Sarah Bassra collapsed at a music festival after doctors twice missed signs of a blood clot, attributing her symptoms to plantar fasciitis.
The 36-year-old patient from the United Kingdom spent five days in hospital fighting for her life after the unrecognized blood clot travelled from her leg to her lungs, causing a life-threatening pulmonary embolism.
Her ordeal began in June 2022 when she noticed that her toes had turned red and felt unusually hot. Within days, the redness and swelling spread to her ankle, leading her to suspect an ankle injury.
Seeking medical advice, Bassra consulted doctors on two separate occasions. During her first visit, medical staff suggested that the inflammation might be an allergic reaction to gel nail polish. When her symptoms failed to improve after removing the polish, she returned to her doctor, who diagnosed her with plantar fasciitis.
Plantar fasciitis is a common orthopedic condition that causes inflammation of the thick tissue band connecting the heel bone to the toes. It typically results in sharp pain along the arch and bottom of the foot, especially during initial steps after rest.
Doctors advised her to purchase orthopedic trainers and sent her home without performing a blood test. "They told me to get orthopedic trainers and sent me home without a blood test," Bassra said.
Initial medical visits and misdiagnoses
Despite following the medical advice, Bassra saw her condition worsen as pain began spreading up her calf and into her thigh. Unaware that a blood clot was advancing through her leg, she assumed the discomfort was caused by physical strain.
"I thought that maybe I was walking too much or overcompensating for the pain in my ankle by putting pressure on other areas," she said. She also felt doctors did not take her concerns seriously, noting: "I think they thought I was being overdramatic when I went to them with my swollen ankle."
In August 2022, while attending a day out at a music festival, her condition reached a critical point. She experienced chest pains and struggled to catch her breath, having to unfasten her shorts due to severe leg swelling. As she walked toward a taxi at the end of the night, she collapsed.
"I thought I was having a heart attack," Bassra recalled. She was rushed to an emergency department, where diagnostic tests revealed she was suffering from deep vein thrombosis (DVT).
Deep vein thrombosis occurs when a thrombus, or blood clot, forms within one of the body's deep veins, most commonly in the lower leg, thigh, or pelvis. If left untreated, pieces of the clot can detach and travel through the bloodstream.
Emergency hospitalisation at music festival
A subsequent hospital scan confirmed that the clot had broken free and migrated to her lungs, causing a pulmonary embolism. A pulmonary embolism is a medical emergency that blocks blood flow in the pulmonary arteries, depriving lung tissue of oxygen and placing extreme strain on the heart.
"Now, looking back and knowing it was a blood clot, I could literally feel it travelling up my leg," Bassra said. She spent five days in hospital receiving emergency medical care and was prescribed a course of blood thinners to prevent new clots from forming and stop existing ones from expanding.
It was not until months after her hospital discharge that further specialized testing uncovered the underlying root cause of her blood clots: antiphospholipid syndrome (APS).
Antiphospholipid syndrome is an autoimmune disorder that causes the immune system to produce abnormal antibodies that attack blood proteins. This condition makes the blood excessively prone to clotting, significantly increasing the risk of deep vein thrombosis, pulmonary embolisms, stroke, and pregnancy complications such as recurrent miscarriages or late stillbirths.
Understanding antiphospholipid syndrome
According to the APS Foundation of America, the condition affects approximately one in every 2,000 Americans, with women accounting for 70 to 90 percent of all diagnosed cases. Many individuals remain completely unaware they carry the disorder until a major blood clot or pregnancy complication occurs.
Medical experts note that antiphospholipid syndrome is present in roughly one in six cases of young strokes, deep vein thrombosis, and heart attacks occurring in people under 50 years of age. Factors that can increase the likelihood of developing APS include genetic predisposition, lifestyle factors such as poor diet, physical inactivity, and smoking, as well as certain medications like the combined contraceptive pill.
Despite its serious risks, research shows that the condition is frequently missed by healthcare providers. A 2023 study found that nearly 15 percent of patients with APS were misdiagnosed or diagnosed late, with many waiting more than seven years for an accurate diagnosis.
Professor Beverley Hunt, an expert in APS and founder and co-chair of trustees of Thrombosis UK, explained that doctors often fail to spot blood clots because they expect classic textbook presentations.
Medical warning over subtle clot symptoms
"Clots are missed because medical professionals are looking for the wrong thing," Professor Hunt said. "About 80 percent of deep vein thromboses don't present as the big, swollen leg we were taught about, so people with unexplained leg pain or swollen ankles and toes are often sent away until the clot reaches their lungs."
Thrombosis UK is a registered charity dedicated to raising awareness, promoting research, and improving prevention and treatment of venous thromboembolism across the healthcare system.
"Our research shows people with deep vein thrombosis often see doctors several times before anyone recognizes the clot, simply because healthcare professionals aren't aware of how varied and subtle the symptoms can be," Professor Hunt added.
According to experts, early warning signs of a blood clot in an arm or leg include localized swelling, pain, tenderness, warmth, or redness. If the clot travels to the lungs, emergency symptoms include sudden difficulty breathing, sharp chest pain that worsens when inhaling or coughing, a rapid or irregular heartbeat, and coughing up blood.
When diagnosed early, antiphospholipid syndrome can be safely managed with daily oral blood-thinning medications, while pregnant patients are typically treated with targeted blood-thinning injections.
Long-term recovery and medication impact
Bassra reflected that, in a way, she felt grateful for collapsing at the festival because the incident forced emergency doctors to investigate and diagnose her condition. "All it would have taken was a simple blood test for them to see it was a blood clot and they would have caught it two months earlier," she said.
Now expected to remain on blood thinners for life, Bassra disclosed that the ongoing medication has caused significant side effects. "It was really scary at the beginning," she said. "My hair started falling out and the drugs made my periods heavier, which really impacted me."
The ordeal also left lasting physical and emotional scars. "For the first two years, I didn't have a holiday because I was just so worried that I would get a blood clot on a flight," she said. She also suffered lung damage that affected her mobility: "I also started getting out of breath really easily on 30-minute walks because of the damage to my lungs. It's probably taken about three years for this to stop happening."
Bassra urged others to seek a second opinion whenever they feel their health concerns are being dismissed by doctors. "There is an assumption that blood clots are things that happen to old people, but I was in my early 30s when this happened," she said. "If I had got a second opinion and diagnosis sooner, it would have never spread to my lungs and I wouldn't have permanent damage."
Professor Hunt echoed the call for vigilance, emphasizing that unexplained leg pain, new swelling, color changes in the foot or ankle, and chest pain require immediate medical evaluation. "They may be subtle," Professor Hunt said. "But these symptoms can be the earliest clues that a dangerous clot is forming."
