Spontaneous Coronary Artery Dissection

My rare dissection

January 20, 2015

I am a 28 year old healthy, skinny EMT Basic and I get to share my life with an amazing fireman. We were blessed with a beautiful baby girl on October 24, 2014. She is my 3rd child and his first. This pregnancy was like any other, no issues with me or the baby. I did however need a repeat c-section. The surgery went perfectly. Baby girl was perfect and I couldn’t have been happier. We were released from the hospital 2 days later with a perfect bill of health. Life was slowly starting to get to some kind of “normal”.

No one would have ever imagined that 9 days after having baby girl that my life would be endangered and changed forever. One of the first days of November around midnight, we were up with the baby and the boyfriend told me to go to bed he would stay up with baby girl. I gladly went to lay down. Right after laying down I started to have a weird tingly pain in my shoulders. I got up and informed him of the pain. We both blew it off and I leaned on a heating pain and the pain lessened after a few minutes. I decided to try and sleep it off.

The moment my head hit the pillow the pain came back but this time it was so much worse. I now had the pain in my shoulders, over to my chest and my extremities. I got up and told boyfriend. We called my dad to come watch the babies so we could go to the ER. I started to assume it was a clot since I just had surgery. By the end of the 2 minute phone call I was losing sensation in my left arm and the pain was growing increasingly weird. I started to have difficulty breathing and I could not keep still. I was pacing my house and trying to lay down in random locations, like the bathroom floor. My dad had arrived a short time later and we rushed out the door, but luckily not without a hug. Boyfriend dropped me at the doors of the ER.

By this time I could hardly walk or speak. I went to the check in desk and was asked several pointless questions about Ebola. She then paged chest pain over the 1MC and an older tech came rushing around the corner. When he saw me, his rush went out the window and he assumed I wasn’t a concern. He walked me to a bed and walked out of the room. A few minutes’ later 2 female nurses walk in. They have no sense of urgency about them. They start a line and put me on the monitor. After printing off a strip one left the room in a hurry. She and a female doctor rushed back in and said they were going to rerun the EKG because they believe the machine misread. The doctor also asked my pain scale and my medical history.

After the second run, they left and came back in and started a second line and told me that I needed to go to CT. Within 10 minutes I was in and out of CT. When I was brought back from CT I was no longer in a regular room, they moved me to a trauma room. The doctor came rushing in right after I was wheeled back in with a tray full of meds and a herd of people following. After pushing only God knows what meds the doctor informed me that “It is life threating and you have to stay still and calm.” She stepped back out and I was attacked by nurses. One put shock pads on me, another ran another strip and another was manually taking my vitals. My fireman, who has being in the industry for 19 years, was puffy and red eyed. I knew it was bad but no one would tell me anything more. The doctor came back and said a helicopter was on their way and I was being flown to the cath lab and the cardiologist is already waiting on me. She stepped out of the room when the flight crew showed up she gave them the run down.

No matter how long you have been in EMS and no matter what you’ve seen and how professional you can be there are moments you can’t hide the “oh shit” look. I saw that look come over the medic’s face while being informed of my situation. They took me to the helicopter with little spoken. We took the 15 minute flight in silence and with them not taking their eyes off me and the monitor or their hand off my radial pulse. We get to the second hospital and they unload me and wheel me to the cath lab. The lab was full of people who all pounced on me the moment they wheeled me in.

At this point I was drugged with everything under the sun. I was moved to their table and the quickly inserted the camera. I remember them saying they can’t knock me without the surgeon because they would lose me for sure. I laid there and watched the monitor in awe. From a medical stand point I thought it was the most interesting thing I’ve ever seen. I wasn’t really putting 2 and 2 together that that was my heart and the black on the screen was blood. The cardiologist asked if I want a splint or a bypass. I was worried about long term limits and I told him to do which ever will give me the least limitations. I now realize he was checking my level of consciousness. But with me so duped up my choice didn’t count.

A moment later my dad, stepmom and boyfriend were by my side. They all told me they loved me with tears running down their faces. Next thing I knew I was gagging from the tubes in my throat.

Since this night I have learned so many more details. My diagnoses was a full dissection of the left posterior descending artery all the way down which caused ripping of the heart and a global MI. The cause is unknown. I am also the only dissection on the heart that cardiologist has seen in his career.

I was informed that the reason everyone was crying was because they were informed that I had a 2% chance to make it to the OR, which was the next door over and at best a 25% chance of coming out of the surgery or surviving the next few days. Also, the moment they knocked me out I coded and they had to rush to open me and someone had to take my heart in their hand and manually pump my heart for the first 2 hours of the surgery. I do have damage to the cardiac muscle and I have an extremely low cardiac output of around 30%.

I have yet to find anyone else with a dissection on the heart, alive or in research. I can’t even find research on dissections on the heart.