September 26, 2023

‘What the heck, am I having a heart attack?’

Heart failure at age 38, but simple steps have helped Madison woman’s heart improve

MADISON, Wis. – At a time when most people are headlong into things like careers or family life, Delonda Jackson found herself mysteriously in the emergency room.

In the summer of 2022, she began experiencing symptoms out of the blue, like shortness of breath and extreme fatigue; carrying groceries from the car was a chore. She thought she might have RSV again since was diagnosed with it in December 2022, so she went to see her primary care doctor who thought it might be asthma. At that time, her care team took an X-ray and prescribed medication to treat the asthma.

But, her symptoms worsened so she went to the emergency room where they thought she had the flu, and the care team took another X-ray. It showed nothing wrong with her lungs, just like the first, but both images revealed a larger-than-normal shadow cast by Jackson’s heart.

“Because I had no history of heart issues, they didn’t think anything of it,” she said.

Then, a few weeks later, she woke up around 2 a.m. with chest tightness and her left arm was numb.

“I thought, ‘What the heck, am I having a heart attack?’ ” Jackson said.

She went to the emergency room and after an initial evaluation, she was found to be experiencing acute heart failure from two major causes. The first was a blood clot that had traveled from a vein in her right leg to blood vessels in her lungs and the second was a severe reduction in function of the main pumping chamber of her heart. In fact, her heart was only able to eject about 23% of its blood. Normally the heart ejects at least 55% of its blood each beat, which is considered the minimum for normal heart function.

By 8 a.m., she was in the ICU suffering from dilated cardiomyopathy, a type of heart failure caused by an enlarging of one or both ventricles in the heart, and a pulmonary embolism, Jackson said.

When her condition had stabilized, and she was able to leave the hospital, she entered the care of Dr. Peter Rahko, cardiologist, UW Health, who has overseen her heart care and rehabilitation since then.

The larger heart shadows the X-rays showed indeed revealed Jackson’s heart had enlarged, he said. When heart muscle cells get weak the heart is stimulated to enlarge because it is trying, as hard as it can, to improve pump function, Rahko said.

“It’s unusual for someone her age,” he said. “It’s so out of the ordinary that when it does present in younger people, health care providers often think it is something like asthma or a respiratory virus because the symptoms are similar.”

And that is exactly what happened in Jackson’s case.

Once she was able to leave the hospital, Jackson began seeing Rahko, Brianne Thornton, registered dietician, Alex Kern, clinical exercise physiologist, and the rest of the care team at the UW Health Preventive Cardiology Cardiac Rehabilitation Program.

The program, one of the country's first heart rehabilitation programs, helps patients who have had a heart event regain heart function and develop lifestyle habits for optimal heart health. One-on-one, and then group sessions include closely monitored exercise, lifestyle counseling and education to help patients long after their time in the program ends. It also offers patients the opportunity to meet others going through the same rehab, providing camaraderie and the chance to learn from one another.

“We are here to help with longitudinal care, and the long-term goal is for her to get optimal treatment and determine if we can get the heart to recover,” Rahko said. “We try to get everyone as healthy as possible, as vigorous as possible, and get them back to work.”

When Jackson was referred to the rehab program, she was apprehensive, she said.

“It was very scary because I didn't know what they were going to tell me,” Jackson said. “I didn’t know if they were going to tell me like, ‘You have a date, this is your life expectancy.’ ”

To the contrary, she was grateful and fortunate to have the experience she had with the rehab team, she said.

“They made me feel very comfortable,” Jackson said. “We are at a research hospital, so there are opportunities I may not have if I lived somewhere else.”

Jackson is not only back to work, but is essentially back to the life she had before her heart failure diagnosis by simply making a few changes to her lifestyle, she said.

After initially going to sessions with the cardiac rehab team, which ended in July 2023, she has been able to improve her heart function by taking a blood thinner, two other heart medications, implementing a low-sodium diet, exercising 30 minutes each day and avoiding activities that are too strenuous as her heart grows stronger.

“I didn't feel like the lifestyle changes were that significant,” she said. “I feel great; it’s really hard to let people know that I have this illness because they don't see it.”

While her lifestyle changes have had a positive impact on her health, the changes in her life have given her perhaps a greater benefit, the chance to be there for her three sons, ages 21, 17 and 1, Jackson said.

“If I don't do it for anyone else, I have to do it for them,” she said. “It makes me feel really good to be able to play with my 1-year-old and go on vacation and walk with my 21-year-old on the boardwalk by the beach.”