Beat the Widowmaker: Surprise Attack | Kendra's Story
Kendra Kasischke thought she was at low risk for heart problems. At Mary Greeley, she learned she wasn’t.
Heart disease runs in Kendra Kasischke’s family, so she was relieved when a health screening indicated she was considered low risk.
A few months after the screening, she went on a vacation to West Virginia, hiking in the mountains with friends. It was hot, but she felt great.
Then, a few weeks after returning home from her trip, Kendra had a heart attack.
Unpredictable Problems
Kendra’s story is an example of how heart problems can be unpredictable, and how symptoms can present themselves in different ways.
“My chest never hurt, but I learned that signs can vary so much between women and men,” she says. “The lesson here is pay attention to your body. Everyone’s symptoms are different, and what you see on television isn’t necessarily how it happens.”
She lost her mom to congestive heart failure, and her father and brother have both had open heart surgery. That family health history was on her mind when she decided to retire after running a wedding venue business.
“I retired a year ago and made a goal to focus on my health,” she says. “I did a screening, and it came back great. It may have given me a false sense of security.”
Kendra relocated to Ames to be closer to family. She had a goal of reducing her cholesterol, so started watching her diet and made walking part of her health routine. On a walk one morning in early July, her left arm started aching, but she didn’t worry too much about it. On another walk a few days later, and just a few blocks from her home, she felt discomfort in her arm again. She blamed it on the heat but later experienced the ache in her arm briefly while relaxing at home.
The next morning, her back started to hurt, too. She called an urgent care clinic, shared her symptoms, and was told to go straight to the Mary Greeley Emergency Department. The pain had subsided, so she drove herself.
Kendra arrived around 1:30 p.m.; a blood test and chest x-ray quickly followed. She also had two EKGs, each about an hour apart. The EKG showed changes, concerning for a blockage, in one of the major arteries of the heart.
“The cardiac team descended on my room. There was someone working on every part of my body,” she says.
Widowmaker Risk
In Kendra’s case, the blockage was in her left anterior descending artery. It’s one of the major arteries supplying blood to the heart muscle; when completely blocked, it is often referred to as the widowmaker.
Dr. Ravinder Dervesh with the MercyOne/Iowa Heart Center was on call in Mary Greeley’s Cardiac Cath Lab when he received Kendra’s EKG results.
“The EKG had shown a high-risk abnormality, and I didn’t waste any time,” says Dr. Dervesh. “I rushed to emergency, saw her, and urgently brought her to the cath lab.”
Kendra was immediately transferred to Mary Greeley’s Cardiac Cath Lab.
“They told me, ‘If you’re afraid of a fast ride, close your eyes,” she says. “There was definitely a sense of urgency, which I appreciated.”
At 3:23 p.m., Kendra arrived at Mary Greeley’s Cardiac Cath Lab, where Dr. Dervesh performed coronary angiography that confirmed a very tight, 95 percent blockage in the left anterior descending artery. A stent was placed in the artery to restore normal blood flow. The procedure was completed in 30 minutes.
Kendra’s sister is a nurse, and her niece is a nurse practitioner. Her niece rushed to the hospital to be with her aunt. Having family present is always appreciated, says Dr. Dervesh.
“They kept me very informed,” says Kendra. “I am a big proponent of patient advocacy and having someone there with me was important. My niece felt respected and part of the team.”
Kendra likely experienced a cardiac event over the span of several days as her heart function ultimately dropped to 35-40 percent; normal is 55 or above, says Dervesh.
“I suspect that for at least 24 hours before she arrived at Mary Greeley, the artery was intermittent becoming completely blocked, which caused her symptoms to worsen and ultimately led her to come to our emergency department,” he says.
Symptom Alert
Dervesh recommends doing calcium score screenings for heart risk.
“Low risk doesn’t mean zero risk. You can still have cardiovascular issues,” he says. “Screening is especially recommended for people who have risk factors like high blood pressure, high cholesterol, diabetes, or family history of cardiovascular disease.”
Women usually present with atypical symptoms and may not realize they are experiencing a heart attack, Dervesh notes.
“Don’t just look for chest pain,” he says. “Also look for atypical symptoms like upper abdominal pain, nausea, vomiting, and shortness of breath.”
Kendra’s heart function is down, and the hope is opening the coronary artery and appropriate medications will help to improve it, says Dervesh.
She’s now taking medications and completed a six-week cardiac rehab program at Mary Greeley. Cardiac rehab allows you to learn more about your heart, how to monitor your vitals, and ask questions as you recover. Her outlook is as calm and optimistic as it was the day she arrived at Mary Greeley.
“I didn’t feel a need to panic,” she said. “I felt like I was at the right place, and they were going to take care of me. They took it seriously. There was a real sense of urgency, and they kept me informed. God was watching over me and my medical team.” ■
