ICU Nurses Save One of Their Own

On April 7, 2020, as Gina and her team at Saddleback Medical Center were preparing for a COVID patient surge, she was in the process of developing standard work for personal protective equipment (PPE) and cross training non-ICU nurses. Suddenly, she noticed pressure in her chest that did not feel normal.

“At first I felt uneasy, then I remember feeling intense pressure in my chest that wasn’t stopping, and I knew I shouldn’t be alone,” says Gina. “I went to my fellow nurses and told them what I was feeling, thinking it was a panic attack. While they quickly started checking on me, I felt a tingling sensation go down both of my arms.”

Recognizing the Signs: When Chest Pain Can Signal More

The pressure centered in her sternum - the vertical bone at the center of the chest protecting the heart and lungs. Once she was hooked up to a heart monitor, her team noticed irregular ventricular beats coming in twos, called bigeminy - a cardiac arrhythmia in which every other heartbeat is irregular. Gina was then rushed to the Emergency Department (ER), where IVs were put in, labs were drawn, and a 12-lead Electrocardiogram (EKG) was ordered.

“It was a surreal feeling. I have always been on the other side, helping patients or helping nurses in providing care,” Gina reflects. “I was now the patient, but I felt comforted knowing my coworkers were well equipped for this situation.”

Gina’s EKG was abnormal, showing signs of an ST segment changes, which is a segment on the EKG showing decreased blood flow in a part of the heart. Gina was diagnosed with acute anterolateral infarct, which is a heart attack that occurs when the Left Anterior Descending (LAD) coronary artery is blocked, reducing blood supply to the heart muscle, and causing cell death. She was then taken to the Cardiac Catheterization Lab, where interventional cardiologists were able to thoroughly analyze her heart and provide immediate care.

The Cardiac Catheterization Lab: Saving Patients with Minimally Invasive Procedures

The cardiac catheterization lab, part of MemorialCare’s Heart & Vascular Institute, focuses on caring for complex cardiovascular issues through a minimally invasive first approach. Utilizing the least invasive percutaneous techniques and specialized equipment, the interventional cardiologist performs the same lifesaving procedures while avoiding traditional open-heart surgery, allowing patients to get back to their lives quicker by saving healthy tissue, reducing scarring, and bleeding, and accelerating recovery time.

By using the catheterization lab, Gina’s care team was able to access advanced digital imaging equipment and electrophysiological mapping systems. The time-mapping system is a crucial tool that enables cardiologists to pinpoint irregularities in real time with unmatched precision. The lab’s 24/7 accessibility ensured Gina could receive the treatment quickly, as expert cardiologists were immediately available.

Once in the catheterization lab, Dr. Allen Kuo, cardiologist, interventional cardiology, Pacific Cardiovascular Associates (PCA) Medical Group, was able to identify that Gina had experienced a Spontaneous Coronary Artery Dissection (SCAD).

“This was a very rare cardiac event, most cardiologist never see it,” said Dr. Kuo. “Thankfully, I have seen it before and had experience with it, which is why I decided to then perform a percutaneous transluminal coronary angioplasty.”

Percutaneous Transluminal Coronary Angioplasty

“Percutaneous coronary angioplasty is a minimally invasive procedure that allows us to restore blood flow in blocked arteries efficiently. Gina’s case required careful planning and swift action, which our team is well-trained to handle,” says Dr. Kuo.

Coronary stents are often placed during Percutaneous Transluminal Coronary Angioplasty. Coronary stent implants help hold an artery open so that blood can flow through the blocked or clogged coronary artery. The stent, a small, lattice-shaped wire mesh tube, props open the coronary artery and remains permanently in place. The stent is passed through the catheter and implanted in the coronary artery.

Patients can usually go home the next day and in many cases the same day once the sedation from the procedure has worn off and the ‘puncture site’ from the catheter shows no sign of bleeding.

“It’s always unique when a fellow nurse becomes a patient. Gina’s insight and trust in the process inspired our team to ensure she received exceptional care,” says Dr. Kuo.

Understanding SCAD – A Rare Heart Attack

Prior to this event, Gina had no known health issues. She was diagnosed with Spontaneous Coronary Artery Dissection (SCAD). SCAD is a tear in the wall of a heart artery that can block or slow down blood flow of the heart. It is an emergency condition that if left without care can lead to:

• Heart attacks
• Heart rhythm problems
• Sudden death

SCAD primarily affects women who are in their 40s or 50s or postpartum after childbirth. SCAD occurs without warning, making awareness of symptoms critical. Women’s symptoms are often different and more subtle than men’s. Know the signs of heart attack:

• Chest pain
• Shortness of breath
• Pain (jaw, neck, back, arm, shoulder)
• Nausea or vomiting
• Heartburn/indigestion/stomach pain
• Extreme fatigue
• Sweating

If you believe you are experiencing SCAD or a heart attack, seek immediate help and call 911.

“I couldn’t believe this was happening to me, I never had any prior health issues,” says Gina.

Although she was frightened, Gina felt reassured knowing she was in the hands of the ICU nurses who were fully trained to manage her condition. In cases like Gina’s, immediate and accurate assessment is crucial.

“As ICU nurses, we focus on stabilizing patients while ensuring they feel supported and informed throughout their care,” says Gina.

Alongside the nurses, Gina was also supported by the catheterization lab experts, who specialize in heart and vascular health, assessing each patient’s condition and tailoring care accordingly.

“The catheterization lab is equipped with advanced tools and a skilled team to quickly identify and treat heart-related emergencies like SCAD,” says Jill Christian, RN, clinical II, MemorialCare Heart and Vascular Institute. “For Gina, she was well aware of the process but now got to experience the personalized care we provide for our patients.”

“When I close my eyes and reflect on those moments, I recall feeling the whole cath lab team and the grace of God around me, saving me,” says Gina. “Everyone caring for me, efficiently rushing in with a well-coordinated approach.”

Gina was admitted to MemorialCare Saddleback Medical Center for five days while under close supervision for any recurring symptoms. During her first night, the pressure in her chest returned, but the nurses and doctors acted quickly to relieve it and ensure her heart remained stable.

Life After a Heart Event

After her release, Gina recovered at home while her care team at Saddleback Medical Center continued to support her. She slowly increased physical activity working through Saddleback Medical Center’s cardiac rehabilitation program.

“Cardiac rehab was a huge part of my emotional recovery as I could test out my body under the careful watch of the nurses.” Although recurrence of SCAD is rare, it can happen. “At first I was scared to do physical exercise and now I’m back to Zumba.”

Today, Gina’s journey continues as she closely monitors her heart health with the support of her medical team at MemorialCare.

Gina’s story serves as a powerful message about the importance of early detection and practicing heart care. To see if you have any potential heart issues, take our free Heart Assessment Quiz. To learn more about SCAD, visit the SCAD Research website.