Veronica's Unexpected Journey: Heart Failure While Pregnant
Eight weeks before her due date, Veronica Williams had an emergency C-section to deliver her daughter, Brooklynn, in St. Elizabeth Hospital’s cardiac catheterization (cath) lab—where imaging equipment is used to diagnose abnormalities in the heart—not in the labor and delivery unit, like she had planned.
The unmatched healthcare community in Cincinnati rallied together to ensure a smooth transition of care for Veronica—from St. Elizabeth’s in Northern Kentucky—to the region’s first and top leader in heart care for over 200 years—UC Medical Center. Access to world-class teams of highly specialized clinicians, including cardiologists, surgeons, respiratory therapists, nurses and advanced practice providers, proved to be the lifesaving difference.
The Critical Role of Technology: Apple Watch Detects Heart Irregularities
“My Apple Watch notified me that my heart rate was high just sitting on the couch,” Veronica said. “I thought it was just a mix up because it only happened once.”
Innovative Heart Monitoring: A New Era in Pregnancy Care
The use of the Apple Watch in Veronica's case signifies a groundbreaking shift in how technology can aid in early detection of heart conditions. This innovation is particularly crucial for pregnant women, who may experience subtle changes in heart function and blood flow during pregnancy. The ability to monitor these changes in real-time represents a significant advancement in maternal fetal medicine, offering a new layer of security and reassurance for expecting mothers.
After her pregnancy stress test the following morning, where she tested normally and her doctors weren’t worried, her Apple Watch went off again—this time, more than just once.
“I started to get a little shorter of breath and just really uncomfortable,” Veronica said. “I never had any chest pain or anything, and before that, my pregnancy was totally normal.”
Veronica consulted her OB/GYN over the phone and went to the Emergency Department (ED) at St. Elizabeth Hospital, knowing something was not right. After being in the ED for a few short hours, Veronica was taken to the cardiac cath lab, where doctors worked to stabilize her heart, which resulted in an emergency delivery of her first child.
The Silent Challenge: High Blood Pressure During Pregnancy
High blood pressure is a common yet often overlooked condition in pregnant patients. In Veronica's situation, the vigilant monitoring of her blood pressure was key in managing her overall heart health. This aspect of her care underscores the importance of regular check-ups and blood pressure monitoring for all pregnant women, as hypertension can be a silent harbinger of more serious cardiac issues.
Veronica’s heart was in trouble—it even stopped all together for a moment—and to save her life, she was put on ECMO mechanical support. Doctors made the decision to transfer her to UC Health’s UC Medical Center—home of the first heart transplant program in the region—while her baby stayed behind in the neonatal intensive care unit (NICU) at St. Elizabeth.
Diagnosis in the Nick of Time: Lymphocytic Myocarditis
It was at UC Medical Center that Louis Benson Louis IV, MD, chief of Cardiac Surgery and the Louis Buckberg Endowed Chair of Cardiac Surgery at the University of Cincinnati College of Medicine, collaborated with a team of advanced heart failure cardiologists to diagnose Veronica with lymphocytic myocarditis, a rare form of myocarditis where white blood cells (lymphocytes) enter the heart and cause inflammation of the heart muscle.
“Essentially, her immune system was fooled into attacking her own heart,” Dr. Louis said. “It is rare, but more importantly, it is treatable. We suppressed her immune system just like we do for our heart transplant patients. We used the same skillsets that we use every day as the region’s most experienced adult heart transplant program.”
Heart Health Education: Empowering Expecting Mothers
Education plays a crucial role in managing heart health, especially for pregnant women. Understanding the symptoms of heart disease, the importance of regular heart rate monitoring, and the potential risks of conditions like cardiomyopathy and myocarditis are essential. UC Medical Center's commitment to patient education helps empower women like Veronica to take an active role in their heart health during and after pregnancy.
Dr. Louis and the cardiology team at UC Health have plenty of experience with patients like Veronica who have severe, unexpected cardiac illness—mainly because the program has been leading the region in heart care for over 200 years. With patient outcomes that rank in the top 10% in the nation, and conveniently located right here in Cincinnati—within a few miles of her local hospital—the UC Health heart care program was the right place for her St. Elizabeth physicians to send Veronica.
First Glimpse Over FaceTime: Maternal Fetal Medicine in Action
During her two-and-a-half-week stay at UC Medical Center, under the care of the cardiovascular intensive care unit (CVICU), Veronica slowly progressed.
“It was scary waking up somewhere that I had no idea where I was,” Veronica said. “My husband was there when I woke up, so that helped, but I kind of forgot they did an emergency C-section, so I woke up and I wasn’t pregnant anymore.”
Veronica met her daughter for the first time over FaceTime. Her CVICU nurse set up the call directly with the NICU team at St. Elizabeth, and Veronica watched them give her eight-week premature daughter her first bath.
“With any questions I had, there was a nurse practitioner that would stop the doctors and explain in normal people terms what was going on,” Veronica said about the care she received at UC Health. “There was one nurse who braided my hair in the middle of the night…one painted my fingernails for me. All the nurses, doctors—everyone was amazing.”
A Community's Embrace: The Role of Patient Support
The healthcare community in Cincinnati rallied around Veronica, her husband, Sean, and their daughter, Brooklynn, to provide the absolute best care to Veronica and to Brooklynn, and to truly care for them as a family.
“We partnered with St. Elizabeth to give the highest level of care to the patient,” Dr. Louis explained. “It’s so important to lean on one another as a healthcare community in Cincinnati. When we can provide the best care for a patient and keep them close to home, everyone wins.”
Throughout her ordeal, Veronica found immense comfort in the support from the healthcare community and fellow patients at UC Medical Center. This network of support is vital, not just for the physical aspects of recovery, but also for the emotional well-being of patients dealing with heart complications during pregnancy.
After Veronica spent two and a half weeks at UC Medical Center, she was discharged and finally able to meet her daughter in person for the first time in the NICU at St. Elizabeth. Two weeks after their first meeting, Veronica, Sean and baby Brooklynn were able to go home as a family.
Looking Ahead: Ongoing Care and Heart Monitoring
“Brooklynn is doing amazing,” Veronica said. “Meeting her was very emotional. She was so much smaller than in the pictures.”
Thanks to the immediate care by her St. Elizabeth doctors, and their decision to transfer her to the region’s heart care leaders, Veronica is doing amazing, too.
“I have to say it was one of those moments that, even to this day I remain in awe,” said George Christensen III, DO, St. Elizabeth cardiothoracic surgeon, who originally cared for Veronica and was integral in making the decision to have her sent to UC Medical Center. “The impeccable teamwork from several disciplines was astonishing—and this extends our seamless collaboration with UC Medical Center, which, without hesitancy, helped this young woman recover to be a mother to her young daughter. I am grateful for all the staff—both at St. Elizabeth and at UC Medical Center—for their extraordinarily compassionate and top-notch care. This was an amazing example of teamwork.”
Without the seamless transition of care—without our community leaning on each other—Veronica would not be where she is today, nor would baby Brooklynn be crawling and teething, completely on-track with other children her age.
“I’m keeping up with my UC Health cardiologists to make sure everything is looking good. They are doing everything they can to monitor me closely,” Veronica said, “but I’m getting better every day.”
Paving a Future for Heart Care in Pregnancy
The collaboration between St. Elizabeth and UC Medical Center highlights the future direction of heart care in pregnancy. By combining advanced technology, comprehensive care, and a focus on patient education, these institutions are setting new standards in the treatment and management of heart conditions in pregnant women. Their approach is a beacon of hope for many, promising a future where heart health is an integral part of prenatal care.
Advancing Heart Research: UC Health's Pioneering Studies
UC Health and the UC College of Medicine are continuously pushing the boundaries of what’s possible through research, and UC Health Cardiologist Richard Becker, MD, is the lead investigator of a multimillion-dollar study by the National Heart, Lung and Blood Institute, in which an Apple Watch app is used to monitor irregular heartbeats, in hopes of preventing complications in patients who experience atrial fibrillation (AFIB). Like Veronica, patients with irregular heartbeats do not always have any symptoms—which can leave complications to go unnoticed and untreated.
