OGDEN — Cecy Wells gave birth by Cesarean section two years ago in Ogden, when she was 30 years old. During her recovery in the hospital, she had significant chest pain.
At first, nurses thought this was the result of her surgery, Wells said.
The pain worsened, and she was taken to get a CT scan, a type of x-ray. As soon as the scan was done, Wells, of Brigham City, said she was rushed back to her room.
“My room was full of doctors and nurses,” Wells said. “I remember my husband came in, put his hands on my shoulders, gave me a kiss on the forehead and said ‘Everything will be OK.’ And then I don’t remember anything after that.”
Dr. Julia Ansari, an interventional cardiologist at Ogden Regional Medical Center, took a picture of Wells’ arteries and discovered that they were 99-100% closed as a result of Type I diabetes, which is associated with higher rates of heart disease.
Her heart also stopped beating.
“(Cardiogenic shock) is not just a blood vessel that is closed,” Ansari said. “It means that the patient’s blood pressure is so low that all the organs in the body get ... damaged from lack of blood flow. If you don’t intervene quickly, patients do not survive that.”
In cardiogenic shock, a person’s blood pressure drops because the heart is not able to pump, Ansari said.
The most common cause is a heart attack, but the condition can also happen under other circumstances, such as when a person is receiving chemotherapy and radiation treatment for cancer or after a woman gives birth.
If a heart is failing, it is not able to contract and open the aortic valve in the heart. It’s through the aorta that the organs receive their blood supply.
Wells was saved by a medical device called Impella — the smallest temporary heart support device that is approved by the the U.S. Food and Drug Administration in the United States, Ansari said.
The Impella device is a small pump inserted into the heart with a catheter. Part of the device is inside the left ventricle of the heart, and the other part is outside the left ventricle inside the aorta. The device sucks blood into the aorta.
An video animation demonstrating how the device operates is available at www.abiomed.com/impella/impella-50.
“It sucks all that blood flow, and it sends that blood flow in the aorta, so a failing heart doesn’t have to work hard to send the blood to all of your organs,” Ansari said.
Often the patient’s heart won’t have pumping ability for 24-72 hours. It relies instead on the device, Ansari said.
“Not everybody survives (cardiogenic shock),” Ansari said. “However, compared to years ago, when you did not have any assist device, there are a lot more patients surviving.”
The stress of pregnancy and childbirth contributed to Wells’ heart attack, but her condition was different from postpartum cardiomyopathy, a complication of childbirth that occurs when the heart muscle stops working after a woman gives birth, but the arteries of her heart are normal.
Postpartum cardiomyopathy is another cause of cardiogenic shock, so it is another condition that can be treated by Impella. It happens in 5-10% of women who give birth, Ansari said.
While the percentage may sound small, Ansari said, it’s a significant number among healthy, young women who don’t have other diseases.
According to the Centers for Disease Control and Prevention, heart disease and stroke cause the most pregnancy related deaths overall. Postpartum cardiomyopathy is the leading cause of maternal death one week to one year after delivery.