Stress and the hurting heart
Feeling frazzled? For many people, job or family stress is a normal part of life. Fraser Pierson certainly thought so—until an unusual heart attack changed her outlook.
The right care at the right time
Last January, Fraser was walking her dogs when she noticed she felt oddly fatigued. A psychology professor at Southern Oregon University since 1988, she was accustomed to maintaining a strenuous schedule. However, a couple days later, she suddenly began experiencing discomfort with every heartbeat.
“I’d been having a busy day,” Fraser recalls. After teaching a four-hour class, she headed back to her office in her usual manner—jogging up two flights of stairs. “When I reached the landing and felt some breathlessness and intermittent pain in my upper mid-chest area, I thought I must be out of shape. I couldn’t have imagined I was having any sort of major heart issue.”
Minutes later, she broke into a cold sweat and felt slightly faint and nauseated. That’s when she knew she had to dial 911.
Fraser arrived by ambulance at the Asante Rogue Regional Medical Center Emergency Department. Cardiologists quickly treated and stabilized her heart, which was extraordinarily weak and dysfunctional. A cardiac ultrasound revealed she had experienced an uncommon, acute attack called takotsubo cardiomyopathy.
“Takotsubo is an unusual, but not rare, cardiac condition, which usually afflicts postmenopausal women under stress,” says Dr. Brian Gross, Fraser’s cardiologist. “It masquerades as a ‘heart attack’ contributing to about 2 to 3 percent of the heart attacks we see.”
While conventional heart attacks are usually caused by blocked arteries, Fraser’s arteries were clear. However, her heart muscle was suddenly weakened or “stunned,” presumably by emotional stress. The telltale sign of a takotsubo event is the left ventricle, which swells into the shape of a takotsubo, a clay pot used in Japanese octopus fishing—narrow at the top and ballooned out at the bottoms.
Although takotsubo cardiomyopathy is a serious and potentially fatal condition, if it’s caught and stabilized quickly, it is fully reversible. “I have the highest regard for everyone I met at Asante Rogue Regional. They were all wonderful knowing how to take care of my condition and how to treat me,” Fraser says. “Not everybody would’ve recognized a takotsubo event, especially not right away. I feel like I had what I needed every step of the way to support my recovery.”
Cardiac rehab: Regaining confidence
Following five days in the hospital, Fraser returned home with a LifeVest, a special wearable defibrillator. The vest monitored her heart rhythm during recovery and could stabilize it if her rhythm became chaotic and caused her to pass out. When she had gained enough strength and no longer needed the vest, Dr. Gross recommended Asante’s cardiac rehabilitation program to help Fraser rebuild confidence in her heart health.
“Cardiac rehab has a host of well recognized benefits,” Dr. Gross says. These include specially trained nurses working one-on-one with patients to increase their heart’s performance following a serious cardiac event or surgery. The program also provides a wealth of education on a heart-healthy approach to life.
Perhaps most valuable, though, is the reassurance cardiac rehab offers—both physically and emotionally. “Cardiac events are such a huge change in a person’s life,” says Sally Seibert, cardiac rehab nurse at Asante Rogue Regional. “It’s scary getting back out there and not knowing what to look for. Patients wonder if their heart rate, rhythm, blood pressure are doing alright.”
“Cardiac rehab really helped me to regain confidence,” Fraser agrees. “Sally called me, described the components and benefits of participation, and warmly invited me to come and take part in the program. Each of the nurses offers so much knowledge, skill, support, and encouragement. They helped me recognize my expanding parameters, what I could do to rebuild my physical stamina but not overdo things, and answered my questions regarding heart health.”
Fraser notes that the other patients were also inspiring. “I felt privileged to recover within a holistic healing community,” she says.
Cardiac rehab is typically an 8- to 12-week program, involving two to three sessions per week. Each patient’s therapy is tailored to their individual needs. In Fraser’s case, she wanted all the information she could get, and her care team was happy to provide it. “They have very good education programs, and the nurses are excellent teachers,” Fraser says. “I thought I lived a healthy lifestyle before, but they taught me things about my heart that I didn’t know. I learned even more how to practice heart-healthy habits.”
Above and beyond the usual training, nurses also gave Fraser a peek inside her heart. With each session, Fraser was hooked up to EKG monitors to record her heart rhythms as she increased her exercise level. Afterwards, by her request, nurses gave Fraser a copy of her report to take home, so she could actually “see” her recovery as it progressed.
“I always tell people that they have to do the work; we can’t do it for them,” Sally says. “Fraser definitely did the work. She was here, she attended very consistently, and she put a lot into it because she was motivated. She knew that rehab was really helping her to feel better about things.”
Less stress for the future
Now that she’s back in the classroom and enjoying her usual activities—including sailing with her husband and spending time outdoors with their four dogs—Fraser is more mindful of her physical and emotional health. “When I look back, I had stressors in my life, but they weren’t unusual for me,” she recalls. ““Mine were the everyday stresses that are part of all our lives. I can’t help but wonder if for me it was an accumulation of stress factors. I’ve learned to take stress seriously, even common, everyday stress; to really pay attention to physical and emotional manifestations of stress and to the cultivation of overall well-being.”
Whereas in the past she would push through a hectic schedule, Fraser now builds in more time to spend with family, go for walks, and really savor relaxation. “I no longer take my health for granted,” she says. “It’s important to take the kind of care with ourselves that we do with everyone we love. It’s not selfish; it’s an integral part of being able to contribute what you have to offer the world.”
And besides—your heart just might depend on it.
Every link matters in the chain of survival
Gloria Ferguson’s story illustrates the importance of a rapid response to a heart attack or other severe heart event. Her life was saved thanks to the many different people who responded to a life-threatening event that occurred near Crater Lake, miles from the nearest hospital.
In 2012 the 52-year old math and science coordinator from Vancouver, Washington, was accompanying her 13-year-old son on a five-day Boy Scout bicycling trip that began at Crater Lake National Park. On the first day of the trip, Gloria developed severe chest pain. A Boy Scout leader drove her to the ranger station at the park’s south entrance, where she lost consciousness upon arrival. Two Boy Scout leaders started “fast and deep” chest compressions, and an automated external defibrillator (AED) was brought to the scene to help maintain Gloria’s heart rhythm until the Mercy Flights helicopter arrived.
The Mercy Flights crew diagnosed a heart attack and brought the critically ill patient directly to the Asante Rogue Regional Medical Center cardiac catheterization laboratory, where a cardiac team had been alerted and was awaiting her arrival. From the moment Gloria arrived at Asante Rogue Regional, she received lifesaving emergent medical care. The team treated her with a cardiac stent to restore blood flow to the heart. She was also treated for cardiogenic shock and required an intra-aortic balloon pump and electrical cardioversion. Gloria was transferred to the Cardiac Intensive Care Unit, where she was on a ventilator for five days. Twelve days after admission, Gloria left the hospital with her husband and son and has since returned to work.
Gloria’s story exemplifies what can happen when each link in the chain of survival works: the prompt recognition of cardiac symptoms by the Boy Scout leader; the quick decision to head to the ranger station; the “fast and deep” chest compressions; the AED availability and its prompt and proper use; the rapid arrival and transport of the critically ill patient by helicopter; the direct transport from the helipad to the awaiting cath lab; and the rapid sequence of treatment that Gloria received once she arrived at the hospital—all saved her life.
Thanks to the training and the preparation of the many people in the chain of survival, Gloria made a full recovery.
Minimally invasive surgery makes heart care available to more people
At 85 years old, Wanda Talley suffered a massive aneurysm in her aortic artery. An aneurysm occurs when a portion of an artery expands or balloons due to weakness in the wall of the blood vessel. In the past this would have been an untreatable problem for a woman in her eighties. In Wanda’s case, however, using a minimally invasive endograft stent technology available at Asante Rogue Regional Medical Center, surgeons repaired the aneurysm, leaving only a small incision in the groin.
Asante’s hybrid operating room was specifically developed with the technology to complete complex procedures like the one that saved Wanda’s life. Below is a letter we received from Wanda’s daughter following the surgery.
Hi. My name is Sheryl Cerri, and this story is about my 85-year-old mother who was told that she didn’t have a chance of survival if she had an operation on a thoracic aortic aneurysm that was already at 7 centimeters.
The doctor we were sent to see was Dr. Folsom. He was wonderful to my mother but didn’t think she could survive that big of an operation; and even if she did survive, there was a chance that she would be a paraplegic. He left the decision up to my mother (as I sat there crying) to have the surgery or not. My mother said she didn’t want to take that chance and would go home and live what life she had left.
Well, just as we were leaving, Dr. Folsom asked if he could talk to one of his colleagues about stents. We told him “sure,” not really thinking much about it because we thought she really didn’t have a chance.
Dr. Folsom took control of everything; he got everything lined up—the surgeons and the surgery. I felt he went the extra mile to save my mother’s life, and that is just what he did. I have never had a doctor who put so much effort into helping us out. He contacted Dr. Traul [David Traul, MD] and another surgeon to do the surgery, and he called us four different times to get this set up. He even got us a place to stay because we live in a small town by Klamath Falls. My mother’s surgery was a giant success. Her stay at the hospital was wonderful.
Most of the people I have talked to say my mother’s surgery is kind of a miracle because most people do not survive a thoracic aortic aneurysm.
I just want to say thank you, and every day I tell someone about your wonderful hospital and the amazing Dr. Folsom and his fellow surgeons.
Thank you so much.
Sheryl Cerri and my mother, Wanda Tully