At 6 a.m. on a Friday morning in late May, Merle Bedient reported to work in the housekeeping department at Schuyler Hospital. Two hours into his shift, as he was sweeping and wiping down the emergency room, sharp pains started darting across his upper chest.He waited, thinking it was heartburn. But the symptoms intensified, and an hour later, Bedient, 48, asked a nurse to check his vital signs. Although they were normal, the nurse warned him that he should have a more thorough examination. Yet Bedient, who describes himself as stubborn, waited another hour and a half before he returned to the emergency room, where care providers performed an EKG and drew a sample of his blood to look for the presence of certain heart enzymes. Both of these tests are part of the standard protocol for ruling out heart attack in patients experiencing chest pain.
After consulting with Bedient’s primary care doctor, the physician assistant in the emergency room told Bedient he was having a heart attack. He was quickly given aspirin to thin his blood and medication for his chest pain, then wheeled into an ambulance headed for Cayuga Medical Center, where a cardiac care team was assembling to meet him at the door. “I’m too young to have a heart attack,” Bedient recalls saying. In the ambulance he jokingly asked the technicians to disconnect his IV. “I’m fine — take me off this,” he said, “and let me get back to work.”
By the time he reached the Cayuga Heart Institute, the pain was subsiding. Still, the cardiologist waiting to treat him, Dr. Marcis Sodums, FACC, FSCAI, performed a radial access catheterization by threading a tiny plastic tube through the artery in his right arm to his heart muscle. Although the dye inserted in the tube showed that there was no blockage in his arteries, it did reveal that Bedient’s coronary arteries were enlarged and saccular in shape.
His abnormal arteries are most likely connected with a rare disorder Bedient was diagnosed with at the age of four — LEOPARD syndrome, which is characterized by a multitude of freckles that appear on the body. Triggered by a genetic mutation, the disorder may also cause deafness, unusually wide-set eyes, and aneurysms.
Whether the condition caused the heart attack is unclear, but Sodums suspects it is the culprit. “The sacs found in the artery walls of a person with LEOPARD syndrome create pockets, which prevent normal blood flow,” Sodums explains. “When there is stagnant flow, blood has a tendency to clot.”
After Bedient’s clot formed, it likely disintegrated, showering particles into the tiny downstream arterial branches and closing some of them, thus causing the heart attack. It is impossible to know precisely what happened in Bedient’s case, Sodums adds, because the smallest arteries are not visible on an X-ray.
The measurement of his enzymes from the blood test showed that Bedient suffered a small heart attack, Sodums says. Yet the positive side of the episode is that he now knows that he has irregular coronary arteries and an aneurysm on the aortic valve, which can be monitored and treated with medication. While he was aware of the potential for heart problems related to LEOPARD syndrome, Bedient says he had no idea his own heart was affected. “I didn’t know I had any of those problems,” he says. “I thought my heart was in good shape.”
Bedient says he felt comfortable and assured by the care he received at Cayuga Medical Center. When he was first brought to the hospital, his mother, who has had her own heart problems, was unable to drive over to the hospital until the middle of the afternoon. “Dr. Sodums called my mother twice to give her updates,” Bedient says.
Three days later, he was released with a prescription for blood thinners, which Bedient expects to take the rest of his life. After resting at home in Montour Falls, he returned to his housekeeping job at Schuyler Hospital a week later.
“Between Schuyler Hospital and Cayuga Medical, I was very lucky,” Bedient says, while taking a break during his shift at the hospital. “I’m grateful to everybody who took care of me. I don’t know where I would be if it wasn’t for the staff at both hospitals and the ambulance crew that got me over to Cayuga Medical Center as fast as they could.”