Amy Rea is being called a walking miracle. After an hour in cardiac arrest, her pulse returned thanks to a tireless, determined and dedicated team of professionals at Hillcrest Hospital South performing non-stop CPR. It all started on a normal workday.
Headed to the hospital
Rea, 48, was at work in Broken Arrow on Monday, Aug. 15, 2022. She was short of breath that morning and told a coworker she felt like she was going to faint.
"By the time I got out of my car and walked to the front doors of the building, I could not breathe," said Rea. "You know when you go under water, and you've held your breath and you know you need to come back up to take that breath? That's how I felt."
The coworker helped Rea sit down and another coworker called 911. Within a few minutes, emergency services arrived and asked Rea several questions.
"I remember one of the paramedics saying, 'I think it's a possible pulmonary embolism' because my heart rate and blood pressure were good, but I was deprived of oxygen," said Rea. "They recognized my symptoms. During that conversation, I was coming in and out of consciousness."
Ankit Chothani, M.D., is an interventional and peripheral endovascular cardiology specialist at Oklahoma Heart Institute. He says treatment of pulmonary embolisms is a rapidly developing area of care.
"Pulmonary embolism refers to a blood clot that is lodged into a major blood vessel of the lungs," said Dr. Chothani. "In most cases, the clot usually starts in large veins of the legs, as deep vein thrombosis. Sometimes as the clot gets bigger, it breaks up and eventually makes its way through the heart and into the lungs. This creates an obstruction and prevents blood from getting oxygen from the lungs. The patient usually experiences shortness of breath, pain and can pass out in severe cases."
When paramedics got Rea into the ambulance and asked Rea's husband which hospital they preferred, he drew a blank.
"My husband, for whatever reason, froze," said Rea. "He said all he could think to do was ask the EMTs, 'Where would you take your wife?' The Broken Arrow paramedics told him that they were taking me to Hillcrest South."
Cardiac arrest
Rea was rushed into the emergency room. She met briefly with Dr. Chothani and as he was leaving her room, her heart stopped.
"We discussed her treatment options, and she had very labored breathing at that time. When we left her room, she had a cardiac arrest," said Dr. Chothani. "Usually with cardiac arrest, we follow ACLS protocol, which involves starting chest compressions."
"The last thing I remember was being in the ambulance and speaking to the paramedics," said Rea. "Then I flatlined."
Staff from the pulmonary embolism response team (PERT), the emergency room and other departments took turns giving Rea CPR in two to four-minute cycles. She was in cardiac arrest for about an hour.
"Anybody who was CPR certified that day came down to help," said Rea. "To this day, I don't know what made them decide to not call me dead."While Rea received chest compressions, Dr. Chothani, a nurse practitioner and the emergency room physician treated the pulmonary embolism.
"Patients with cardiac arrest because of a pulmonary embolism tend not to do well," said Dr. Chothani. "Unless the embolism breaks up because of the chest compressions or from medication, it's hard to get the patient back."
After 30 minutes in cardiac arrest, doctors administered a clot-busting shot to dislodge or dissolve the blood clot and restore blood flow to Rea's lungs. When her pulse didn't return, they administered another shot around 20 minutes later.
"This was a life-saving measure," said Dr. Chothani. "After we gave her the second shot, we got her pulse back. It seemed the clot-busting medicine broke up enough of the clot that she started having blood flow to her lungs again. The reason we as a PERT exist is to find severe cases and remove blood clots before it causes severe complication. With our patients, we're trying to prevent what happened with Amy."
Rea was in the hospital for 12 days, nine of those days in intensive care.
"People would come by my room and just look at me. They'd introduce themselves and tell me they did CPR on me. They couldn't believe I was alive," said Rea. "I was a living miracle in their eyes."
The recovery
Rea had no brain or other organ damage from the hour she spent without a pulse.
"That goes to show you the quality of CPR that was performed for Amy," said Dr. Chothani. "The point of doing chest compressions is to keep circulation going, keep blood moving through all the vital organs. In her case, excellent quality CPR helped her avoid long-term damage."
After six weeks of physical therapy to work on her stamina, Rea has no limitations or deficits. She returned to work full time just eight weeks after she was admitted to Hillcrest South and is working with a hematologist to figure out how the embolism developed.
"I don't think anyone's PERT program is as robust as ours, we take pride in that," said Dr. Chothani. "Stories like Amy's are a huge motivation for us as team, it makes us realize why we do the things we do. These cases are not easy, we're learning a lot from them, but I'm happy that we're able to provide this service to our community."
"My care was top-notch, the whole time I was there," said Rea. "Any need that we had was taken care of. It just felt like I was at home."
Click here to learn more about the cardiovascular services offered at Oklahoma Heart Institute.