Heart Aware: Edward doctors diagnose, treat rare heart condition

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Marlis Panagos, shown working out at the Edward Health & Fitness Center at Seven Bridges, nearly died when she had a spontaneous coronary artery dissection, a condition so rare that only about 150 cases are reported each year. | Submitted by Edward Hospital

Updated: March 9, 2012 8:07AM

Fitness is a way of life for Woodridge resident Marlis Panagos. Whether it’s running a marathon, taking a brisk walk outside or relaxing with yoga, Panagos always has exercised.

That’s why she never considered herself to be at risk for heart disease.

But on a fateful night two years ago, Panagos almost died when she had a spontaneous coronary artery dissection (SCAD) — a rare and sometimes fatal cardiac condition.

“I didn’t think things like this happened to healthy, young people. I’ve run four marathons in my life. I don’t have any risk factors, and I’ve never weighed more than 115 pounds,” says the 46-year-old mother of three.

Late Jan. 20, 2010, Panagos experienced “a burning ball of fire” on the left side of her chest. She could barely stand or walk because of the excruciating pain. Her husband drove her to the Edward Hospital emergency room.

“I knew something was terribly wrong. I shouldn’t have let my husband drive me to the ER — I was having a heart attack,” she says.

Soon after Panagos was admitted to the ER, doctors were in contact with Edward Heart Hospital about her condition. The initial labs were inconclusive and her condition stabilized, but doctors wanted to keep her for observation.

A few hours later, her normal enzyme levels escalated to critical levels and these biomarkers confirmed that Panagos had a myocardial infarction. It was concluded that a cardiac angiogram was necessary to further evaluate her condition.

During the angiogram, another dissection started, but this time, it was on the right side of Panagos’ chest. Sonjai Bhatia, a cardiologist with DuPage Medical Group, visibly saw the second dissection occurring in the right anterior descending artery, opposite of where the first dissection had previously occurred on the left side.

“The same excruciating pain came back,” Panagos recalls. “All of sudden, alarms started ringing. My husband thought the other patient was crashing — but it was me. Instantly, 20 people rushed into the operating room to work on me.”

Within minutes, Bryan Foy, a cardiovascular thoracic surgeon with Cardiac Surgery Associates, started emergency coronary artery bypass surgery. At first, the dissections continued and her condition was extremely grave. When Dr. Foy had successfully completed the bypass, Panagos experienced extensive swelling, preventing her from being closed up. After the swelling subsided and surgery was concluded, Panagos was moved into the critical care unit. She experienced another set-back when extensive bleeding resulted in another open-heart surgery so surgeons could find the source, which ended with wires attached to her sternum. Dr. Foy was able to stop the bleeding, and the surgery was a success.

Doctors are still trying to pinpoint the exact cause for Panagos’ condition. SCAD is extremely rare, and the fact that Panagos experienced two is even more uncommon. The majority (about 80 percent) of all SCAD cases occur in young women during the peripartum period or in association with oral contraception use, according to David Holmes, a cardiovascular disease expert from the Mayo Clinic. Panagos consulted him for additional care after her release from Edward.

Hormone levels and stress can play a role in the condition, and traditional risk factors are usually not present as was the case with Panagos.

The condition is so rare that only 150 or so cases are reported each year, according to Dr. Holmes.

“Had I been somewhere else with different doctors and different technology, I wouldn’t be here today,” she says. “The immediate treatment I received saved my life. Everyone at Edward from the ER to the Heart Hospital and the surgeons, worked as a team. I was fortunate and blessed to be at Edward.”

To find out if you are at risk for heart disease, take the free five-minute test that could save your life. Log on to www.edward.org/heartaware.

Heart Aware is courtesy of Edward Hospital