Leslie Zeiger felt on top of the world last spring, and why not?
The 39-year-old Southlake mom had delivered her third child, a son, on May 20 at Baylor Scott & White Medical Center-Grapevine. She had already resumed her running regimen just days after baby Aidan’s arrival.
“I had a very healthy pregnancy, a natural birth, and we came home the next day,” Zeiger said last week as she wrangled her cheerful, squirming son on her lap.
It was indicative of the family’s happy, hectic lifestyle since relocating from Manhattan to Southlake two years ago for Brendan Zeiger’s financial-sector job. Their two daughters, now 7 and 5, had adjusted well. Aidan was “kind of a surprise,” Leslie Zeiger said.
The pregnancy was “the best of my three. I exercised the whole time, gained 24 pounds,” she said. “I was induced because I was older this time, and I took nothing, not even a Tylenol.”
Then, at 7 a.m. June 4 , everything changed.
“The most pronounced symptom at first was intense nausea,” she said. “I was lying in bed nursing him, and it was instant.” She also had a headache and “a circular, burning pain in my chest that wouldn’t go away.”
Her father took the baby; her mother insisted on calling 911.
The paramedics treated Zeiger for a heart attack, though they were not sure what had happened.
It could hardly have been worse. An artery leading to her heart had torn, a condition called spontaneous coronary artery dissection, or SCAD, that kills half of its victims before they reach the hospital. It can affect anybody.
At first, doctors had trouble putting in lifesaving stents to divert the blood flow. After surgery, she spent two days in intensive care and a third day in a regular room before returning home.
“I have been in private practice for 21 years and had previously not seen a case in my practice,” said Zeiger’s obstetrician, Dr. Robert Wai, “Spontaneous coronary artery dissection is very rare and is estimated at an incidence of 1 in 20,000 to 30,000 deliveries. It usually occurs in the postpartum period.”
Even so, Wai said, it cannot be predicted. While they shouldn’t be overly concerned, pregnant or postpartum women should be aware of symptoms.
Warning signs may include chest pain or pressure, shortness of breath, profuse sweating and dizziness.
After the surgery, Zeiger had to deal with the natural drawdown of pregnancy hormones in her body and the added effects of the sudden cessation of nursing. She was also on heart medication.
“I couldn’t stop crying,” she said.
Zeiger has since been able to stop taking one medication completely and drop to a quarter dose of another. She also takes a low-dose baby aspirin.
Wai said he did not believe that Zeiger’s breastfeeding had any effect on what happened.
“No one knows completely why this happens, but it is believed that both hormonal changes and changes in blood flow after delivery play a role in causing the coronary artery dissection,” he said.
I’m just thankful for being here for my family, my kids.
Leslie Zeiger, a Southlake mom who had a heart emergency days after giving birth
“My heart’s as good as it can be right now,” Zeiger said, though she will always need care from a cardiologist. “I’m just thankful for being here for my family, my kids.
“I still get paranoid sometimes when I have a sore shoulder or something,” she said. “[But] there’s no reason to think that it will ever happen again.”
Dr. Vikas Jain, a Baylor-Grapevine cardiologist, did not treat Zeiger himself, but he has seen five pregnancy-related cases of spontaneous coronary artery dissection in 15 years of practice.
“Once treated, the outlook is relatively good if no damage occurs to the heart,” Jain said. “If a patient develops a full scar or is unable to be stented or bypassed, then their morbidity and mortality are worsened.”
Once treated, the outlook is relatively good if no damage occurs to the heart.
Dr. Vikas Jain, a Baylor-Grapevine cardiologist who has seen five pregnancy-related cases of spontaneous coronary artery dissection in 15 years of practice
Jain said some studies indicate that women with connective tissue disorders, a specific antibody disorder that can cause blood clots, or hypertension may be more at risk, but there are also cases like Zeiger’s where victims have no known risk factors. Women in their 30s have been found to have the condition more often than women in their 20s.
Zeiger is also thankful that she has been able to resume her active lifestyle.
“I started cardiotherapy, and within a month I was running again,” she said. “I kickboxed before this happened. My doctor said, ‘If I told you your heart was good enough to kickbox again, would you feel better?’ I said, ‘Yes!’ ”
Now Zeiger runs 4 to 5 miles three or four times a week, kickboxes once a week and does cardio ballet.
“Leslie is a very fit woman and she sought medical attention promptly, and that saved her life,” Wai said.
But it wasn’t all her doing.
“Had my parents not been here, I’m not so sure I would have called 911 as soon as we did,” Zeiger said. “Had I not, I wouldn’t be here.”