Memorial Hermann doctor survives rare heart attack during pregnancy
HOUSTON - We're used to talking to Dr. Annamaria Macaluso Davidson as an expert from Memorial Hermann to help our viewers. This time, we're featuring her as the patient!
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She and her baby's lives were both at risk when she suffered a rare type of heart attack toward the end of her pregnancy. Doctors were able to spare them both at the hospital where she works at Memorial Hermann-Memorial City in west Houston.
Dr. Annamaria Macaluso Davidson is now home with her happy and healthy baby, Charlotte.
This busy mother of five children survived a major medical crisis.
"So, the pregnancy really had gone well and was uneventful during the whole course. I was close to delivery at about 37 weeks and was just here [at home] working, and I started feeling bad," explains Annamaria. "I had some chest pain and back pain, felt nauseous. I wasn't quite sure what was going on."
Since she is both a doctor and an experienced mom, she knew she couldn't ignore those symptoms and rushed to Memorial Hermann-Memorial City.
"It got really serious really quickly!" explains Annamaria. I went in knowing it's not just about me, just making sure my baby is OK." Then, when things were serious, there was a conversation of who can we save, do we save mom first, do we save baby first."
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Dr. James O'Neill wasn't originally on the work schedule that day and helped make that crucial decision. He was unexpectedly filling in for someone, and now believes it was meant to be that he was there that fateful day.
"I thought, ‘OK, if we send her for a c-section and her cardiac condition becomes unstable during that surgery, that can be a threat to her life,'" he said. "If we take her to the Cardiac Cath Lab, and we have to commit her to blood thinners that could lead to life-threatening bleeding during delivery of the baby,’ or if she became unstable in the Cath Lab and the baby was still in there, that could even be a threat to both of their lives.'"
"So, I decided to advise them to take her for an emergency c-section, so that the baby can be safe and delivered, and then we could do whatever we needed to do for her heart," Dr. O'Neil continued.
Baby Charlotte was successfully delivered via c-section with the skills of an obstetrician, then it was time to address Annamaria's life-threatening heart condition after she was transferred to the Cardiac Catheterization Lab (Cath Lab).
"I inserted a small plastic tube called a catheter into the radial artery in the arm, and I advanced the catheter through the arm, up the interstate highway to the heart, and once the tip of that catheter is in the heart, we inject dye into both the left and the right coronary artery to locate where the problem is," says Dr. O'Neill. "With Annamaria being a pregnant woman, I already had a suspicion that she had a condition called spontaneous coronary artery dissection (SCAD). This is the most common reason for which a pregnant woman would present with a heart attack."
The exam proved his suspicions were correct. Dr. O'Neill explains that this is different from a classic heart attack which is typically caused by plaque or a blood clot.
"With SCAD, a small tear forms on the interior of the vessel wall, such that the vessel wall separates, and you can actually have bleeding into the wall of the artery, and then that compresses the true lumen of the artery, so that obstructs flow going down the artery, so it's a different type of heart attack. It's very rare," he states.
"That can happen for different reasons, but sometimes when you're older and pregnant, or you've had multiple kids," Annamaria states.
She survived the first scare and was ready to meet her newborn baby! That happened while she was in the intensive care unit (ICU).
"As soon as I woke up from that first heart attack, they were able to bring her to me, and Brandon (husband) was able to show me pictures of the other four kids meeting her and getting to see her and hold her, so that was really special," says a smiling Annamaria.
They were all hoping her medical drama was over. Dr. O'Neill says the protocol for SCAD is to wait and not place a stent, as 90% of cases heal once blood flow is restored. Annamaria was being closely monitored in the hospital, just in case.
Days later, her condition worsened into a major heart attack, and she was rushed back into the Cardiac Cath Lab.
"I'd given her husband my phone number and I saw his name pop up on my phone," explains Dr. O'Neill. "He said that she was having a sudden onset of really severe chest pain for the first time since she arrived in the emergency room, so at that point, I canceled my office hours and the rest of my clinic patients, and I started running over to the hospital and anticipating that she would likely need an emergency bypass surgery."
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"I took a new set of pictures, which confirmed the issue," he continued. "I put a pump in her heart called an Impella, which helped offload her heart and support her circulation while we were getting the operating room set up to take some of that load off the heart, which was not getting flow down that artery."
Then she was prepped for open heart bypass surgery with a surgical team that specializes in that. Her case was so severe, Dr. O'Neill expressed his concerns to another surgeon.
"I'll never forget his response," states Dr. O'Neill. "It was very inspiring the way he said confidently, 'I can do it', and it was just like that, so he took her immediately to the operating room. He put a bypass graft on and just performed the surgery flawlessly and saved her from that heart attack! It made me realize how amazing it is to be part of this journey to help a loving mom of five."
During her two weeks in the hospital, Annamaria was still trying to pull off her mom duties, keeping up with her children at home, and talking to them via FaceTime.
"I was really missing them but knew they were being well taken care of," explains Annamaria. "I tried to keep up, processing it all and thinking about different things for school, all while trying to focus on getting stronger and healthier, so I could be back and enjoy their basketball games and all the things they're involved in."
In the meantime, her colleagues at Memorial Hermann were giving her plenty of tender loving care.
"The team was so wonderful. I was definitely wearing a different hat to be on the receiving end," exclaims Annamaria. "The way they cared for me with simple things that I couldn't do for myself, even cheering me on while I was brushing my teeth, and then there was their expertise, handling these hard conversations. It was just wonderful to see them in their element and doing the amazing things they do every day and be on the receiving end of that."
In the middle of it all, Dr. Davidson and Dr. O'Neill realized they go to the same church and their pastor prayed over both of them at the hospital. They believe those prayers were answered!
"The whole situation is remarkable!," states a matter-of-fact Dr. O'Neill. "To be able to see her through this frightening, life-threatening high-risk event and see her come through to the other side and be back with her family where she belongs is one of the most special experiences of my career; in fact, probably the most meaningful case of my career so far."
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It's certainly a blessing for Annamaria to be back home, truly cherishing her family now, more than ever.
"It's so amazing, I'm so thankful," she concludes.
To learn more about heart attacks, click here. For more information on Memorial Hermann's Heart and Vascular Disease, visit their website. You can also learn about the services Memorial Hermann offers by clicking here.