Written By Patricia Walters-Fischer
Photos by Karen Ray
March 2, 2008
Lori Shaw-Kupetz seemed to be the perfect example of a woman who’d taken care of herself. She’d never been a smoker, had a thin physique, exercised regularly, and had chosen a vegetarian lifestyle. This 37 year old, mother of two had been more than proactive for her health. Because of the family history of heart disease and high cholesterol on both sides of her family, she opted to start taking statins (medications that lower your cholesterol) in her twenties to avoid problems early in life.
In 2005, on a hike with a friend, “I got really blinding, bad chest pain,” explained Lori. “I had no warning, but the pain last two minutes.” After a short recovery period from it, she opted to continue with the hike and finished it, but the event left her wondering what happened.
Within a month, she had two more episodes while exercising. She remembers the feeling before the pain would begin. “There were very clear signs. I got a weird feeling in my neck right before the chest pain started.”
Her internal medicine doctor sent her to a cardiologist who conducted a stress test. “During the test, the pain started and I told him I had it,” but the (EKG) test came up negative. (Changes in a patient’s electrocardiogram or EKG/ECG—changes in the electric conduction of the heart rhythm can be indicative of heart attack and/or damage.) “Signs of small vessel disease don’t get picked up on a stress test,” Lori explained.
After being told by the cardiologist “I think you’re barking up the wrong tree,” Lori felt frustrated. “He said a woman of my make up (thin, vegetarian, in good shape) doesn’t get heart disease. He said he didn’t think I needed a cardiologist and suggested I go to a GI (gastrointestinal) doctor.” She did and that physician found nothing that would have caused her chest pain. That doctor suggested another specialist and when the next doctor found nothing, she yet, another specialist was offered.
“All these expensive workups and nothing,” Lori sighed. “It was suggested that I had cancer, I’d have the work up then everything would be negative.”
During this entire period of going from doctor to doctor, the chest pain episodes were becoming more frequent and more intense. It got to the point where “I couldn’t do anything without the pain occurring. That included sex. I felt drained all the time.”
At the end of that year, Lori had almost reached the end of her rope. “Doctors were suggesting antidepressants and I knew, I knew something wasn’t right and yet, no one would listen to me. They kept saying ‘a healthy women like you doesn’t get heart disease.’” She started to second guess herself and tried to shake it off, but when she was short of breath reading out loud and laying down, she knew this was far more than panic attacks or depression.
She explained the pain got so bad that she, her husband Daniel, brother, and sister-in-law were in New York City during the winter and “I had a bout of chest pain so intense that I laid down in the middle of a busy sidewalk and couldn’t get up.” Feeling drained and running out of hope, Lori started to wonder where her life was headed.
Then hope arrived.
In February 2006, an article published in the LA Times during Women’s Heart Month. Dr. C. Noel Bairey Merz, MD, FACC, the current the national spokesperson for VHA’s Women’s HeartAdvantage campaign, which seeks to raise awareness of heart disease in women. She discussed the signs and symptoms of heart disease in women.
“I saw the article and called her immediately. Within a week, I was in her office. I had an Adenosine MRI stress test (test that looks at the function of the heart. It looks for areas of the heart not receiving a good supply of blood) which lead to the need for an angiogram (The patient is on a table where an x-ray machine is over the table. A small catheter is inserted into the femoral or leg vein and threaded up to the heart with the x-ray machine displaying the catheter’s journey on a monitor. A dye is injected into one of the major coronary arteries which carries the dye to the heart. The dye travels through the vessels and shows where blockage may be in the arteries around the heart.) “I asked her, can’t we do a CT of my heart instead? Her comment was I want to be 100 percent sure and the scan is only 99 percent.”
On March 16th, Lori underwent an angiogram that showed she had 99 percent heart blockage in three of her vessels. The doctor attempted to avoid major surgery by correcting the blockage with an angioplasty (a non-surgical procedure where a small balloon is placed in the vessel and inflated in hopes of opening up or dilating the vessel), but it was unsuccessful.
By five the next morning, she was in surgery having a triple cardiac bypass or Coronary Artery Bypass Graft or CABG [During CABG, a healthy artery or vein from another part of the body is connected, or grafted, to the blocked coronary artery. The grafted artery or vein bypasses (that is, it goes around) the blocked portion of the coronary artery. This new passage routes oxygen-rich blood around the blockage to the heart muscle. As many as four major blocked coronary arteries can be bypassed during one surgery.]
Because of her intent to stay healthy all those years before, her blocked vessels had formed collateral or alternative vessels to carry the blood where it needed to go. “My doctor said it was amazing I was alive and I probably wouldn’t have made it much longer. But because I’d been so healthy all these years, it swayed in my favor.”
(Many patients with heart disease will develop collateral vessels as the blockage builds up, but they are much smaller and cannot feed the heart as readily as their main ones.)
“It was scary, especially for my children,” remarks Lori. “Can you imagine, Mommy went to the hospital to have a test done and didn’t come home for nine days?”
Her recovery went well and since, she’s had to alter her exercise routine. “I am better about it, more of a routine,” and she balances her medications to help with heart and cholesterol.
Looking back, she says there were warning signs that she just didn’t understand. “I used to think my when my cholesterol was below a certain amount, I was doing fine. But that’s not the only thing I should paid attention to. My LDL (low density lipoproteins or bad cholesterol) and my triglycerides (main constituent of vegetable oils and animal fats) ratios weren’t good.” Lori stated if she’d known better, she would have gone to a preventive cardiologist when her test results came back to be more proactive in her care and to have been more aware of what to watch for when signs and symptoms did occur.
Education and prevention are always great tools, but Lori has been gracious enough to add another aspect to the community. Her experience speaks volumes and she has become a voice for women to learn more about heart disease. Working with her cardiologist and Cedar-Sinai, she’s spoken at several events to bring more awareness of the signs and symptoms of heart disease. “Women have no idea about heart disease. Many think their pain is cancer, but they avoid it and ignore it. They are too afraid of what they might find and then they don’t take care of themselves.”
Her work has not gone unnoticed. In February 2008, Lori and her two daughters Zoe and Sophie, attended the Red Dress Event for Women’s Heart Health Month at the White House. “We had a really nice time, girls went with me, George Bush and Laura Bush were there, and the director of the National Institute of Health was there.”
Although she’s enjoyed her recent trip to Washington, Lori said her main concern and focus is educating women and her girls. “The amount of gratitude it has brought to my life, to speak to others and help the community. My community helped us so much during that difficult time, I want to give back.”
If you have questions about heart disease in women, please talk to your primary health care provider and go to American Heart
And no matter who you support in the upcoming election, a great website is Laura Bush ’s campaign to education women about heart disease with her Red Dress Events. .
Don’t avoid taking care of yourself or pushing for answers when it comes to your health.
Think if Lori had accepted it was “all in her head”, she wouldn’t have been able to be such an inspiration to all of us.