If it wasn't for CPR and the medical team at St. Luke's Hospital, 35-year-old Rebecca Graves wouldn't be here today to share her story.
"A little over a year ago I went into sudden cardiac arrest at my home," said Graves. "One minute I was sitting on the bed vomiting and the next minute I was on the floor with my eyes rolling in the back of my head and my lips were blue."
Her fiancé's daughter, Kateliyn, who is 12, started CPR while her sister, Kylee, called 911. Her fiancé, Ashley, took over CPR from his daughter until an ambulance arrived. "I don't remember a lot leading up to the cardiac arrest," admitted Rebecca. "It happened on a Monday after a long weekend, which involved a family funeral. I hadn't been feeling well but never felt it was a life or death emergency. Everything happened so suddenly.
Rare heart condition
"Rebecca has a rare congenital heart defect called transposition of the great arteries (TGA)," said Dr. Mark Zittergruen, UnityPoint Clinic - Pediatric Cardiology. "This is a heart condition present at birth and occurs when the two main arteries going out of the heart are switched in position. The result of these transposed vessels is that too little oxygen in the blood is pumped from the heart to the rest of the body, which is incompatible with life."
About four in 10,000 babies are born each year with this condition. Dr. Zittergruen sees babies born with this condition in Cedar Rapids about once every couple of years. There are two potential surgeries for children born with this condition. The Mustard procedure, which creates a tunnel or wall to redirect blood flow or the arterial switch procedure, which basically "switches" the two arteries and puts them back where they should be. The Mustard procedure was a pioneering surgery many years ago but now, because of surgical advancements, most children have the arterial switch.
"When I was six months old I had the Mustard procedure," said Graves. "The surgery corrected my heart problem. For the most part I have been able to live a normal life. I went on to have a family and don't typically give my heart condition much thought."
"I started seeing Rebecca in October 1999," said Dr. Zittergruen. "She was pregnant with her first child and her doctor asked me to follow her during the pregnancy. I see some adult patients like Rebecca, who have these rare heart conditions. Many of them have done well as they have aged, and because of that there is a growing movement to have more adult cardiologists trained to oversee patients with congenital heart disease."
Fighting to live
"Rebecca was fighting for her life when she arrived at St. Luke's Emergency Department," said Robin Brown, nurse manager in the cardiac critical care unit (CCU). "Paramedics had intubated her (placed a breathing tube) and started several medications in an effort to stabilize her. She was treated with the hypothermia protocol to reduce the risk of damage to her brain after cardiac arrest."
"I remember I was called in by Dr. Todd Langager, UnityPoint Clinic - Cardiology to consult on Rebecca's care that evening," recalled Dr. Zittergruen. "She was very sick. I remember being very worried about her. We decided she needed to see a pediatric electrophysiologist (works with heart rhythm disorders) to perform a thorough evaluation and she would likely need an implantable cardioverter-defibrillator (ICD), which is a small device used to regulate irregular heartbeats."
Thankfully Rebecca's condition improved and the hypothermia protocol was discontinued. "She had several contributing factors working in her favor, quick response, young age and an experienced medical team along with her strong will to live," said Brown. "Because of her surgery when she was an infant and the stitches in her heart she is more susceptible to heart rhythm disorders," said Dr. Zittergruen. "I would venture to guess that the vomiting that lead up to her cardiac arrest depleted her electrolytes. These things can make your heart a little twitchy and interrupt the rhythm. An ICD can detect when her heart goes out of rhythm and shock it back into correct sinus rhythm."
"After my stay at St. Luke's I had the ICD placed," said Graves. "I was able to return home in a matter of days. I am told I will eventually need a heart transplant but I am grateful to be alive. I'm thankful for my family and their quick thinking to start CPR and everything the staff did for me at St. Luke's."
"This is an example of good, effective care coordination," said Brown. "The team came together and saved this woman's life. It's also a testament to why everyone should learn CPR. Shortly after her hospital stay Rebecca and her mom came back to the Cardiac Care Unit to thank us. To see Rebecca so soon after hospitalization was rewarding and a reminder of how our mission, which is to give the healthcare we'd like our loved ones to receive is a team effort. To see her looking so good and full of life was awesome."
St. Luke's is an accredited Chest Pain Center by the Society of Cardiovascular Patient Care (SCPC), which means the hospital meets or exceeds stringent criteria for treating heart patients.
When it comes to matters of the heart don't wait. Call 911 or go to St. Luke's ER immediately.