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Six days after delivering a healthy baby girl, 27-year-old Maria Lueken collapsed while hosting family and friends for a get-acquainted visit with the newborn.
“I wasn’t doing anything strenuous, just sitting on the floor,” Lueken says. “All I remember before-hand was feeling kind of out of it.”
When Lueken regained consciousness, she initially wanted to shrug it off. After all, she was young, healthy, and physically fit. No need to over-react.
However, her mother knew better and called an ambulance.
“It was absolutely the right thing to do,” Lueken says.
While internal bleeding from her pregnancy was a possible cause, doctors in the Emergency Room at St. Luke’s Hospital in Cedar Rapids, Iowa, took note of her blood pressure, which had been high two days before she delivered and was now quite low.
In retrospect, Lueken also recalls a brief “panic attack” (an episode of tight breathlessness) the night she came home from the hospital with her newborn.
At St. Luke’s, a CT scan revealed an ascending aortic dissection, a life-threatening splitting of the layers of the wall of the aorta.
A dissection is rare for someone Lueken’s age and often leads to sudden death.
Lueken’s dissection was especially complex, prompting Ryan Sundermann, MD, to transfer her immediately to the UI Heart and Vascular Care Center at University of Iowa Hospitals and Clinics. Every passing minute was crucial.
James Davis, MD, a professor of cardiothoracic surgery in the UI Heart and Vascular Care Center, notes that an aortic rupture leads to pericardial tamponade (bleeding into the pericardium), stroke, and kidney failure.
“Barring treatment, about 98 percent of the people who experience aortic dissection die within one month,” he says. “About 50 percent of patients with aortic dissection die the first day, so time is of the essence.”
During a six-hour open heart procedure, Davis and his colleagues replaced Lueken’s ascending aorta with an artificial graft. They also repaired the splitting of the wall of the remaining aorta. In many cases, the aortic valve must be repaired as well.
The UI Heart and Vascular Center is an automatic accepting center for aortic disease. “Many hospitals send us patients with acute aortic dissections, giving us extensive experience in the treatment of aortic disease of all types,” Davis says.
The reasons for Lueken’s ascending aortic dissection may never be known. It could have been a combination of high blood pressure and hormones related to her pregnancy. While there is no evidence of a genetic predisposition, she has been approached about participation in UI research aimed at evaluating genetic factors for the condition.
“I’d love to help if I can,” she says.
Remarkably, Lueken spent only five days in the hospital following the April 2008 episode. Since then, she has resumed a normal life with only a few limitations (related to strenuous exercise). She works full-time as a computer programmer and partners with husband, Ben, to raise two daughters: Reegan, the newborn, and Rylee, age 4.
“I have a new appreciation for just how great a gift life really is,” she says.
For more information about UI services for patients with aortic dissection, patients and family members may visit UI Heart and Vascular Center online at www.uihealthcare.com/uiheartcare, or contact UI Health Access at 319-384-8442
or 800-777-8442.
For consultation or referral, physicians should contact UI Consult at 319-384-8008 or 800-322-8442.
—Michael Sondergard
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