Time-Life Medical

 

A Personal Account of Angioplasty
By Connie Broomfield as told to Joe Mullich

All day, my back and shoulders hurt and my arms ached. I'm a diabetic and I'd only felt this way in the past when my blood sugar level was high. I measured my blood sugar three times, and it was fine. I went out to dinner with my husband, Jim, but could hardly touch the meal because of the pain. We had to come home and I sat for a couple of hours with a heating pad.

Finally, I called my family doctor and because I am asthmatic, he thought I might have a collapsed lung. At the hospital, I was given an electrocardiogram or EKG, a test to measure the electrical impulses of the heart. A collapsed lung made sense, but I didn't know why the doctors were even concerned about my heart. I was only 40 years old. The results of the EKG were normal. I was given some asthma medication and sent home. A few hours later, I was sprawled on my bathroom floor, having a heart attack.

I try not to dwell on what happened, because I become very upset. I've been a diabetic since I was 28 and didn't realize diabetes is a risk factor for coronary artery disease, especially for people who develop diabetes as adults. I was overweight, standing at 5'1", 190 pounds. If a 40-year-old man with that medical profile came into the hospital complaining of chest pain, I suspect he'd be treated differently. He'd probably be kept overnight for evaluation.

Fortunately, my husband found me in the bathroom and brought me back to the hospital. I was given an angiogram, a procedure in which a catheter, a small tube, is inserted into your groin and guided up a blood vessel to your heart. Dye is then released into the catheter so doctors can look at a picture of your heart on a monitor. I was given a pamphlet to read explaining the procedure but I just kept thinking, "How can they put a catheter in your heart and release dye without killing you?"

During the angiogram, I could have looked at the monitor while the doctor did, but I didn't want to.
The angiogram revealed the left descending artery in my heart was blocked 98 percent by plaque, preventing an adequate flow of blood from reaching my heart. The doctor said I'd need balloon angioplasty to correct the problem. This is the same procedure as an angiogram, except instead of releasing dye, a small balloon at the end of the catheter is inflated to push back the plaque and allow more blood to flow.

I was put in the Intensive Care Unit (ICU) for two days. The doctors wanted my heart to rest from the heart attack before the angioplasty. The heart attack was mild, affecting a piece of heart muscle about the size of a dime. I felt miserable in the ICU. I was the only one there under 75 years old. I wanted to get out and walk around the hall, but I wasn't allow to.

On the day of the balloon angioplasty, I wasn't afraid because I'd already been through the angiogram. I still couldn't watch the monitor -- if I'd seen a catheter going into my heart, I think I'd have had a heart attack just from the idea of it. The cardiologist was wonderful, talking to me throughout the procedure. He told me I'd feel discomfort when the balloon was inflated. But you can't really prepare for what it's like -- you feel like you're suffocating. It's as if you can't catch a breath. The balloon had to be inflated three times to push back the plaque.

Afterwards, I returned to the ICU for two more days of rest. I was transferred to the Progressive Care Unit. I was exhausted and slept a lot. A dietitian came in and talked to me about reducing the fat in my diet. But no one told me that sometimes balloon angioplasty fails. Roughly a third of angioplasty patients develop restenosis, or renewed blockage, within six months of the procedure.

I'd been home about five days when the chest pain returned. My fingers felt like they were clogged. My arms felt strange. I returned to the hospital for another EKG and angiogram, but the results were normal. The doctors thought my artery was going into spasm, a possible complication of angioplasty. The pain didn't go away and 10 days later I was back at the hospital. This time my artery was 99 percent closed again.

It was my 41st birthday. I didn't understand why the artery was closed. I thought the angioplasty had fixed the artery. The doctors decided they would try an atherectomy, an experimental procedure that uses a high-speed cutting drill attached to a catheter to shave plaque from the artery wall. The doctors explained this is like a roto-rooter that bores into the plaque and pulls it out. That sounded good -- if the plaque was pulled out, the artery couldn't close again. While attempting to do the atherectomy, however, the doctor had difficulty. The curvature of my vessels made the procedure too difficult and the doctor was afraid he might poke a hole in my artery. After three hours, the doctors opted for balloon angioplasty again. The doctor had to try several sizes of balloons. I wasn't afraid anymore. I was mad. This time it had to work.(continued)

 

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