A Young Woman’s Heartfelt Battle -- Won with the Help of Cardiac Rehab
September 12, 2016
Studies point time and time again to the positive effects cardiac rehab has on heart patients. The US Department of Health & Human Services’ Agency for Healthcare and Research and Quality concluded that these secondary prevention programs improve processes of care, enhance quality of life and function, reduce hospitalization, and reduce the recurrence of cardiac events. (Click here for more detail on their research). Often, though, a study involving thousands of individuals has less impact than the story of one. Here is one such story.
Chloe* was born with a ventricular septal defect, otherwise known as a hole between the right and left pumping chambers of the heart. Because of this condition, she had her first cardiac surgical intervention at only 2 years old. Unfortunately, that was the first of many.
At that time, she was diagnosed with idiopathic dilated cardiomyopathy, a condition in which the heart muscle begins to dilate, stretch out and become thin. She had a difficult time keeping up with her friends, becoming easily tired and short of breath. At age 13, she had a heart transplant, and for a while, seemed to be doing well.
At age 26, though, her health suffered once again when she had an acute transplant rejection requiring a 3-week hospitalization. She stayed on the ECMO (extracorporeal membrane oxygenation) machine for 7 days due to:
- acute systolic heart failure - when the heart muscle contracts with too little force, and
- cardiogenic shock -- when the heart suddenly fails to pump enough oxygen-rich blood throughout the body to meet the body's needs - a condition that is rare but often fatal.
She was in cardiac arrest.
The severity of cardiac arrest can be measured by one’s ejection fraction, which tells how well the heart is pumping out blood. An ejection fraction of 60 percent means that 60 percent of the total amount of blood in the left ventricle is pushed out with each heartbeat. A normal heart's ejection fraction may be between 50 and 70 percent. A measurement under 40 may be considered heart failure or cardiomyopathy. Chloe had an ejection fraction of only 10 to 15 percent.
When she was stabilized and finally discharged from this visit, she wore a LifeVest, which is a personal defibrillator that monitors the patient’s heart continuously. If the patient displays a life-threatening irregular heartbeat, the LifeVest delivers a shock to restore the patient’s heart to normal rhythm. At this point, Chloe was referred to cardiac rehab by her transplant team.
Upon starting cardiac rehab, Chloe was doing 19 minutes of exercise with a 2.9 Metabolic Equivalent level, which is the ratio comparing one’s heightened metabolic rate from activity to one’s resting metabolic rate. Her starting rate of 2.9 is roughly the equivalent of walking 2.5 mph, but Chloe, not one to give up or take the easy route, wanted to jog.
Her cardiac rehab team received clearance from her physician. By the time her cardiac rehab was complete, Chloe was doing up to 50 minutes of exercise at a greater than 10 Metabolic Equivalent level.
After 30 sessions of cardiac rehab, she followed up with her transplant team for an echo, during which she achieved an ejection fraction of 50 to 55 percent. Skeptical about the results, her physicians repeated the test. She got the same results!
“Chloe came in with the biggest smile and hugs for the cardiac rehab team following those test results,” says Virginia Ard, Senior Charge Nurse over Providence Cardiopulmonary Rehab program. The youngest participant in her class, Chloe became affectionately known as the “baby girl,” though she performed continuously like an experienced champion. The excitement she created generated tremendous camaraderie among all the program’s participants. All were at the same time, motivated by, and cheerleaders for, her work and achievement.
“We can all say that we have become ‘a better person’ watching the determination that Chloe displayed. We are so grateful to have had the opportunity to work with her in the Providence Cardiopulmonary program,” says Ard. “We may have guided her down the course, but she lead us across the finish line.”
If you would like information on the Providence Cardiopulmonary Rehab program, call 803-256-5463.
*The woman featured in this story asked that we protect her identity by changing her name, as she enters the world of young professional, beyond her condition and medical record.