Listen to Your Heart

February is Heart Awareness Month and knowing your body and listening to it can mean the difference between a healthy life or a devastating alternative

By JONATHAN SCOT

When Julia Brokmeyer woke up on a Monday morning in October 2017, she had no indication that by the evening she would be in FirstHealth Moore Regional Hospital, not knowing if she would live another day. Brokmeyer was only 43, thin, active, with no particular risk factors. She felt great.

Brokmeyer and her husband were remodeling the kitchen in their Southern Pines home. In the afternoon she went upstairs where it was a little quieter to help her son with homework. Then her life changed.

Her chest began to burn and suddenly felt as if it were going to explode. In the midst of the excruciating pain, she managed to gather her wits. Julia called her husband and told him that something terrible was happening. “He could have just dismissed it,” she remembers. “But, thankfully, he understood. He told me to get help immediately.”

Brokmeyer went downstairs and interrupted the workmen in her kitchen. “You're not going to believe this,” she told them. “I think I'm having a heart attack.”

They did believe it. One of them drove her to Urgent Care, where an ambulance was called to take her to FirstHealth Moore Regional Hospital. The physicians there first eliminated the possibility that her symptoms were being caused by something less serious. “There's a chemical called troponin that the heart releases when it has an attack. When they found that in my blood, they brought in Dr. Kent.”

Steven Kent, M.D., is one of 18 cardiologists at FirstHealth. With over 20 years of experience, he was able to make a difficult diagnosis. “There's a condition called spontaneous coronary artery dissection, or SCAD,” he says. “It was thought to be rare, but now we're finding it's likely to have just been misdiagnosed. It most often affects younger, otherwise healthy women.”

“SCAD is a tearing of the inner lining of the vessels that carry blood to the heart muscle. What made Julia's diagnosis so difficult was that the procedure to put in a stent, or support, could easily cause more tearing.”

“It was my fourth day in the hospital,” says Brokmeyer. “Dr. Kent came to tell my husband and me that I would be facing a risky procedure. We had to make a life and death decision.”

Brokmeyer's husband remembers the agony of being in the waiting room. “He knew the surgery had been a success the minute he saw Dr. Kent’s face,” Brokmeyer says. “Dr. Kent was so caring, and it was clear that he and the entire staff at FirstHealth know exactly what they’re doing.”

The procedure, which was performed primarily by cardiac surgeon Patrick Simpson, M.D., was a complete success. Brokmeyer says she immediately felt better following surgery. She looked in the mirror and was delighted that the color had returned to her cheeks for the first time in days. 

Fortunately for her, the staff at FirstHealth's Reid Heart Center was well prepared to deal with her condition. The five-story facility itself contains six operating rooms equipped with the region’s most advanced electrophysiology equipment. 

Since 2014, the Valve Center team has been successfully performing a highly-advanced procedure called a Transcatheter Aortic Valve Replacement, or TAVR. It involves delivering an artificial heart valve replacement to repair a damaged one through the body's own system of blood vessels. It eliminates the need for open heart surgery for some patients.

“We’ve had outcomes well beyond the national average,” says Steven J. Filby, M.D., an interventional cardiologist. “That’s a fairly remarkable run.”

TAVR can also mean that the patient may have minimal, or what's called “conscious” sedation during the operation. The newest replacement valves are now made smaller, which means a smaller incision and faster recovery.

“It's common for a patient to be sitting up in a chair and walking shortly afterward, which is pretty tremendous,” Filby says.

Two days after Brokmeyer's surgery she was back home. It took her a while to fully feel like herself again, but she can confidently expect to be around when her children are grown. “This kind of thing really makes you appreciate your family and your life,” she says.

Today, she's back running the business she started in 2015, a local online guide of things to do and places to go called Moore Choices. She was left with three small dots on her wrist—scars from where the catheterization to reach her heart had been inserted. Recently she had the design of a heart tattooed inside the area of the three dots. The significance of the image is difficult to miss.

“It's a reminder that life is precious,” she says. “And that every day is a gift.”