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A new mom who went to the ER with crushing chest pain and vomiting was dismissed as anxiety. It was a heart attack.

May 10, 2022, 03:45 IST
Insider
American Heart Association Go Red for Women
  • Wakisha Stewart went to the ER 2 weeks after childbirth with chest pain, numbness, and vomiting.
  • The receptionist dismissed it as a panic attack, but another knew she was having a heart attack.
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Two weeks after Wakisha Stewart delivered her second child, Diego, she and her husband let relatives take over so the pair could enjoy a friend's dinner party baby-free.

While there, Stewart became disoriented and foggy-brained, and suddenly fatigued. But, she reasoned, "all of those things can be attributed to pregnancy and motherhood in general." She knew it wasn't the wine; she'd only had half a glass.

Then Stewart felt a sharp chest pain, which she hoped would pass after a trip to the bathroom to splash water on her face. It only got worse, shooting into her back and neck, and radiating through her jaw.

"It felt like my chest was in a vice, like it was just being crushed," Stewart, who was a 31-year-old nursing assistant in Florida at the time, told Insider. She also had trouble breathing, a tingly sensation down her left arm, and nausea.

"Something's really, really wrong," Stewart told her husband. "We have to get to the hospital." Along the way, she vomited.

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But when she described her symptoms, as well as the fact that she'd been at her first night out since giving birth, to the receptionist, the woman said: "Oh honey, it's anxiety. You're having a panic attack." When Stewart pushed back, she said the employee rolled her eyes and told her to take a seat in the waiting area.

It wasn't until a nurse passing by the triage bay caught sight of Stewart 30 to 40 minutes later that clinicians realized she was having a heart attack. Prepared to die, Stewart told her husband, "make sure Diego knows how much I loved him, and how much I wanted him."

Now, 10 years later, Stewart is ready to share her experience as a volunteer for the American Heart Association's Go Red for Women campaign.

Since recovering from her heart attack, Kisha Stewart had a third baby.Courtesy of Wakisha Stewart

"I want to let people know cardiovascular disease is the No. 1 killer of new moms," she said. "I want the medical community to start opening up their eyes and not accusing women or misdiagnosing women as having panic attacks or anxiety attacks, because it could be more."

Stewart had a type of heart problem more common among postpartum women

Stewart was transported to a hospital with a cardiac intervention unit, where a cardiologist inserted a stent that saved her life. She'd suffered a spontaneous coronary artery dissection (SCAD), or when a tear forms in a heart blood vessel.

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In Stewart's case, it completely blocked blood flow in the left anterior descending artery, leading to a widow-maker heart attack.

As a 31-year-old nurse who'd always been an athlete and has no history of heart disease, Stewart said the experience felt surreal. "How could this be? How could I be having a heart attack?" she said she thought. "I just had a baby. I just brought life into this world, and now I'm about to die."

SCADs most commonly affect women in their 40s and 50s, and there's an increased risk in the first few weeks after childbirth, according to the Mayo Clinic. They're different from a better-known complication that leads to heart attacks — or the hardening of the arteries from plaque buildup — which tends to affect men more.

It's unclear why the postpartum period puts people at higher risk for SCAD, but it could be related to the stress pregnancy and vaginal childbirth puts on the heart, Dr. Garima Sharma, cardiologist and an AHA medical volunteer, told Insider. Hormonal changes may also play a role.

Pregnant and postpartum women with high blood pressure, high cholesterol, a history of smoking, or a family or personal history of aneurysms or heart problems are most at risk.

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Still, Sharma said, "most women are able to deliver vaginally, completely without any problems."

The worst effects were mental

For eight weeks after Stewart's discharge, she couldn't hold Diego, who was over 10 pounds.

"I didn't have that bonding that you would normally have. I couldn't just rush into my son's room and pick him up and just lay with him," she said. Stewart said she developed agoraphobia, anxiety, and depression.

Kisha Stewart sits with her son over a month after her heart attack. She couldn't lift him on her own.Courtesy of Wakisha Stewart

"I was angry at God. I was angry with myself. I was angry at my body. Waking up every single day was hard," she said.

Over time, and with the support of her family and friends, Stewart got better. She got back into music and dancing. She pursued higher nursing education and graduated valedictorian. She shopped around for a doctor she trusted.

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"I found a cardiologist who is willing to do the work, who is willing to listen to me and help me feel acknowledged," she said. "That really makes a big, big difference."

Women are increasingly reporting experiences of medical gaslighting

Medical gaslighting is when medical professionals dismiss a person's symptoms, deny tests or treatments, and ultimately misdiagnose them. Research shows Black people, women, and young people can be especially vulnerable.

"They're not being believed, and that's causing significant delays in care, misdiagnosis, late diagnosis, ineffective treatment, and ineffective triaging," Sharma said. "Women are paying a very heavy price."

Some studies have found women patients tend to wait longer for cancer and heart disease diagnoses than men. One study showed that younger women were two times more likely than young men to have a medical expert give a mental-health diagnosis when their symptoms pointed more to heart disease.

Black patients, meanwhile, are more likely to have their pain under-recognized and misdiagnosed by medical professionals, one 2016 study found.

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Sharma encourages postpartum patients in particular not to ignore symptoms just because they may be due to childbirth or pregnancy, or because new moms don't feel like they have time to get medical help. Bring a friend or relative who can emphasize to clinicians that this is very out of character for you too, she said. Women can also sign up to participate in AHA's Go Red for Research campaign to advance research in women's health.

Medical professionals, meanwhile, need to trust young women's concerns — regardless of, or perhaps because of — their lack of apparent risk factors, Sharma said.

"The fact that they are in the ER at that time means that they're so worried about their symptoms that they're ready to drop everything that's more important to them," like an infant, she said. "If a young woman comes in and is really saying, 'this does not feel right,' they need to believe her."

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