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Juggling life, work and unexpected cardiac events

For Natalie, a young wife, mother and nurse, her cardiac event happened on what seemed like an ordinary evening. But her nursing background immediately sounded internal alarms and she knew she was experiencing something out of the ordinary.

“It all happened one night when I was folding laundry in 2018,” she recalls. “My husband was working from home while our youngest played in the bath. I had felt a little stressed for some time but had no idea that this could be having an effect on my heart.”

Suddenly, Natalie felt a wave of nausea wash over her, accompanied by a pain down her arm and a burning sensation in her chest.

"We need to call an ambulance, I think I'm having a heart attack," Natalie told her husband, who was initially in disbelief. "Take over the bath. I need to lie down."

The ambulance officers were on their way to another job, so they were able to triage her call out and see her straight away. 

“Because of the way I presented when they arrived,” she says, “they decided it was a cardiac issue and they transferred me to North Shore hospital.”

The search for answers

Despite the absence of prior cardiac issues, her bloods showed raised troponins. These proteins are released when the heart muscle has been damaged, such as occurs with a heart attack. After a three-day hospital stay and an angiogram, her diagnosis was inconclusive. 

“It was a very disorientating experience.” 

Confused but determined, Natalie sought a private consultation for a second opinion.

"Being in my 30s and facing so much uncertainty, I had questions I needed answers to. I wanted to understand what my body had experienced and how to take care of myself moving forward," Natalie says.

The second cardiologist diagnosed her with myocarditis, inflammation of the heart muscle, though there was also suspicion of SCAD (Spontaneous Coronary Artery Dissection). Both of these conditions can present suddenly and have similar symptoms to a heart attack. 

Natalie's health journey didn't end there; two years later, she developed heart rhythm issues and was diagnosed with AF (Atrial Fibrillation) and SVT (Supraventricular Tachycardia).

During the Covid-19 lockdown, Natalie felt a growing need for clarity. A private cardiology review and an MRI revealed scarring on her heart muscle, confirming the myocarditis diagnosis. The development of heart rhythm disorders, like AF, is a known complication of myocarditis.

"I felt some relief to have some answers but it was challenging to understand these changes as they were out of the blue," Natalie says. “I had no family history of heart disease or previous health issues.”

The emotional toll

Natalie soon realized the importance of mental health in her cardiac journey.

"You feel incredibly vulnerable after a sudden health event like this," she explains. "I saw a psychologist to help process my experiences. We worked on understanding that avoiding life out of fear would mean missing out on the good things.

“You can feel anxious when something unexpected occurs. It knocks your confidence,” she adds. “I'm quite internal so working through what is actually stressing me out is important.”

The medication maze

Finding the right medication was another part of Natalie's journey, fraught with its own challenges. 

"It can be scary to fine-tune medications for your heart," she says. "I went through two medications before landing on the right one. It's essential to advocate for yourself throughout this process."

She was also clear from the start how she wanted her medication to go.

“I told my cardiologist I wanted to start the meds at the minimum dose and work my way to where they want me to be,” she says. “They were happy with that, and so was I because it’s for life. I always think of other people that have significant conditions to manage and think I’m okay because this is just a pill. I take one in the morning and one at night – it’s manageable.”

Cardiac medications often require a few changes before the right type and dose are found.

Natalie also had insomnia after her diagnosis.

Sleep is so cardioprotective,” she attests. “It’s one of those important things to manage. Melatonin was really good at helping with that. Lack of sleep can be a trigger and set your heart off in a bad rhythm. And sustained lack of sleep can be really damaging.”

Everyday challenges and coping mechanisms

Natalie's condition had a significant impact on her day-to-day life. 

"Simple activities like a day at the zoo would exhaust me, but I initially blamed it on chasing around two toddlers. It took a while to realise it was my heart causing the exhaustion. I presented several times to the emergency department with AF and SVT, over a couple of years. It took time to learn the symptoms and identify triggers. I was a “frequent flyer” for a time, as heart rhythm changes can be frightening." 

To manage her condition better, Natalie took several proactive steps: she started wearing a smartwatch to monitor her heart rate, installed a St. John's alarm at home for emergencies and became mindful with her diet and stress management. 

"I've completely cut out caffeine and almost all alcohol, and I work on identifying my stress triggers before they become overwhelming," she says.

The power of community and family

Natalie found solace in connecting with others who had experienced similar health issues. 

"I attended a SCAD group at Auckland Hospital and heard some incredible stories," she shares. "While it's not a community anyone wants to join, it's comforting to know you're not alone."

Support from loved ones has also been crucial for Natalie. 

"My husband, parents and friends have been fantastic. We've learnt to adapt. I'm careful about how I discuss my health with my kids; they need to be aware but not burdened."

A message for others

"For women, especially during times of hormonal changes like childbirth, it's vital not to ignore stress and tiredness," Natalie advises. "And if there's one thing I'd like everyone to know, it's to check in with your health provider if you have any concerns or notice any changes."

Natalie's journey is one of resilience, self-advocacy and a deep desire for knowledge. While she continues to manage her complex cardiac issues, her story serves as a beacon of hope and a guide for those navigating similar challenges.

"Manage your sleep and stress. Don’t be afraid to ask questions or seek a second or even third opinion. Stay proactive in your health journey.”

Please note: the views and opinions of the storyteller and related comments may not necessarily reflect those of the Heart Foundation NZ.

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