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Heart Attack, Catheterization

Dottie OBrien 570

Published: December 2010

October 25, 2009 dawned a perfect, sunny fall Sunday. For Dottie O'Brien, 63, of West Chester, it was her first day home after a week watching her two grandchildren -- "the joy of my life," she calls them -- on Long Island, NY. It had been an enjoyable, but busy week.

"I remember sitting at the kitchen table with my husband, Terry, and thinking how wonderful it was to just sit there and have a hot cup of coffee," Dottie says. "He went out to work in the yard, and I started trying to get caught up after the week away."

Before long, though, Dottie wasn't feeling quite right. She had some pain in her jaw that she initially ignored, but soon it turned into what she describes as a "radiating" sensation. And then the pain moved down into her chest.

"I knew I had never felt anything like this before," Dottie says. "I went to lie on the couch for a few minutes, thinking maybe I was just tired from the week away, but then I realized this was something I could not ignore."

As the pain worsened, she waved her husband into the house and told him about her symptoms. Terry acted quickly: He gave her two baby aspirin to chew, dialed 9-1-1, and called their son, Kelly, who lives nearby. Dottie recalls that the ambulance arrived quickly, but by that time she could barely talk through the pain.

Dottie did have some risk factors for heart disease, including her age, a strong family history, and a diagnosis of late-onset Type 1 diabetes at age 40 (Type 1 or juvenile diabetes usually develops in childhood). But, she had done everything she could to counter those risk factors: she ate right and exercised regularly by biking, golfing, and going to the gym. In her mid-50s, she began seeing a cardiologist for regular workups, since her father and brothers were affected by heart disease. Dottie had completed a full battery of tests three months before, and they all came back normal.

"I have to say I am grateful that I presented with the classic heart attack symptom of crushing chest pain," Dottie says. "I know that women often experience different symptoms, such as fatigue or back pain or arm pain -- and I think it would have been easy for me to ignore those."

Before she knew it, she was on her way to The Chester County Hospital by ambulance. Dottie says that much of the experience was a blur, but she does remember the speed, efficiency, and sense of urgency with which everyone cared for her. She was aware of the paramedics monitoring her heart and communicating with the Hospital. Still, she could not believe she was having a heart attack -- even when the paramedic told her it was very likely.

When she arrived at the Emergency Department, she says there were "no less than 10 people" waiting for her in a room, and they were ready to get to work.

"I was not sure what was happening, but I could tell each one had a clear role to play and they went into a very swift action plan," Dottie says. "They were getting me ready for something, and I remember them running me down the corridor at one point. They lost no time."

Dottie soon met cardiologist Mian Jan, MD, whom she calls her "guardian angel." He performed a cardiac catheterization and found that three of her coronary arteries were 85 to 95 percent blocked. Dr. Jan opened two of the blockages and propped the arteries open with stents. Dottie returned a month later to have the third stent placed.

"Dr. Jan was wonderful," she says. "I remember him bending down to tell me calmly that he was there and they were going to do a catheterization, and he briefly explained what that process was. The people in the Catheterization Lab were amazing at keeping me informed and supporting me throughout the procedure.

"From the time we called 9-1-1 to the time I was finished could not have been more than 90 minutes," Dottie adds. "It all happened so fast. My husband and I were taken aback by the preparedness and speed of the staff. Here it was, a beautiful Sunday morning, and they were all ready for a heart attack patient to come in and work together to give me the best outcome."

Dottie had the best possible conclusion: There was no evidence of any damage to her heart, and just two months later she and Terry were off to Florida for their annual January golf vacation. She continues to remain active by playing golf, biking and working out, and she recently started volunteering at the Chester County Food Bank. She sees Dr. Jan for regular follow-up visits, but she has moved on with her life and says she has "no worries" related to what happened.

On October 25, 2010, Terry gave Dottie flowers and a card to celebrate the first anniversary of her heart attack -- a celebration made possible by his quick action and the quality of care she received at The Chester County Hospital.

About a week after that special anniversary, on November 1, The Chester County Hospital learned it had received full accreditation as a Chest Pain Center with PCI (percutaneous coronary intervention, or catheterization) from the Society of Chest Pain Centers (SCPC). SCPC's goal is to reduce heart attack-related mortality by teaching the public to recognize and react to the early symptoms of a possible heart attack, reduce time to treatment, and increase the accuracy and effectiveness of treatment. To become an Accredited Chest Pain Center, the Hospital had to demonstrate an outstanding level of focus and expertise in all of these areas -- the kind of expertise that saved Dottie's life and her heart muscle.

"As I look back on that day, I know I am a very lucky person," she says. "I thanked Dr. Jan for saving my life, but he credited my husband for his quick thinking. That along with the sense of urgency in the ER and Dr. Jan's skill was critical. Dr. Jan later told me that a delay of just minutes could have changed my outcome and made it much, much worse. Minutes made the difference -- so now I tell everyone I know never to deny possible heart attack symptoms or attempt to drive to the hospital. Always call 9-1-1 right away."

By Kristine M. Conner

Dottie's Doctor

Mian A. Jan, MD

Dr. Jan completed his fellowship at Temple University in Philadelphia. He has received numerous awards throughout his career. He is board certified in Internal Medicine, Cardiology and Interventional Cardiology. Dr. Jan is the lead research physician with many clinical trials through West Chester Cardiology and Chester County Hospital. Dr. Jan is President-elect for Chester County Medical Society, the President of West Chester Cardiology and works as an Interventional and Clinical Cardiologist at Chester County Hospital where he is also Chairman of the Department of Medicine and Chief of Staff.

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