Quick action saves new mom from cardiac peril

Seven-month-old Christopher Trulley has his mom's beautiful blue eyes and easygoing disposition. But best of all, he has her.

Two weeks after her third child was born last July, Sarah Trulley suffered a spontaneous coronary artery dissection, a potentially deadly tear in one of her heart's main arteries. An uncommon condition, most patients with this artery tear are healthy young women without the conventional risk factors for heart disease.

Sudden symptoms, fast action

Trulley, of Evanston, knew something was seriously wrong when pain, which first felt like indigestion, began intensifying and was accompanied by shortness of breath and nausea.

She called her internist, who sent her straight to the emergency department at NorthShore Evanston Hospital.

As a team of emergency physicians began running tests and calling in cardiology experts, Trulley recalled being most upset about not being able to stay with and breast-feed her infant son.

A healthy, fit 36-year-old, Trulley had no immediate family history of heart disease or obvious risk factors, so a severe cardiac incident was the furthest thing from her mind.

When interventional cardiologist Dr. Justin Levisay saw Trulley's angiogram, the dissection he suspected was confirmed, likely caused by the physical stress of childbirth.

He knew it needed immediate repair.

"Sarah was so unstable - with her heart rate down to the 20s and her blood pressure plummeting - that we had to repair the dissection with a stent to open up the artery," explained Levisay, who holds an academic appointment at the University of Chicago Pritzker School of Medicine.

Precision treatment

While timing was critical, Levisay had to move very carefully to thread the wire through the artery without making the dissection worse.

Once the first of three stents was put in, the artery opened and Trulley's condition instantly improved.

When Trulley woke up, she was thrilled to have complete pain relief and in disbelief about what happened. She was also grateful to live in a region where she had such quick access to the needed expertise.

After taking it easy for a few weeks, Trulley successfully completed cardiac rehab and was cleared to resume her regular activities.

"It's very unlikely this will ever happen again," Levisay said.

Looking ahead to a healthy future, Trulley knows Christopher's birthday will always be extra special, and a reminder of just how fortunate she is to be reunited with her baby.

• This story was first published by NorthShore University HealthSystem.

Dr. Justin Levisay Photo courtesy of Jon Hillenbrand
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