the heart starts pumping harder and harder, the heart can actually start to fail.”

There are many risk factors for pulmonary embolisms, including genetic conditions that increase the risk of blood clot formation, a family history of blood clotting disorders, and situations in which mobility is limited, such as extended bed rest, flying or riding long distances, or paralysis. Other risk factors: Surgery or injury or COVID-19 infection.

“We believe the cause of the pulmonary embolism in Mariana's case is that she had recently undergone surgery, and that is a risk factor for developing blood clots in secondary pulmonary embolism,” said Dr. Powell.

The first line of treatment is usually anticoagulation medication. But that was not sufficient in the case of Ms. De Leon. She was reassessed after administration of the medication.

“She wasn't doing better -- in fact, she was actually doing worse,” said Dr. Powell. “Her heart rate was increasing. And to us, this was a woman who was, not only suffering a significant pulmonary embolism, but might actually die from the condition. So, we decided to perform a percutaneous intervention.”

During a percutaneous thrombectomy, a long, thin, hollow tube (catheter) is threaded through the blood vessel to the site of the embolism guided by X-ray. Once the catheter is in place, it's used to break up the embolism, pull it out, or dissolve it using thrombolytic medicine.”

“First, we assess the pulmonary artery, and then we introduce a tool that can actually remove the clot from the lungs,” said Dr. Powell.

Ms. De Leon’s recovery was swift and complete, he adds. “Mariana is doing fantastic today. She's completely recovered from her pulmonary embolism, and her prognosis is fantastic. She has no long-term sequelae (resulting conditions) from the pulmonary embolism. We've had CT scans that show the clot is completely gone, and her prognosis is excellent.”

Ms. De Leon is extremely grateful to Dr. Powell and his team at the Institute.

“I don't know how I'm alive,” she says. “I feel like 21 again, but healthier and wiser and stronger because I learned a lot with that situation. But I'm feeling okay. My mom is okay, thanks to Baptist Health too. We are very grateful. Dr. Powell -- thank you, thank you, thank you so much. You are the best doctor. He's one of a kind.”

Dr. Powell implores anyone who feels symptoms that could be diagnosed as a pulmonary embolism to seek urgent medical care.

“One of the lessons here is that if you're feeling sick and you're feeling short of breath, then you should seek care in the emergency room immediately because those can be signs of a pulmonary embolism,” he said.