Hailey Bieber is addressing the "scariest moment of her life" with fans.
In a new video posted to her YouTube channel the 25-year-old model spoke candidly about her recent hospitalization after suffering a blood clot last month.
When her husband asked her if she was OK, she says she “couldn’t speak.”
“The right side of my face started drooping, I couldn’t get a sentence out,” she explains in the video. “Immediately I thought I was having a stroke.”
Doctors discovered the model had suffered a transient ischemic attack (TIA), which is a temporary blockage of blood flow to the brain, also known as a mini-stroke. The blood clot typically dissolves on its own and symptoms last a few minutes. However, that still didn’t explain how Bieber’s blood clot travelled to her brain.
It wasn't until after her emergency hospitalization that doctors discovered a congenital heart defect that contributed to Bieber's stroke.
What caused Bieber’s stroke?
As for what caused the stroke, Bieber says she recently went on birth control pills and didn’t discuss it with her doctor even though she suffers from migraines. She also recently recovered from COVID-19 and had travelled to Paris and back in a short time frame.
“All the doctors came to the conclusion that it was a perfect storm that led to me having a small blood clot,” she says.
In an interview with TODAY, Dr. Gayatri Devi, confirms all three of those factors could have contributed to Bieber’s stroke.
“Birth control (and) migraines that have auras – in other words, flashing lights or neurologic symptoms – can increase the risk” of stroke for women,” the neurologist at Northwell Health in New York City says.
After being discharged from the hospital, Bieber had more follow-up tests, including a transcranial doppler, an ultrasound that uses sound waves to identify potential problem impacting blood flow in the brain.
That’s what led doctors to diagnose her with a patent foramen ovale (PFO), which is a hole in the heart.
Dr. Hani Najm, chair of pediatric and congenital heart surgery at Cleveland Clinic Children's in Cleveland, Ohio, did not treat Bieber, but says it’s the PFO that allowed the blood clot to travel to her brain.
What is a patent foramen ovale (PFO)?
A patent foramen ovale (PFO) is a small opening between the upper two chambers of the heart, the left and right atrium. Normally, a thin wall made up of two connecting flaps separates these chambers and prevents any blood from being able to flow between them. If a PFO exists, blood can flow between the chambers.
A PFO can raise the risk of a stroke because blood clots can travel from the right atrium to the left atrium and out to blood vessels of the body. If the clot blocks a blood vessel in the brain, it can cause a stroke.
“[Bieber] had something called a paradoxical embolism and that is basically a blood clot that goes from the body through that hole, it shouldn’t go to the brain, but it did go through that hole to the brain and that’s why she needed that hole closed,” Najm explains to Yahoo Canada.
Bieber says her PFO was between 12 and 13 millimetres large and was classified as a grade 5 PFO, which is “the highest it can be.”
Before birth, everyone has a PFO. According to Hopkins Medicine, it’s a normal part of the circulation of a fetus. After birth, the small hole is naturally supposed to close. However, Hajm says for 25 per cent of people the hole will stay open.
“This is a congenital heart defect […] people think about heart disease as being those patients who smoke, and have diabetes and they have valve problems when they are in their 60s and 70s,” he adds. “Sometimes we have to operate in the first hours of life [...] to anytime during the lifetime.”
Experts say it’s unclear what causes the hole to stay open in some people.
What are the symptoms of a PFO?
PFOs can often go undetected, since in a majority of cases there are no symptoms.
“If she didn’t have that clot, she would’ve lived for years and years without knowing about it,” Hajm notes.
The Cleveland Clinic says the condition can play a role in migraine headaches, and increases the risk of stroke, transient ischemic attack and heart attack.
How is a patent foramen ovale diagnosed?
There are several tests that can be done to diagnose a PFO, including a cardiovascular MRI, a multidetector CT scan and a transcranial doppler, which Bieber received.
How is a PFO treated?
One option to treat a PFO is through open heart surgery, in which a surgeon will stitch the hole up.
A second option, which Bieber reveals she had, is a closure procedure called a cardiac catheterization. Doctors insert a catheter into a blood vessel in the groin and the device “plugs” the opening.
“She needs further follow-up with an echo probably in two months to make sure that this is truly closed the hole and that she doesn’t need anything else,” Hajm speculates.
Bieber says ever since she had her mini-stroke, she has been on a blood thinner and Aspirin every single day.
Now that it’s all done, Bieber says she “feels so much relief” and is grateful to all the doctors who helped treat her.
“If there’s anybody that watches this that has gone through the same thing or something similar, I definitely really emphasize with you and I understand how life-altering and scary it is,” she says.