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Pulmonary hypertension is high blood pressure within the artery that connects the lungs and heart. It forces the heart to work harder to transfer blood between the heart and lungs, which may lead to an enlargement of the right side. Thyroid problems, whether they involve an underactive or overactive thyroid, can cause a heart to enlarge.
1 If the blood clot is large enough, it can block blood from exiting the right side of the heart, thus preventing blood from entering the lungs.  No blood enters the left side of the heart to pump blood throughout the rest of the body. This can result in shock (circulatory collapse) and sudden death.