Theresa Leisen is a 42-year-old wife and mother of two. She’s healthy and active. The last thing she expected was to have a heart attack. Thanks to the coordinated efforts of her medical team at UnityPoint Health in Dubuque, Theresa has a bright future and shares her story – hoping to save just one other woman’s life from a life-threatening heart attack. Here’s her story:
Theresa was out weeding her garden on a hot summer day. After a refreshing shower, she started experiencing numbness in her left arm, and heaviness in the chest. She tried to relax, the feelings passed. The next day was even more hot and humid and she had an all-day golf outing to attend. No symptoms interrupted her golf game, but at 2:00 AM the next day, she woke up out of a deep sleep – again experiencing the same symptoms from the day before. This time symptoms were more intense and lasting longer.
Now Theresa started to worry and woke her husband. Was she having a stroke? Knowing someone who had a stroke a few days earlier, the thought crossed Theresa’s mind. Twenty minutes later and the symptoms were gone. Unfortunately, they came again. “At that time, my husband said we needed to go to the ER,” says Theresa. “We were getting ready to go, figuring out what do with our kids, and the symptoms were suddenly gone again. I was extremely tired and went back to bed.”
When Theresa woke the next morning, she still felt some numbness in her left hand. She decided to go to work but called UnityPoint Clinic Family Medicine and Walk-in Clinic in Peosta for an appointment. Her primary care provider, Guy McCaw, MD was able to see her that same day.
Dr. McCaw did a thorough exam and EKG, a type of heart test, all of which appeared normal. Even with a clean check-up, Dr. McCaw wanted Theresa to go to Finley Hospital’s Emergency Room for a CAT scan of the chest. Reflecting on her experience, Theresa is thankful that Dr. McCaw was so proactive, thinking about the what-ifs.
In the ER, Finley’s experienced ER team did a complete cardiac workup which included blood work as well as a CAT scan. One by one, the results came back OK. “I called my kids and told them we’d bring a pizza home for supper around 7:00.”
Then the blood work came back. It showed troponin I, a type of protein found in heart muscles, was elevated – a sign of a possible heart attack. The ER team consulted with the on-call cardiologist who started her on an IV and oral blood thinners promptly. Theresa was admitted to the cardiac unit. She was having a heart attack without the typical symptoms. “I still felt fine,” says Theresa.
UnityPoint Clinic Cardiology’s Tauseef Khan, MD saw Theresa in the hospital that evening. “He couldn’t believe my stats,” says Theresa. “We were scheduled for a Saturday morning cath lab procedure to check out what was going on.” Her angiography revealed evidence of a tear in the wall of the front artery of the heart; a very rare condition known as Spontaneous Coronary Artery Dissection (SCAD). However, there was still adequate blood flow in the artery and the pumping function of her heart was normal with no visible clot on the angiogram. Theresa was without any symptoms of chest pain or arm numbness. Typically, a healthy, young person with no heart history in their family with no blockages or clots - which was the case for Theresa – as a rule, heal on their own. Dr. Khan decided to manage her conservatively based on available research and guidelines on this rare condition.
Theresa and her family were relaxed and prepared for possible discharge. Just two hours later, however, Theresa again experienced the numbness in her left arm, as well as chest pain. This time was different. Theresa’s pain was severe, persistent and associated with low blood pressures. Her EKG clearly indicated an evolving heart attack. Finley’s cath lab team was mobilized immediately. “In about 20 minutes, I was on my way back to the cath lab,” says Theresa. In the cath lab, Dr. Khan observed the development of a blood clot and decided to evaluate the artery from inside using sophisticated ultrasound catheters and finally placed a stent to repair the tear in the wall of the artery. Theresa’s symptoms resolved almost immediately as the blood was normalized. Her family, including her daughters, all came to visit while she recovered from her heart attack.
“I was off work for two weeks and finally towards the end of my time off, I did some reading on my type of heart attack. I read enough to know that I’m very lucky and very grateful.”
Theresa’s heart attack is known as a spontaneous coronary artery dissection (SCAD) heart attack and tends to happen to healthy, active women with no previous heart history, usually in their 40s – just like Theresa. Signs of a SCAD heart attack are similar to symptoms of a traditional heart attack, but in women, especially, those symptoms can be hard to detect. Things to watch for include: chest pain, rapid heartbeat, pain in your arms, shoulders or jaw, shortness of breath, sweating, unusual tiredness, nausea, and dizziness. Many times, heart attack symptoms in women can be mistaken for indigestion. Whenever in question, call 911 and head to the emergency room.
SCAD heart attacks are rare and most often heal on their own or with medications alone. When they are complicated with blood clots, not all outcomes are as promising as Theresa’s. Luckily, Theresa has no heart damage and is not expected to have any heart issues in her future.