“I started sweating profusely, like someone had turned the hose on me,” she recalls. “My shoulders across my back started cramping, and my jaw was aching.” When she turned an ashen gray, her husband told her he thought she was having a heart attack.
As a busy horticulturist, Deb Hopewell has never had any trouble getting in the recommended 30 minutes of exercise a day to keep healthy.
“I’m outside all the time helping people with their gardens,” she says. “I do a lot of weeding, pruning and planting.”
She also practices yoga a couple of times a week, swims laps in the neighborhood pool and walks her coon hounds, Archie and Rowdy, a mile or two twice a day.
When it comes to her diet, she’s just as careful to follow the nutritional guidelines, avoiding junk food and processed meals.
“We don’t eat out of a box,” says Hopewell, who lives on Fripp Island with her husband, Gary Braatz. “We cook at home every night.”
The picture of health, Hopewell never imagined at the age of 57 she’d end up in the ER with a heart attack.
“I didn’t have high cholesterol or high blood pressure, and I have only a minimal family history of heart disease,” she says. “There were no red flags.”
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Recognizing the Signs
But on the afternoon of Oct. 29, 2013, Hopewell came home from work and began having weird symptoms. Her upper left shoulder ached as if she had pulled a muscle.
“I started sweating profusely, like someone had turned the hose on me,” she recalls. “My shoulders across my back started cramping, and my jaw was aching.”
When she turned an ashen gray, her husband told her he thought she was having a heart attack.
“I had lunch that day at a new restaurant,” Hopewell says. “I was hoping it was just food poisoning.”
Not wanting to take any chances, her husband took her to the Fripp Island fire station just two minutes from their house. Paramedics gave her aspirin and nitroglycerin, hooked her up to an EKG and called an ambulance.
Hopewell was rushed to Beaufort Memorial Hospital’s emergency room and within 30 minutes was taken to the cath lab for an emergency cardiac intervention. Tests confirmed she was having an ST elevation myocardial infarction, or STEMI, the most dangerous type of heart attack.
Her left interior descending artery, ominously referred to as the “widow maker,” was nearly 100 percent blocked, keeping blood from flowing to her heart. BMH cardiologist Stuart Smalheiser, MD, was called in to perform an emergency percutaneous coronary intervention (PCI) to open the occluded artery.
“I remember complaining that my shoulders ached,” Hopewell says. “Dr. Smalheiser kept telling me, ‘You have had a heart attack.’ I was in total denial.”
Lifesaving Intervention
During a PCI, a catheter with a balloon at its tip is inserted into the blocked artery and then inflated to push away the clot and restore blood flow to the heart. After the balloon opens the blocked artery, a stent is placed in the area of the clot to stabilize the artery and prevent it from closing again.
Only 25 percent of U.S. hospitals have PCI capability. Beaufort Memorial had received state approval to perform the lifesaving procedure just four months before Hopewell’s heart attack. Prior to June 2013, BMH patients having a STEMI were given clot-busting medication and airlifted to a hospital in Charleston or Savannah approved to perform the emergency intervention.
For patients like Hopewell who live 30 minutes from the hospital, it wasn’t always possible to get them into a cath lab for the procedure within the 90-minute practice guidelines established by the American College of Cardiology and the American Heart Association.
Timely intervention is critical with STEMIs because the longer it takes to clear the clot and restore blood flow, the greater the amount of damage to the heart muscle. Yet fewer than half of STEMI patients in the U.S. undergo PCI within the recommended time frame.
BMH’s door-to-balloon time averaged 57 minutes in the first quarter of 2014, beating the national average by seven minutes and the AHA’s guidelines by 33 minutes. Hopewell was treated even faster. Her blocked artery was open 47 minutes after she arrived in the ER.
Making a Difference
“The program has been more successful than anyone ever thought it would be,” says Smalheiser, one of three BMH interventional cardiologists trained to perform the procedure.
In the first 14 months the program was in operation, the cardiologists performed 50 emergency PCIs on patients having STEMI heart attacks. All of the interventions were successful.
Last fall, BMH received prestigious national awards for its cardiac care from the American Heart Association and the American College of Cardiology Foundation.
“I can’t say enough about the care I received at Beaufort Memorial,” Hopewell says. “Dr. Smalheiser was so kind. And the ICU staff was incredible. They treated me like a princess.”
To reduce the chance Hopewell will have a second heart attack, Smalheiser prescribed drug therapy that includes a baby aspirin every day, along with blood pressure and cholesterol medication.
“Despite having zero or minimal risk factors, you can still have a heart attack,” says Smalheiser, of Beaufort Memorial Heart Specialists. “If you take care of yourself, you will reduce the risk, but you can’t eliminate it. That’s why it’s so important to be vigilant about symptoms, even if they’re atypical. Recognizing the warning signs and getting to a hospital quickly could save your life.”