Mirjana

Heart attack

It’s different when it happens to you

Fourteen years of nursing did not prepare Mirjana for her heart attack. Like many others, she initially thought it was indigestion… except the pain would not let up.

Registered nurse Mirjana had just come home from a 12-hour shift and was looking forward to going on holiday the next day.

“I had something to eat, I had a shower and then I started to make the bed up and I got a bit of pain in my chest and I just thought it was indigestion at first.”

She continued to make the bed, but the pain got more severe and, before long, she was struggling to catch her breath.

“I thought that this was a bit more than indigestion but I thought it will just go away – I don’t know why I thought that but I did, and after 20 minutes I called my husband because I was a bit upset.

She told her husband she was in pain which felt like a 10 out of 10 in severity. He called an ambulance straight away. 

When the ambulance arrived, Mirjana was given two GTN sprays and the pain went within minutes, she says. “GTN spray is a spray that you give people if they have angina, if they start to get chest pain, and usually it goes away if they rest and then they can continue what they’re doing,” says Mirjana.

The ambulance took her to hospital to get checked up, but on the way the pain came back, so she had more GTN spray. Once at the hospital there was more pain, and they gave her more spray as well as morphine. But even then, “I don’t think I realised I was having a heart attack,” she says.

It wasn’t until she’d had an ECG and a blood test that showed her troponin levels had risen, that a clearer picture was starting to form.

The next day Mirjana was flown to Christchurch Hospital for an angiogram, but after the procedure, once she came to, she was told that her arteries were too blocked and that she would need open heart surgery.  

“I think that’s when it clicked,” she says. “I definitely have had a heart attack...”

A frightening ordeal

A long Waitangi weekend meant Mirjana had to wait three days for surgery, but her pain was so bad that interim measures had to be taken.

“They actually took me back into surgery and inserted a balloon through an artery in my groin that went up to my heart to try and reduce the workload of the heart so that the pain would be not so bad. It’s a pump and you’ve got to lay flat for several days, you can’t move at all, you’ve just got to lie flat until you have your surgery and that’s what happened.”

Even with the balloon, she was still in pain.

On Monday she had her surgery – a quadruple coronary artery bypass graft surgery.

When she woke from her surgery, both her children were there – one had come from Auckland and the other from Nelson – “so obviously they were worried,” says Mirjana.

But even after the quadruple bypass, she still had chest pains and her troponin levels had gone up again.

“They thought I was having a STEMI this time (involving damage to the full thickness of the heart) so they tried to rush me back into having an angiogram,” says Mirjana.

“They were trying to put oxygen on me because my oxygen levels had dropped and they tried to put a thing over my face, which I think is called a CPAP machine. But all I remember is it felt like they were trying to suffocate me.

“And I actually thought I heard a man’s voice say to me that I was going to die. And I said, did you just say I was going to die? And he goes ‘what?’ I just heard somebody say I was going to die and he just said, ‘no I didn’t say that’.”

The angiogram found that one of the grafts was quite delicate and was “flickering” causing the changes in the ECG and the blood. They assured me I wasn’t having another heart attack. “They said they just had to leave it and it actually just settled by itself.

After a while Mirjana had no chest pain other than the discomfort from the wound down her chest from the quadruple bypass. She was in hospital for 11 days.

“It’s different when it’s you”

“Being a nurse and knowing that people go through this thing – it’s different when it’s you,” says Mirjana.

She considered herself too healthy and – at only 53 – too young to have a heart attack. Apart from having rheumatic fever in her younger years (which the doctors said was not a factor) and sometimes getting indigestion, she had not had any sickness.

“I suppose even till the very end, actually once I went into Angio, that’s when I believed that I was having a heart attack.”

She adds that, before, as a nurse, though she understood what happens in a heart attack, she couldn’t appreciate the impact of such a large surgery.

“It didn’t actually sink in what people go through after a quadruple bypass. That you’re actually cut open and that you’ve got this wound there and there’s a lot of pain and you think you could have died, that your life expectancy is not what you thought it was. All those things run through your mind.”

Mirjana’s memory was also affected for a few days after surgery – probably from the medications, she assumes. Like some other details she’d forgotten, when someone paid her a second visit about cardiac support, Mirjana couldn’t remember the first visit at all. “I said, ‘look I’m sorry I don’t know you.’ She said, ‘yes you do, you saw me two days ago,’ and I said, ‘well I’m really sorry but I actually don’t remember you.”

Why me?

Understanding why she’d had a heart attack was another challenge for Mirjana. Though she was overweight, she did not have high cholesterol, was reasonably active and didn’t smoke or drink very much. Probably the major reason for the heart attack, she says, was that heart disease is in her family – something she only recently discovered.

Both her parents had died young, but not from heart disease – her dad was the victim of a car accident and her mum passed away from pneumonia. She’d only recently discovered that some of her aunties and uncles who’d all lived overseas had died in their 30s and 40s from heart disease. 

“So we never knew that and when I told the surgeon, he said… you’ve got a very bad, strong family history of heart disease, so that’s the reason why you’ve had your heart attack, not that your cholesterol was overly high but it’s in the family. ‘Unlucky’, he said actually.”

Back on track

Six months after her heart attack Mirjana was back to full-time work and taking every measure to prevent a repeat scenario.

She now walks about five kilometres a day, outside or on her treadmill, and she eats well too. “I love vegetables and I don’t eat a lot of fried stuff.” In addition to that, her cardiologist advised her not to eat bread, potato, rice or pasta and she hasn’t done that since.

“I do that because I think that I got quite a fright from it. Being 54 and quite healthy, and all of a sudden told that I’ve had a heart attack and it just made me take a look at myself and say, well what can I do?  I never want another heart attack again, so I thought, what can I do to ensure that I don’t get one.”

There was real benefit in doing the cardiac rehab course offered by the hospital, says Mirjana. “I did that with 10 other people for five weeks, and they weighed us and did our blood pressure and showed us exercises that we could do at home that didn’t cost anything.

“I was the youngest one there but they all had either heart valve replacements or pacemakers or stents. They’d all been through the journey, and we did the exercises together and we did the 10 or 15 minute walk on those days and it was really good to actually talk to somebody that had been through it.

“Even though I talk to my husband, unless you’ve been through something like this it’s hard. He understands very well but I feel more comfortable talking to somebody that’s actually had a heart attack because then they know what it felt like and the fears that you had at the time and it just makes it easier to cope I suppose.”

Shared November 2016