Speaking from the heart

Ruby Wright always thought she would know if she were having a heart attack. In fact, her father had nine heart attacks during the last 15 years of his life, so Ruby was familiar with the telltale signs, such as pain radiating down the left arm, the feeling of an elephant sitting on your chest, or severe heartburn.

So, on Tuesday, March 26, 2013, when Ruby found herself in the emergency department at Mount Nittany Medical Center, she was bewildered to learn that she had just suffered a heart attack.

Ruby 1000x715Leading up to that fateful day, Ruby admits she hadn’t been feeling quite like herself.

“I had awful ear pain Sunday and Monday,” said Ruby, who described the pain as a stabbing sensation in her ear. “I also had a sore throat, was a little achy, and felt some odd pain near my right shoulder joint.”

The symptoms weren’t debilitating, so Ruby chalked it up to an ear infection that she had probably contracted from one of her granddaughters, and went about her day-to-day activities.

By Tuesday morning, Ruby still wasn’t feeling better. In addition to the other symptoms, Ruby now had pain in her jaw and heartburn. She even remembers grabbing a pack of Tums® at the store on the way to work at Mount Nittany Health.

“By midday, I knew I needed something for the ear pain,” said Ruby. “I called over to my friend Adam Hoover (RN, clinical supervisor) in the emergency department and asked him what he thought.”

The hard truth

But Adam didn’t tell Ruby what she wanted to hear. Instead, he encouraged Ruby to come over to the emergency department to be checked.

“When I got to the emergency department, they performed an electrocardiogram (EKG) and ran blood work, but neither of these tests proved that I was having a heart attack. In fact, the blood test was only slightly elevated for a heart attack. Because of how I described my symptoms, they decided I was going to be admitted and have a cardiac catheterization the next day,” Ruby recalls.

Ruby later found out she was having a “silent heart attack,” where normal heart attack signals may not show up on an EKG or in blood work. In most instances, when a patient arrives at the hospital with chest pain, a physician will order blood work and an EKG to determine if the chest pain is being caused by a heart attack. There are specific cardiac markers that present in the blood that can signify the patient is having a heart attack, and if the blood test does not show anything out of order, an EKG will typically show something suspicious. But, in Ruby’s case, you could say that more of a gut reaction from the physician was necessary.

Cardiac catheterization

The next morning, Ruby’s nerves were running rampant.

“I did not want to have this done, but I knew it was for the best. I was so thankful for the staff in the cath lab though,” said Ruby. “They did such an amazing job at keeping me calm and explaining the entire procedure.”

During Ruby’s cardiac catheterization, a long, thin, flexible tube (catheter) with dye was inserted into her femoral artery and showed 95 percent blockage of the left artery and 75 percent blockage of the right. The cardiac team put two stents in Ruby’s left artery.

“My doctor and I discussed changing my diet, adding in more exercise, and using prescription medication to try to treat the blockage in the right artery, rather than putting in another stent. So, after the cardiac cath, I was back home in three days, and back to work a week later.”

Ruby describes her entire experience as smooth, from start to finish. “I was so impressed by everyone. The emergency department staff, the nursing staff, the cardiac cath lab team and the cardiac rehabilitation team were all amazing. I can’t thank them enough,” she said.

Skyrocketing energy

RubyMany aspects of Ruby’s life changed after her heart attack. Although she had already quit smoking in September 2012, Ruby quit eating chocolate and ice cream after her attack. She planted a garden with her granddaughters and added fresh veggies to her meals. She even clipped a pedometer on her hip and aimed for 10,000 steps of activity each day.

“After the heart attack, I noticed my energy levels just skyrocketed. I felt so much better than I had in years,” she smiles. “I had been taking karate for a while, so I kept that up, and also attended cardiac rehabilitation twice each week.”

Additionally, Ruby tried to cut the added stress out of her life. Now, she no longer worries so much when her desk at work is piled with papers. She’s even changed the rock music she’s always loved to something a bit softer.

“I know what’s important now,” Ruby said, referring to her family and her quarter horse, Cheyenne. “I had to make more time for me and for my family. That’s what matters most.”

But as vigilant as Ruby was with her diet, exercise, and medication, just over three months later, on July 1, 2013, Ruby had a second heart attack.

The days leading up to the attack began with a similar pain in Ruby’s shoulder joint. “I had no jaw pain and no other symptoms, so again, I just chalked it up to something else. I thought maybe it was lingering pain from brushing my horse.”

But when Ruby and her granddaughter attended karate that night, all of a sudden it felt as if someone had dumped an entire bucket of water over her head. She was suddenly drenched in sweat.

“I knew something wasn’t quite right at that point,” said Ruby. “I had developed a little bit of pain in between my shoulder blades, but I still wasn’t sure what was wrong. I decided to take a nitroglycerin tab that I always carry with me, just in case this was another heart attack, and I went to sleep.”

When Ruby woke the next morning, it was as if she were having déjà vu. The jaw pain she remembered from the first heart attack was back.

“I went in to work the morning of July 1 and called my cardiologist, right away. I was admitted for the blockage in my right artery,” she said. Albert Zoda, MD, FACC, cardiology, Mount Nittany Physician Group, performed another catheterization, in which a stent was put into place in the right artery.

Similar in almost every way to her previous attack, Ruby said she was treated with nothing but compassion every step of the way.

“The cardiac rehabilitation department was great both times. They really pushed me, and if I had a good day, they’d give me more to do the next time,” Ruby said with a laugh.

Signs in women

Since her two heart attacks, Ruby has made it her mission to tell her story to anyone who will listen. “I especially want all women to know that female heart attack symptoms can be very different from what men experience. Don’t ignore your pain or make excuses about the pain, especially if it’s not something you’ve experienced before,” said Ruby.

And how is she today? “People might think my heart is damaged from the attacks, but actually, it’s like a brand new, re-built heart. I have no more blockage, and there was no damage done to my heart from these heart attacks,” Ruby said with a smile.