“Don’t Go Breakin’ My Heart”
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.
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
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.”