Heart Scare

Let me tell you about the last few months in my life. I had quite a scare a few months ago regarding my heart. I want to share with you the night it all happened and some of what I think lead up to my scare.

April 22^nd

This morning I woke and had a strange pressure in my chest. I am not feeling good. I think I am getting pneumonia. I am going to Urgent care to see if I am. Sitting in Urgent care now. Doctor came in listened to my lungs said he did not hear anything. Blood pressure was 148/102 pulse was 108. Doctor said I had a virus and I just needed to let it run its course. He did give me an inhaler and sent me on my way.

April 22^nd-April 24^th

I spent the last three days at home with a horrible headache. It hurts all the way to the back of head. I still can’t breathe very well.

April 25^th

Back to work today. Jon is gone on a diving trip. Came home from work and started to walk Captain. I walked to the middle of the first block. I feel like someone has stabbed my back. I can barely breath and I feel like I might pass out from the pain. Good thing Captain is a puller, I am going to let him pull me back to house. Finally, I am sitting on the porch. I think I have been sitting here for 30 minutes. At least the pain is gone.

April 26^th-29^th

Made it thru the weekend. I was so tired that I stayed home and tried to get better before I went back to work on Monday. Still coughing and can’t breathe very well.

April 30^th

I went to work today. I seem to be doing better. Still coughing but at least the breathing is slightly better. I am just exhausted though. Jon came home yesterday so he is getting dinner thank goodness. I decide to have a coconut ice cream pop. This will make my throat feel better from all the coughing. Nope, oh my gosh, I cannot breathe again. I am going to bed. Oh man I tried to lay down and I can’t. I can’t catch my breath. What is going on? Now I am scared. Ok I will just sleep in the chair. Jon keeps asking me if I should go to the ER. ER? Huh, they won’t find anything. Ok Jon wins we are going to the ER. Here at the ER getting checked in. My blood pressure was 183/125 and pulse was at 130. Wow that must have scared the nurse checking me in because she rushed back to a room. Now they are doing all the normal things. Getting me set up with a heart monitor, checking all my vitals, drawing lots of blood. Ugh I must go get an x-ray of my chest. Man, I can barely stand to get this x-ray. I get back to my room and off I go to get a CT Scan. I tell the nurse that I can’t breathe. Can’t I just sit on the edge of the bed to catch my breath. Nope we are on our way to the CT Scan. I feel sick, I feel like I am going to throw up. Nurse hands me a bag to throw up in. Good thing he did because I started throwing up. The nurse looks at me and says we must go back as I continue to throw up. Then I looked down and saw that it was pink. Pink? What is that? Oh my gosh I am throwing up blood. I start to panic and now I can’t breathe. He is screaming we have blood here as he rushes me back to my room. Then like the scenes in movies and tv there were people everywhere. I remember saying Please help me as I try to breathe. And that was the last thing I remember from that night.

Here are the doctor’s notes from my ER Visit. Continue to read past notes for the rest of my story.

A 49-year-old female with a history significant for hypertension, gastropathy reflux disease, obstructive sleep apnea on CPAP at home. She presented to ER with worsening dyspnea over the last week and a half. According to the patient’s spouse who is the primary source for this history in addition electronic medical record, patient was seen MidMichigan urgent care on 4/22 for symptoms of started on 4/20. Symptoms include chest tightness, cough and congestion. She was diagnosed with viral infection and given a Ventolin inhaler. Patient’s husband stated that she was taking this at home did not seem to help her shortness of breath. She initially felt that she is feeling better but then had worsening of her symptoms over the last 3 days. She finally presented to the emergency department by family vehicle at the prompting of her husband tonight.

Upon arrival to the emergency department, she was undergoing workup for pulmonary embolism when she had sudden onset hemoptysis and acute respiratory failure. She was intubated emergently and CT scan was negative for pulmonary embolism did show bilateral consolidation and small bilateral pleural effusions. Patient has not undergone any recent travel, had any recent falls, any exposure to illness. She lives alone with her husband.

Notes from Cardiologist

I have seen and examined the patient with my APP colleague. I have personally gathered history and performed my own physical exam. I have personally reviewed laboratory and diagnostic studies. I agree with the comprehensive note and plan of care.

Amy Pangborn is a 49-year-old female seen in consultation for new cardiomyopathy and LBBB. She presented to the hospital with progressive shortness of breath, hemoptysis, and peripheral edema. She was found to have ARDS as well as new CHF. She is currently intubated in ICU. Echo reviewed showing LVEF of 30-35% with no prior history of CHF. Initial focus on diuresis while also being treated for multilobar pneumonia / ARDS. Plan for ischemic evaluation when extubated. Start lasix gtt at 5 mg/hr.

General: alert, cooperative, no acute distress, critically ill

Notes from Cardiac Team

Amy Pangborn is a 49-year-old female patient who is unknown to our service. Primary cardiologist: None prior. The patient has a history of HTN, OSA compliant with CPAP and GERD and was admitted 4/30/2019 for acute respiratory failure. Sought evaluation in the ED for worsening dyspnea for the past week. While in the ED, patient has sudden onset of hemoptysis which precipitated acute respiratory failure needing emergent intubation. ED work up, negative for PE. Positive for bilateral multilobular pneumonia.

Upon evaluation of this patient she is awake but intubated. When asked, she does report dyspnea on exertion for the past few months, no chest discomfort. Does have more lower extremity edema recently than is normal. Must use 2-3 pillows at night recently to sleep. Denies PND. She is currently scared, but in no pain. No family is present, but patient requests for information to be relayed to her husband. She reports no known history of LBBB and has not had a cardiac work up previously.

May 1^st

I woke up early morning hearing my husbands voice greeting our friends Andie and Jeremy. I couldn’t talk due to the tube down my throat. I remember looking at Jon and crying wondering why my hands were tied to the bed. (I guess I was trying to tear out the tube) As tears were slowly falling down my cheeks my best friend Andie was talking to the nurses about why I still had blood all over my face and gown. She asked for a washcloth so she could wash my face. I just love her. Mama Bear was not having any of that. I remember her squeezing my hand and telling me everything was going to be ok. I was so scared. I couldn’t remember much of the night before, so Jon was telling me that I was in ICU and what had happened since I arrived in the ER.   I remember spelling out words to family and friends with my finger on my sheet. I know I had a lot of visitors that day. I am so sorry for the ones that came to visit but I don’t remember. I was heavily sedated.  Much of the day I was trying not to choke on the tube in my throat. I wanted a drink of water so bad or just an ice cube on my lips.  My room of course was right next to the ice machine which I heard being used all night.

May 2nd

I was more aware as the morning went on. I remember a Doctor coming in and talking to me about my Left Bundle Branch Block and if I had been told that I had it previously. I shook my head no. I pointed to my wedding ring and she asked me if I wanted her to relay this onto my husband. I shook my head yes. With the tube still in I could not answer the questions she was asking me, and my hands were still tied to the bed. The nurses said they would be doing a test to see if I would be ok to take the tube out. I did everything they told me to do. I wanted that tube out so bad. Sometime this day they did finally get the tube out but no ice or water for at least an hour or two. That was a longest 2 hours of my life. I just wanted a sip of water so bad. Later that day is when I finally realized how close I was to losing my life. It was one of the moments where you take a minute to collect yourself. At that moment I told Jon God must have a plan for me because I am still here. I must have more to do.

May 3^rd– May 6^th

The next few days I went from ICU to progressive care to a regular room. May 6^th I was supposed to have a Heart Cath done. One to see if I had any blockage and two to see if there was any damage done to my heart.  But I was cancelled until the next day.

May 7^th

Early morning, I went in for the Heart Cath. They found no blockages, but my heart failure rate was still in 30-35%.  I waited for most of the day to be sent home. Around 5 o’clock I was told I could go home. One week in the hospital was enough.  I was scared to leave but glad to go home to my own bed. We scheduled appointments with my family doctor, Cardiologist, and the Heart Failure Clinic. Nurse ordered all my new medications and then I was off to go home.

I just wanted to give all the nurses at MidMichigan Medical Center that took care of me a huge shout out. They were the best. Some of you made staying at the hospital so much better. You took great care of me. Saying Thank you does not seem enough.

In my next blog I will go over what has happened to me since this day. I want to share some links that helped me understand what I was going thru.

Understanding ARDS https://www.mayoclinic.org/diseases-conditions/ards/symptoms-causes/syc-20355576

Left Bundle Branch Block https://www.mayoclinic.org/diseases-conditions/bundle-branch-block/symptoms-causes/syc-20370514

Heart Failure 30-35%- Knowing your EF https://my.clevelandclinic.org/health/diseases/17069-heart-failure-understanding-heart-failure

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