“My family and friends were amazed when they heard what had happened,” said Kathy. “And not because I’m a heath nut by any sense of the word, but I was active, ate healthy and had no prior health concerns.”
In August 2011, Kathy was visiting family when she had her first “episode.” While on a morning walk with her husband, she started feeling a strange tightness in her chest. Her breathing became forced and difficult and she stopped to catch her breath. The strange feeling caught her off guard, but she insisted they keep walking. As they pushed on, the feeling of discomfort in her chest grew worse. Her husband insisted they turn around and head back to the house, and after some reluctance she agreed.
“On the walk back to the house the pressure became more intense -- not painful, just pressure in my chest - and then I became nauseated and sick. I just kept thinking to myself, what in the world is going on?” said Kathy.
Rather than going to the hospital Kathy thought she would try to rest and see if the feeling got better. Within 15 minutes the feeling was gone and she was fine. Like nothing had happened. It wasn’t until the end of the following week while taking the stairs to her second-floor office that the feeling returned. She once again pushed it to the back of her mind. The occurrences were so sporadic she found them easy to ignore. But when it happened at home while carrying grocery bags up the stairs, her husband encouraged her to see the doctor and she agreed, knowing something was not right.
“A heart problem was the furthest thing from my mind,” said Kathy. “I thought I had a breathing issue. I was having a hard time breathing and the pressure was in my chest, plus I don’t smoke and I’m not overweight, so I thought I had a lung problem.”
Kathy’s Tests & Diagnosis
Kathy’s doctor recommended a stress test. She resisted a little, not understanding why that was necessary.
“I told my doctor I needed a breathing test. I didn’t have any pain and my blood pressure was normal,” said Kathy. “My doctor explained that the heart is the most important part in that area of the body. He suggested we start there.”
The doctor performed a treadmill stress test and a nuclear stress test. Both tests would help reveal how much stress or exertion Kathy’s heart could manage before showing signs of irregular rhythm or abnormal blood flow. During the nuclear stress test, a small amount of radioactive substance was injected into Kathy’s heart and then a camera took images of her heart to reveal areas with decreased blood supply. While on the treadmill, the incline and levels were slowly increased until she started experiencing similar symptoms of forced breathing and tightness.
It turned out the results from the two tests performed on Kathy were mixed: The nuclear stress test was relatively normal, suggesting her heart muscle was healthy, while the treadmill stress test suggested she might have blockages in the arteries that supply blood to her heart.
Concerned about the mixed test results and the nagging concern about increasingly distressing symptoms, Kathy sought out a second opinion from a team of cardiologists at the University of Chicago Medical Center, including interventional cardiologist Dr. Sandeep Nathan.
“It was the disparity between the two tests and the rather dramatic nature of the symptoms Kathy had experienced at home that drove the decision to proceed with cardiac catheterization,” said Dr. Nathan. “Discrepancies in test findings are not unusual, but when they do occur they often engender confusion regarding the diagnosis and the best course of action. In Kathy’s case, we felt an angiogram would provide answers we needed to develop a treatment plan.”
As recommended, Kathy underwent an angiogram that revealed a 95 percent blockage in the most important of her three coronary arteries. That same day she underwent angioplasty and stenting to open the artery and restore blood flow to her heart.
Dr. Nathan is one of a growing number of cardiologists who regularly practices the less invasive transradial approach where the heart arteries are accessed through the wrist rather than the groin. Dr. Nathan inserted a small, flexible tube called a catheter into Kathy’s right wrist to access the blocked coronary artery. Once inside the clogged artery, a balloon was inflated to open the space and a stent was implanted to facilitate blood flow.
“I was awake during the procedure and felt no pain. Dr. Nathan and the nurses walked me through what they were doing,” said Kathy. “When they inflated the balloon and placed the stent I could feel pressure similar to what I was feeling before. But they reassured me it would only last about 30 seconds and was completely normal.”
Kathy had the procedure done on a Thursday morning, was up walking immediately after the procedure and was released from the hospital the next day. She was even able to make the trip from her home in Indiana to Houston to visit her son less than a week later.
In follow up to the procedure, Dr. Nathan spoke with Kathy about the severity of her symptoms, pain level, and why she finally sought help.
“I explained that never at any point did I feel pain. I had tightness in my chest and it was annoying and uncomfortable for a short time, but then it would go away,” said Kathy. “I told Dr. Nathan – pain to me is childbirth, horrible menstrual cramps or someone taking a spear to your heart!”
“Fortunately for me, I didn’t ignore my body and I did pursue treatment, said Kathy. “But what if I just decided to quit walking and go on with my life?” said Kathy. “I might not have had a life to go onto.”
Kathy has started making changes to her everyday life, including a low-sodium and low-fat diet. She shares her story with others hoping that it will impact at least one other person.
“I now realize, as common a misconception as it is, not everyone experiences pain during heart events,” said Kathy. “I just want to encourage everyone to not ignore irregularities in everyday life.”