I Thought It Was Just Stress, Until It Broke My Heart

Enlarge this image Katherine Streeter for NPR Katherine Streeter for NPR

That Friday, I was dizzy and sick to my stomach with what felt like food poisoning, only sometimes my chest throbbed. I declined my husband's offer of a ride to the emergency room because I had to prepare for a crucial school meeting on Monday.

Our six-year-old son, a gifted child with a disability, had been repeatedly sent home for eloping from class and disruptive behavior. The school had laid a paper trail to ship him to a more restrictive program across town, but I was blocking the exits. My goal for Monday was to keep him in his class and get him support to develop coping skills. I was afraid he would learn to hate school.

While I liked my new job, day care kept evaporating. One after-school program kicked our son out without notice while my husband was out of the country. Our kid had already trashed the other semi-affordable options. Hey, but what working mom isn't stressed? It seemed that whenever I solved one problem, another wrapped a tentacle around my leg to drag me down.

The day before I got sick, I received emails that another school parent had been circulating for months, making our son out to be a menace to society and lobbying to have him removed from school.

At the Monday meeting, we were congratulated on our son's progress. He was welcomed to second grade, where he would receive a trained aide. I was relieved.

But I could feel my heartbeat flicker erratically. It didn't hurt, but it wasn't normal, so after work I asked my husband to take me to the emergency room. A burly nurse with a tattooed neck joked during the electrocardiogram. But his expression changed as he looked at the screen. With breathtaking speed I was hoisted onto a gurney, stripped, wrapped in a hospital gown, had an IV jammed in each arm and was pumped full of heparin.

Somebody told me I was having a heart attack.

"Your troponin levels are rising," said a doctor who resembled a hedgehog with glasses. "It's a protein your heart gives off when it is damaged." People kept asking me about chest pain, but I had none.

"I'm sorry for leaving you with the kids!" I called to my husband as EMTs rolled me away. I feared that not going to the emergency room earlier may have fatally damaged my heart.

An echocardiogram showed that my left ventricle had ballooned and the tip of my heart wasn't working. I was scheduled for an angiogram the next morning. Any artery blockage, and I'd get a stent.

On Tuesday I lay sedated in a chilly operating room while a cardiologist snaked a probe through an artery in my right wrist straight to my heart. The last time I got narcotics this good was when I gave birth to the twins.

I woke up afterward with my right wrist in a splint, but no stent in my heart. The cardiologist looked pleased. "Your arteries are completely clear," he said.

I was shocked. My dad had a heart attack at 40, but he was a smoker. I was in my early 50s, and I knew that with less estrogen my risk of heart disease was rising. What I didn't realize is that symptoms of a heart attack in women are different from those in men.

But it turned out that I hadn't had a heart attack at all. Instead, it was a rare condition called Takotsubo cardiomyopathy or "heartbreak syndrome" that mimics one.

The cardiologist said he saw perhaps 25 cases a year out of hundreds of heart patients. Triggered by intense emotional or physical stress, the left heart ventricle distends to resemble the shape of a traditional Japanese octopus trap. Cases tend to spike after earthquakes and hurricanes, particularly in women past menopause.

I hadn't experienced an earthquake. I had been internalizing too much stress for too long. The doc told me that my heart now pumped at only two-thirds of normal capacity, but that the damage would likely heal within months.

And a few months since being takotsubo-ed, I am stronger. Our son's behavior has been stellar in second grade. He adores his teacher. A trained "class substitute" helps everybody out; and both our children have made new friends in the city after-school program that welcomes all kinds of kids.

The poison-letter writer moved out of the district. One parent invited my son to join his child's Aikido dojo. A neighbor offered help with after-school pickup.

I have used my reprieve to take my kids to the beach as often as possible. I wear a red bikini under my rash guard. Yoga irks me, but I'm trying to touch my toes anyway. Retraining the stress response of a lifetime is difficult, but it helps to remind myself what I can't control and what I can.

My heart's got to keep going for another 30 or 40 years.

Wendy Wolfson is a science writer in Orange County, Calif.