Interventional cardiology expertise saves life of patient with rare artery dissection
Legacy Good Samaritan Medical Center | Heart Care
To call 45-year-old Michele Gray the picture of health would be an understatement. She runs almost daily, plays golf and tennis regularly, and enjoys all sorts of physical activities with her husband and three children. yet this past January, she suffered a heart attack as the result of a spontaneous coronary artery dissection (SCAD) of her left anterior descending artery – a relatively rare acute heart event estimated to affect only about 800 people a year in the U.S., most of them women under age 50.
"I'd played golf with friends over the long Martin Luther King, Jr. holiday weekend, got home that Monday night, then got up the next morning and went for a run before going to work," recalls Gray, a sophomore English teacher. “After work, I met some friends at the club to play tennis."
After her game, as she was chatting with other players, Gray collapsed to the floor. By chance, a fellow player was a paramedic and determined that Gray had suffered more than a fainting spell and started performing CPR. A staff member of the club, trained and experienced in using the club’s AED (automatic external defibrillator), quickly got the device, which revealed that Gray was in ventricular fibrillation, so two rounds of shock were administered. In the meantime, 9-1-1 was called and Gray was transported to Legacy Good Samaritan’s emergency department and immediately brought to the catherization lab.
“Dr. Banitt knew when he saw me that this wasn’t a typical heart attack,” she continues, referring to interventional cardiologist Peter Banitt, MD, FACC. “He'd seen SCAD a couple of times before, so when he saw the cath results – which showed the whole lower left part of my heart hadn't been getting much blood – he determined he needed to stent my LAD. An open-heart surgeon was also there in case Dr. Banitt couldn't stent it via my femoral artery.”
Dr. Banitt was successful in placing four stents in Gray’s LAD within 70 minutes of her collapse. After the cardiac intervention in the cath lab, therapeutic hypothermia (cooling of the body) was induced in the ICU to slow her metabolism and protect her brain against any damage initiated by lack of blood flow and oxygenation (although, thanks to the quick response of everyone at the athletic club, Gray’s brain had not been deprived of oxygen for more than a few minutes). She also was ventilated and heavily medicated for four days.
By Friday, she was taken off the ventilator and warmed up. “I don’t remember anything about being in the hospital until then,” she says.
On Sunday – less than a week after suffering a SCAD – she was discharged to home. Within a month, she was back to work and playing golf. And she began cardiac rehabilitation at Good Samaritan.
“Rehab for most people is to incentivize them to exercise,” Gray says. “For me, it was to give me the confidence to get back to it since there’s a lot of fear about doing things by myself. If this [SCAD] had happened while I was out running that morning, I probably wouldn't be here; I was so fortunate to be with people when it happened. And I couldn't have been luckier to have competent people around me.”
“The care I received at Legacy was and is excellent,” she continues. “I can’t say enough…while I can’t remember being in the ICU, my husband was blown away by the nurses. Dr. Banitt was so competent and able to get four stents in…he makes me feel very well cared for. And the cardiac rehab nurses – they’re amazing in there…they’re funny and kind and they listen.”
Gray admits that the randomness of SCAD is disconcerting. “I’m the last person you’d think would have a heart issue, and I keep thinking if it happened once, why not again,” she says. “But it’s also been a reminder to be in the moment, to pay attention to what’s happening now. I was super sick, but now every day is getting better. I don’t remember the low part, just the trajectory up. And I feel lucky.”