If you were going to name someone you thought likely to have a heart attack, Kayla Wolthoff of Luzerne would not be on your list.
She’s 30 years old, she watches what she eats and in addition to her job in special education, she’s a fitness instructor who rides her Peloton and enjoys long walks with her dog.
“I live a very active lifestyle,” she said. “And my diet was pretty clean. I always tried to eat whole foods, and organic.”
“A close friend was diagnosed with breast cancer a while back, and that scared me because she was the healthiest person I know,” Wolthoff said, explaining her friend’s situation motivated her to be even more health conscious.
“That’s not to say I don’t have pizza every once in a while,” Wolthoff admitted.
Speaking of spicy food, when Wolthoff experienced what she thought was “really bad heartburn” on May 6, she chalked it up to the “really spicy” meal she’d eaten the previous day, in honor of Cinco de Mayo.
“I re-hydrated all that day and took Tums,” she said. “Nothing was helping, but the next day, May 7, I was fine.”
The next month, it happened again with “bad pain in my back, between my shoulder blades. It radiated to my chest and arms.”
Those are symptoms of a heart attack, especially in women, Geisinger cardiologist Dr. Eva Vaishnav explained during a recent telephone interview. And if you experience those symptoms, you should go to the emergency room.
“The main thing is, just recognizing heart attacks in young women,” Vaishnav said. “You’re young, you’re healthy, you don’t necessarily think you’re going to have a heart attack. But there needs to be more awareness on both sides.”
Just as young, healthy patients don’t expect to have a heart attack, their primary health care providers may not expect them to have a heart attack either.
As Wolthoff experienced more pain throughout the summer, she thought she had acid reflux; her primary care provider ordered an ultrasound of her gall bladder “and it came back perfectly normal.”
“It was happening a couple times a week,” said Wolthoff, who was scrutinizing her diet, wondering if perhaps the arugula she’d eaten was triggering the discomfort.
What Wolthoff didn’t realize was that she was suffering from a rare condition known as spontaneous coronary artery dissection, or SCAD for short.
SCAD occurs when a tear forms in a blood vessel in the heart. Little is known about what causes SCAD, but it is more common in women than in men, and it can lead to a heart attack, a problem with heart rhythm or even sudden death.
On Aug. 22 Wolthoff went to her fitness class, as usual, at the Salt Barre in Pittston. Afterward, she experienced a feeling in her back that made her think “It’s gonna be a bad day.”
She took a shower, hoping it would make the pain subside. She vomited, again and again. “My boyfriend called the doctor and the P.A. said ‘go to the emergency room.’ “
“My body was clammy. I was dizzy. The pain in my chest and in my back was unbearable at this point,” Wolthoff said.
At the Wilkes-Barre General Hospital emergency room, Wolthoff remembered, “I had to sit there for two hours. By the time I went back to triage, I was also having pain in my jaw. The pain was getting worse and worse and worse. I started passing out.”
The patient later learned what she was going through was “worse that a ‘widow-maker.’ ” The medical team inserted three stents, but still Wolthoff was going into heart failure.
Put into a medically induced coma and intubated, Wolthoff said, “I was very very unstable.”
Her boyfriend, John Waleski, was told she needed to be transferred to a facility with an ECMO. That machine provides extracorporeal membrane oxygenation, giving the heart and lungs a rest by pumping and oxygenating a patient’s blood outside the body.
The University of Pennsylvania Health System accepted her, but severe thunderstorms made a flight to Philadelphia too dangerous. Instead, Wolthoff was Life Flighted to the Geisinger Medical Center in Danville.
“When I arrived at Danville, I was ‘dead’,” she said. “But they all saved my life. There was continuous life-saving going on that day.”
Wolthoff was hooked up to the ECMO for days, and when she was finally free of tubes it took her a few more days before she was strong enough to sit up in bed. But by Labor Day weekend, she was determined to go home.
Her rehab had started with small steps with a walker, then without a walker, followed by laps around the ICU.
“I had to relearn how to walk,” she said, recalling she also had to build up her stamina so she could climb a flight of stairs without stopping to catch her breath.
When she started walking outdoors, Wolthoff said, “It took a very long time to just go around the block. I would get very winded.”
But she has persevered.
“I’m able to walk over a mile and keep my heart rate low,” she said during a recent interview, noting she and her boyfriend enjoy taking their two golden-doodles, Ellie and Reggie, for a walk. “I’m slowly getting back to the Peloton, at low intensity.”
She also regularly attends cardiac rehab sessions, supervised by a Geisinger clinical exercise physiologist.
“I want everyone to understand it’s important to live a healthy lifestyle,” Wolthoff said. “And something like this can happen to anyone, even the healthiest person.”
“One of my purposes now is to push for more research” into SCAD, she said.
Wolthoff and Vaishnav agree that Wolthoff’s healthy lifestyle has led to an easier recovery for her.
“Kayla did not come into this with a long list of other problems,” the cardiologist said. “I think it was quite the asset.”
Physician and patient also agree that more research is needed regarding SCAD, which may be responsible for 35 percent of heart attacks in women younger than 50.