So You Can Be the Heart of the Team Again—Jessica’s Story

It’s never the right time to be down a team member. Your family is your team—a group of individuals who complement one another and share a common bond to overcome anything in their path.

Jessica, a 34 year-old South Park resident is the captain of her team. Jessica gave birth to her fifth child with no complications, and within two weeks, ended up in the emergency room in cardiac arrest.

“My pregnancy was completely normal,” said Jessica.  “When I was having chest pain after returning home, my brain kept going back and forth, saying ‘this can’t be a cardiac incident. I’m healthy. I don’t have any risk factors.’ I just kept thinking the pain would go away.”

Although she convinced herself this was not a true cardiac event, Jessica still decided to follow up with a specialist and received multiple tests and procedures without being able to identify the problem. A few days later, the severe chest pain was back and Jessica needed help. Her husband followed her downstairs and soon found her unresponsive, started CPR, and immediately contacted 911.

Jessica’s husband couldn’t believe what was happening—he couldn’t understand how she could be having a heart attack—she wasn’t.

Jessica was having a spontaneous coronary artery dissection (SCAD).  St. Clair Health is home to some of the top cardiac experts in the Pittsburgh area. And the emergency room physicians at St. Clair instantly recognized her condition upon arrival and alerted the cardiovascular team.

“It’s a frightening and potentially fatal condition where the heart’s artery walls start tearing apart,” said Dr. Andy Kiser, Chief of Cardiac Surgery and Director of the Cardiovascular Leadership Group at St. Clair Health.  “Unlike a traditional heart attack caused by blockage in the artery due to buildup of plaque and blood clot formation, SCAD occurs when the layers of the coronary artery separate and blood becomes trapped in between.”

“The wall layers then peel and bulge, which can lead to blockage or reduced blood flow to the heart and that, of course, can lead to a heart attack or cardiac arrest.”

Although some forms of heart disease affect older people more, SCAD is a rare form that often occurs in young, healthy people who may not suspect any problem.

Dr. Kyle Buchanan, Interventional Cardiologist with St. Clair Medical Group, and the cardiac team admitted Jessica, took her to the catheterization lab and found that she had a dissection causing blockage of the left main coronary artery.  Dr. Buchanan and Dr. Kiser reviewed Jessica’s case and radiographs and determined she needed emergent open heart surgery.  Given the unusual nature of the case, Dr. Kiser performed bypass surgery then asked Dr. Buchanan to repeat the angiogram in the operating room.

“Although the operation seemed to go perfectly, we wanted to confirm that we had completely repaired the tear in the artery.” Dr. Kiser said.  “We rarely perform a cardiac catheterization in the operating room but Dr. Buchanan was able to prove the bypass surgery was successful.  This unique collaboration among cardiovascular specialists at St. Clair provided Jessica a confident solution to a very dangerous problem.”

Jessica says she’s forever grateful for her team of experts at St. Clair. “They kept me alive,” she said. “Now with cardiac rehab, I am working on getting back to being active and doing my job.”

Jessica is a full-time employee at her local Home Depot and a full-time mother to her five children ranging in age from six months to 12 years old. With the help and continued support from the experts at St. Clair, she is looking forward to being the heart of her team again. “I may always have limits on what I can do now, but I am alive and get to see my kids grow up—that is a miracle within its self,” she said.

The Heart and Stroke Foundation mentions that 90 percent of all SCAD cases are women between the ages of 30 and 60 with most being young and healthy. Although the exact pathophysiology of SCAD is uncertain, and often no warning signs precede, those at the highest level of risk include pregnant and postpartum women, those with fibromuscular dysplasia (FMD) or connective tissue disorders and those who experience considerable mental and physical stress, all of which can lead to weakened artery walls. While both men and women can experience SCAD, women have a greater risk.

“SCAD is the most common cause of heart attack in the peripartum female — so either during or right after pregnancy,” said Dr. Kiser. “It’s thought to be related somehow to hormonal changes or changes in the wall of the coronary artery.  Turbulent blood flow during labor may also contribute when your blood pressure increases.”

“It’s an amazing feeling to be surrounded by people who care,” said Jessica. “If I can give any advice to others—remember that I had an ideal pregnancy and am considered a healthy young woman. So you might not fit the typical heart patient check list, but that doesn’t mean this can’t happen to you.”

Jessica is now back to enjoying life while being the heart of her team—caring for her family and watching her five children grow.

Andy C. Kiser, M.D., FACS, FACC, FCCP
Dr. Kiser specializes in cardiac and thoracic surgery. He earned a B.S. in biology with honors and distinction, and a medical degree with honors from the University of North Carolina at Chapel Hill. He subsequently completed a residency in general surgery there, as well as fellowships in cardiac and thoracic surgery. From 2011 to 2016, he served as the Chief of the Division of Cardiothoracic Surgery at the University of North Carolina at Chapel Hill, where he was also the Byah Thomason-Sanford Doxey Distinguished Professor of Surgery. Dr. Kiser served as the J. Mark Williams Distinguished Professor in Cardiac Surgery, Chief of Cardiac Surgery, and the Director of Cardiovascular Surgical Services at East Carolina University Heart Institute, which is affiliated with East Carolina University, in Greenville, North Carolina. In May, 2018, Dr. Kiser earned an MBA degree from the Kenan-Flagler Business School, also part of the University of North Carolina at Chapel Hill. Dr. Kiser practices with St. Clair Medical Group.

To contact Dr. Kiser, please call 412.942.5728.

 

Kyle D. Buchanan, M.D., FACC
Dr. Buchanan specializes in cardiovascular diseases and interventional cardiology. He earned his medical degree at Loyola University Chicago, Stritch School of Medicine. He completed a residency in internal medicine at the University of Pittsburgh Medical Center, and completed his fellowship in Cardiovascular Medicine at Medical College of Wisconsin, Georgetown, MedStar Washington Hospital Center. Dr. Buchanan is board-certified in cardiovascular diseases, cardiology, and internal medicine by the American Board of Internal Medicine. He practices with St. Clair Medical Group.

To contact Dr. Buchanan, please call 412.942.7900.