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Eagles quarterback Jalen Hurts will not lead the Birds for the foreseeable future, after comprehensive medical evaluations found he had deep vein thrombosis (DVT) and bilateral pulmonary emboli, the team and Hurts’ agent revealed Monday.
“Jalen was initially diagnosed by specialists in London with a left calf superficial vein thrombosis,” the Eagles and Hurts’ agent, Nicole Lynn, said in a released statement. “After further testing and monitoring, the current diagnosis is a deep vein thrombosis, as well as bilateral pulmonary emboli.”
“He is clinically stable and has no significant functional limitations. His treatment should only involve anticoagulation (i.e. “blood thinners”). During this time, he will not be allowed to participate in any contact activities, including football.”
That’s a lot of medical jargon. Here’s what all that means in simpler terms.
Hurts’ first diagnosis, the left calf superficial vein thrombosis, is a blood clot and associated inflammation located in a blood vessel close to the surface of his leg.
The second diagnosis of deep vein thrombosis is a similar clot but located in the deeper, larger blood vessels, where they can grow larger. These clots are much more concerning.
“If those clots form and happen to break off or escape that vein, they travel up to the right side of the heart, then they get pumped into the pulmonary arteries, into the lungs to pick up oxygen and then to the left side of the heart will go to the body.” said Dr. Heather Giannini, a pulmonologist and intensivist at Virtua Health. “But if the blood clot gets trapped in the lungs, it can cause respiratory failure and cardiopulmonary collapse, essentially.”
The bilateral pulmonary emboli that was seen means that clots were discovered lodged in the blood vessels of both sides of Hurts’ lungs.
“We worry very much about patients with pulmonary embolism,” Giannini said. “The people who develop this, they can have chest pain, shortness of breath, feeling of palpitations and racing heart rate. In rare circumstances or less common circumstances, fainting or lightheadedness, dizziness because the blood pressure tends to drop, the oxygen levels can drop. It can be really acutely life-threatening.”
Hurts was reportedly cleated — stepped on by another player — while playing against the Los Angeles Rams on Sunday, Oct. 4 and visited the Eagles training room to treat his half on Thursday, Oct. 8, after fully participating in practices ahead of the Sunday game against the Jacksonville Jaguars in London.
After practice and further treatment on Friday, Hurts was added to the team’s injury report and flew with the Eagles flew to London Friday night. On Saturday the team performed an ultrasound imaging test, where the superficial blood clot was discovered.
Giannini said that the clots can form if someone hasn’t been moving for a while — like sitting on a long flight or ride or stuck in a bed after surgery or illness — for people going through hormone therapy, with a family history of the condition, or through a hit or injury. About 30% of the time, there is no cause.
Hurts then was in hospital until 4 a.m. Sunday without sleep before the Jaguars game, according to reporting from NFL Network, and then he played all offensive snaps of the game. When the Eagles returned to the U.S., he received treatment Monday and Tuesday, and practiced fully on Wednesday. A follow-up ultrasound that night showed the clot had moved.
On Thursday though, the Eagles ruled Hurts out for the Sunday, Oct. 18 game against the Carolina Panthers and he did not practice Thursday and Friday. On Saturday afternoon, he was placed on the injured reserve list and Tanner McKee played Sunday’s game.
Giannini said that blood thinners are initiated as soon as possible after a pulmonary embolism diagnosis and treatment can typically last a minimum three to six months, but can also be indefinite.
Going on blood thinners raises someone’s bleeding risk and, while blood thinners today come with a relatively low bleeding risk, staying off the field at this early stage of treatment is appropriate.
“The clots themselves that are in the lungs will take time to break up,” Giannini said. “The blood thinner doesn’t necessarily break up the clots, but it does help the body break them down. So just like a very large bruise that you might get on your leg or somewhere — where you see that big purple bruise — has to break down over time, the same process has to happen with these clots. So he needs to get through sort of the acute phase. Usually the first three to six months can be needed in order to do that.”
“Jalen’s prognosis is very good, and we expect a full recovery,” the team’s statement said. “We anticipate that he will have the opportunity to resume contact football activities when off the blood thinners. In the meantime, he will remain active around the team and continue to condition. More importantly, we anticipate that he will have no long-term effects.”
“With bilateral pulmonary emboli and DVT, I think six months at minimum,” she said. “But if there’s no sort of very clear reason why this developed, we call it an unprovoked pulmonary embolism or DVT, and in that case, a lot of the time we recommend indefinite anticoagulation because the risk of recurrence is high.”
Whether or not being indefinitely on blood thinners would prevent Hurts from playing football would be a complex conversation between him and his medical team, Giannini said.
Hurts being labelled “clinically stable” with “no significant functional limitations” indicates that his other vital signs are otherwise relatively normal and he can go about his daily life and activities as normal.
Giannini said that the majority of patients with pulmonary emboli recover fully with no residual deficits or problems. In rare cases, the clots in the lungs can fail to dissolve, leading to chronic thromboembolic pulmonary problems that causes raised blood pressure in the lungs or shortness of breath during exertion.
Both DVT and pulmonary emboli are more common than the general public might expect. Giannini said that anyone worried about them can work to prevent them either by staying moving, particularly during long-distance travel, and following the physical therapy and medications recommended by physicians after surgery.
