Young Mom Survives Cardiogenic Shock
Erin Hanussak, a 33-year-old wife and mother, had been under a lot of stress during the summer of 2016. She and her husband, Peter, were house hunting in Roseburg, Oregon, and Erin was adjusting to a new job. After losing their first daughter, Nevaeh (“Heaven” spelled backwards), to a congenital heart condition, Erin and Peter were rebuilding their lives back home closer to family.
Erin enjoyed an active lifestyle, often hiking with her husband and chasing around her 2-year-old-daughter, Olivia; however, in late June, she began experiencing flu-like symptoms, which only added to her stress.
Erin decided to go see a doctor for what she thought was an anxiety attack; he prescribed anti-anxiety pills, but the medication didn’t help. Even Erin's hairdresser knew that stress was taking a toll on Erin’s body when she discovered Erin’s hair was falling out. She recommended Erin see a doctor if the hair loss continued.
On the day that would have been Nevaeh’s fifth birthday, Erin – unable to tolerate the abdominal pain, nausea and vomiting and so weak she was barely able to stand – called her father to drive her to the local urgent care center. When she arrived, she was so weak she could barely stand up.
The urgent care team found Erin to be dehydrated with significantly low blood pressure. Consequently, they promptly referred her to the Emergency Room (ER) at the nearby hospital for advanced care. Upon evaluation in the ER, doctors concluded that Erin required an urgent gall bladder removal.
Subsequently, she underwent surgery later that day. However, the surgery failed to alleviate her condition as the underlying issue was not related to her gall bladder, but rather her heart. Erin was swiftly transported via MedEvac air ambulance to Providence St. Vincent Medical Center in Portland, Oregon, located 180 miles away.
By the time she arrived at the catheterization lab at Providence St. Vincent, she was in cardiogenic shock, a life-threatening condition in which the heart is suddenly unable to pump enough blood and oxygen to support the body’s vital organs. Erin’s condition deteriorated and her kidneys and liver began to fail. “She was on the verge of complete collapse” Dr. Jacob Abraham said.
Dr. Abraham and his colleagues suspected that Erin had myocarditis – a life-threatening inflammation of the heart muscle that can affect its rhythm and ability to pump. There are many potential causes for myocarditis, including infection; often, the cause is unknown. The prognosis varies, but myocarditis can lead to heart failure, arrhythmias, heart attack or sudden cardiac death. Myocarditis typically occurs in otherwise healthy people like Erin; in fact, up to one in five sudden deaths among young adults is due to myocarditis.
Dr. Abraham and colleagues knew Erin’s heart needed support and decided to implant the Impella CP® heart pump to allow Erin’s heart and allow it to rest and recover.
A week after she went in for gall bladder surgery, Erin woke up. Thoughts raced through her mind: "Was I in a car accident? Somebody had better tell my boss I'm not coming into work."
According to Dr. Abraham, Erin's ejection fraction – which measure the amount of blood a hear is able to pump – was dangerously low at 15 percent. Although Erin improved with the help of Impella CP, her heart still needed additional support, so doctors wanted to try a more powerful pump – the Impella 5.0®. The Impella 5.0 was inserted through her axillary artery near her collarbone, allowing Erin to sit up in bed – and, potentially, to leave her bed to move around.
While on Impella 5.0 support, Erin because stronger and was able to begin physical therapy and walk up and down the hospital corridors. Her kidneys began to improve and the Impella was explanted. Her ejection fraction was up to 50 percent, just under normal (55 percent and higher).
Erin's heart had recovered and she was able to finally go home to her husband and daughter. The day she went home was the three-year anniversary of Nevaeh’s death.
“Not a day or an hour goes by that I don’t think about her,” Erin said. “She’ll always have a special place in my heart.” In fact, she felt that Nevaeh was with her from the moment she woke up at Providence St. Vincent Medical Center.
Erin continued to regain her strength. Erin’s ejection fraction is now between 60-65 percent and today, she is picking up Olivia and chasing her around. She has a new job as medical coder, helping patients navigate insurance.
“There’s nothing I feel I can’t do,” Erin said.
That includes hiking to see new waterfalls with her husband.
Erin is eager to share her story – and her daughter's heart disease story – as a Heart Recovery Advocate. She enjoys working with patient advocacy groups, such as Mended Hearts and Mended Little Hearts, a patient group for patients with congenital heart disease like Nevaeh.
When Erin was discharged, Dr. Abraham noticed a drawing filled the whiteboard on the wall by Erin’s bed. It was a heart with wings, drawn by Erin’s father-in-law. He took a photo of the drawing with his smartphone.
Today, Erin is happy to be alive thanks to the amazing care she received, the support of her friends and family, and the Impella heart pump. One of the first things she did after leaving the hospital was to go to a park and breathe fresh air.
IMP-1964