Don’t Go Breakin’ My Heart

“Don’t Go Breakin’ My Heart”

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Originally appeared in the Bend Bulletin’s U Magazine April 4th, 2011

It was a typical August day in Central Oregon. A leisurely summer morning sipping tea and plotting the day’s activities. Then it started. Knifing pains travelled from the chest to the back and through the shoulder to the left arm. More tell-tale signs began to appear; shortness of breath, dizziness, cold sweats and almost passing out. A sense of urgency replaced the initial denial. But, how could this happen to someone who follows all of the heart-healthy guidelines?

Bend resident since 2007, Katherine Hilst lived this horrifying tale August 23rd of last year.  As an active, fit, 51 year old helicopter pilot, aviation safety consultant and lawyer, a heart attack was the last thing on her mind. Katherine ate healthy, practiced yoga, and exercised regularly. A classically trained pianist, Katherine also performs as a cellist for the Central Oregon Symphony as well as with several gigging bands around town, including Hilst & Coffey and Wild Rye.

Proud of her lifestyle, Katherine exhibited no previous signs leading to a heart attack. But, unbeknownst to her, an extremely rare spontaneous coronary artery dissection (SCAD) of her right coronary artery (RCA) had occurred.

What is SCAD?

SCAD is essentially a tear in the inner membrane of the artery wall. The tear allows blood to flow between the artery walls, creating a pocket of blood. This bad flow competes for space in the artery with the normal flow of blood, resulting in a blockage, and ultimately, a heart attack. Because the symptoms present themselves like a “regular” heart attack, medical caregivers are unable to detect a dissection until they get inside your arteries with a catheter.

SCADs have been known to occur during exercise or rest, as in Ms. Hilst’s case.  According to www.spontaneouscoronaryarterydissection.com , eighty percent of SCAD cases affect women and it is not uncommon for SCAD to occur in people in good physical shape and with no known history of heart-related illness. There may be a link between SCAD and female hormone levels, however, because SCAD is so rare, each case is treated as unique.

What happened next…

What happened next probably saved Katherine’s life. A call was placed to 911 within minutes of Katherine’s symptoms occurring. The 911 operator advised an aspirin and relaxation of her breathing. The ambulance arrived after a few excruciating minutes and began to give treatment. Because of Katherine’s physical appearance, the medics first wondered if Katherine was experiencing a panic or anxiety attack. Luckily, the first EKG reading was abnormal and put her on the fast track to cardiac care at the hospital. Three more EKGs on the way to St. Charles read normal, even though she had an artery that was torn, bleeding and creating a blockage. 

St. Charles Cardiovascular Care Services

Once Katherine arrived at St. Charles Medical Center, a small army of medical professionals greeted her at the cardiac catheterization lab (Cath Lab). A catheter inserted in the brachial artery administered a dye that found the dissection. Four stents were placed in her right coronary artery. The doctor later mentioned it was only the third one he had seen in twenty years. All in all, Katherine spent 36 hours in the hospital.

After being released from the hospital, doctors recommended Katherine rest for a few days and then slowly begin to resume her normal activities. After consulting with her cardiologist, she began to attend cardiac rehab at the St. Charles Cardiac Rehabilitation Center. Designed to keep patients out of the hospital, cardiac rehab programs have been shown to reduce mortality in heart patients by 25 percent. During the class, EKG rhythms, heart rate, and blood pressure are monitored. This, along with information on healthy diet and exercise allows the patients to formulate a path toward better overall heart health.  Another benefit, especially for Katherine, is the support from fellow heart attack survivors.

Sidebar

The St. Charles Heart 1 Program

  • A collaborative effort to reduce average “door-to-balloon” time
  • “door-to-balloon” is the time it takes for a patient to make it from the emergency room to the cardiac catheterization lab
  • Hospital staff, cardiologists, emergency physicians and local EMS providers all participate
  • The St. Charles current average is 50 minutes
  • National average is 180 minutes
  • St. Charles is #1 in Oregon for the lowest number of in-hospital deaths due to myocardial infarction

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NOW

Any major medical event with the word, “spontaneous” in the title is bound to set someone on an emotional roller coaster. “Mostly I’m just very, very grateful to be here”, says Katherine. “This whole thing has been another reminder that life needs to be lived as fully as possible. I totally intend to do that!”

A common saying of heart disease patients is “the new normal” which means you have to relearn what is now normal for your body to feel like. However, in Katherine’s case, “new normal” refers to her continuing drive for personal and professional growth. In addition to her aviation consulting work, Katherine recently added teacher to her resume. She now teaches several classes in the Aviation Department at Central Oregon Community College.

Katherine’s performance schedule with Hilst & Coffey and Wild Rye has also increased.  You can catch her on stage several times a month in the various music venues around town. Among the recent performances Katherine is proud of includes her recent Hilst & Coffey CD release performance at McMenamins. You can also listen in a more formal setting at upcoming Central Oregon Symphony performances.

As Katherine wrote in a letter to Dr. Bruce McLellan at the Heart Center, “because of the great care I received through the whole process, I am here to live what I hope is many more decades.”

Important Websites

www.scmc.com

www.inspire.com

http://www.womenheart.org/

www.spontaneouscoronaryarterydissection.com/

http://www.goredforwomen.org/

2 thoughts on “Don’t Go Breakin’ My Heart

  1. Wow, I am so encouraged by this westbie!I am 55 yrs old. On Sept. 9, 2011 I had a weird back/and chest pain. After an angiogram I was diagnosed with SCAD, my RCA had a dissection in the smaller vessel so couldn’t be stinted.Upon getting ready for work one morning, I developed back/chest pain’ that lasted 40 min. It radiated from my upper back to my upper sternum. Being diagnosed with SCAD leaves me feeling alone’ as little is known about SCAD and most Dr’s have never heard of it. My Cardiologist has me on 81 mg aspirin and 75 mg Plavix, and wants another angiogram in 6 mos. He advised no lifting nor exercise for several months. Bummer! ( this has been hard and depressing). I am an avid walker/hiker, don’t smoke nor drink and my angiogram showed a healthy heart, I don’t have high BP, eat healthy (for the most part!) and am not overweight 5’4 110 pounds.’This is so disappointing and all my friends say and you’re so healthy!’ I feel like a walking time bomb’ as no one knows what can prevent this. Therefore I am very interested in this study.I have concerns over having another angio. Do yo think this is necessary? I would like to have a less invasive test. My Dr. still wants to go ahead and sched. one for Feb.I want to mention that in 2010 I had a routine vag. hysterectomy w/ A&P repair, of which I had 3 spontaneous hemorrhages from each site in the 4th ,5th and 6th week post op. I saw many Doctors and ended up in Loma Linda Med Ctr. in CA. This was extremely frightening and almost died of blood loss. The specialists told me I was very rare’, strange and unheard of’. My vessels from each incision had to be cauterized wondering if there is any relationship in regards to my vessel tenacity/turgor along with fluctuating hormones. The Drs were so puzzled and still are. I am continually haunted, emotionally over this. Now I am again told, with SCAD, that this is very rare’ ..I am looking forward to what will be learned in this study, and hope I can be of some use!Thank youElaine

    • Greeetings,i’m not sure i’m in the right place here since i did NOT have a heart attack. I had a Stroke as a ruelst of a R spontaneous carotid artery dissection in January 2010; the doctors called it a freak accident, but i thought that stress was a major contributing factor to this; they balked when i asked if stress could have contributed to the dissection .no secondary heart problems or issues, was 56 at the time, was very physically fit (had a regular yoga practice for 20 years and in past years was practicing 90 minutes per day, 6 days per week The doctors attributed the stroke to yoga and I attributed yoga to my survival and good health and that the effects of the stoke were light’ and my recovery has been very good was in a headstand when this happened (two day 10 hour workshop, i admit this was very strenuous and it was a different form of yoga than my body was accustomed to)..no family history, one risk factor, i was smoking a couple cigarettes a day for two months i was fairly stressed out; flying back and forth coast to coast for about eight months .ill family members .I would like to participate in this study if i am eligible, have no angiograms but had three CAT scans of the artery and my brain,, no further CAT scans ware recommended.I took aspirin for one year as a precautionary measure. And i’ve been given a clean neurological bill of health; as far as the artery, it has apparently healed with a small flap within the artery If i am eligible for this study, i would like to participate, as its’ been so difficult for me to find any information on this. And I just found this site a few minutes ago .Doctors told me that it would be highly unlikely for me to have a second tear, but i’m reading now that this happens quite often ..Breathe, go easy and enjoy life!thank you..Lauriei