When a Heart Attack Strikes

Heart disease and attacks can happen to anyone, no matter how healthy they seem.

The first sign was numbness in her feet. The muscles in Carol Cutler’s arms and legs also ached. Then again, she had just finished a grueling workout with a new personal trainer. 

In 2006, at the age of 45, Cutler was seeing the trainer to get into even better shape. She was thin and athletic, with no history of high blood pressure or cholesterol issues. She was in perfect health—aside from the fact that she was in the early stages of a catastrophic heart attack.

Dr. Francis Sutter became Cutler’s physician after her diagnosis. The chief of cardiothoracic surgery at Lankenau Medical Center, Sutter believes that exertion from a workout caused a tear in the lining of her arterial wall. It’s called spontaneous coronary artery dissection, and doctors aren’t sure what causes it. 

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Sutter’s best guess is that, as she was lifting weights, Cutler’s blood pressure skyrocketed, pumping so much blood through her heart that it tore the inner lining of her artery. The tear may have started small, but the artery eventually split open, spilling blood and interrupting its flow to other parts of the body, including her extremities. Hence, the numb feet. 

Sutter first saw Cutler three days after her symptoms began. She’d attributed them to overdoing it at the gym and went on with her life. “Never once did it dawn on me that my symptoms were related to a heart attack,” she says. 

Cutler didn’t call 911 until she felt pressure in her chest, which occurred while watching TV in the living room of her Bryn Mawr home. The EMTs came, telling Cutler that her vitals checked out. She insisted that something was wrong, so they transported her to Lankenau, where she was held overnight for observation.

The next morning, Cutler’s symptoms worsened. Physicians did an exploratory catheterization to see what was happening. During the procedure, Cutler’s arterial lining tore open, stopping her heart. 

“Never once did it dawn on me that my symptoms were related to a heart attack.”—Carol Cutler

Sutter was called to the catheterization lab and asked to perform emergency quadruple bypass surgery. Such a procedure is rarely done in an emergency—it’s usually scheduled. And Sutter typically does minimally invasive, robotically assisted coronary artery bypass grafting. 

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But there was no time, so Sutter had to open Cutler’s chest. “It was a harrowing experience,” he says. “I thought she would die before I could get her on the bypass machine. It was such an emergency that we prepped her as best we could and just started the surgery.” 

Equally harrowing was what Sutter found when he opened Cutler’s chest. It looked like an IED had exploded in her artery, shredding it to pieces. Sutter stitched her artery back together using veins harvested from her thighs. He wasn’t sure how long Cutler’s artery would stay open, if at all. But it did—and it has for the past 10 years.

Although she’s on a host of medications that ensure her blood pressure and cholesterol remain in check, Cutler is otherwise healthy. “The scar tissue was minimal, and her heart muscle strengthened and healed,” says her cardiologist, Dr. James Burke, director of the cardiovascular disease fellowship program at Lankenau Medical Center. “She’s left with virtually a normal heart.”

Now 56 years old, Cutler is fine—medically speaking. “The emotional part has been much more difficult to recover from,” she admits. “In many ways, I’m still recovering, and so is my family.” 

Cutler’s parents moved into the family’s house and stayed for four months. They nursed her back to health, feeding, bathing and medicating her. Cutler couldn’t handle stairs for a long time and was confined to her bedroom. 

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“I was virtually absent from my kids’ lives,” she says. 

Even when Cutler got the all-clear to leave her room, and then her house, she had trouble acclimating to the life she’d once lived. When going out in public, she felt like everyone treated her differently. Venturing away from the area was also psychologically difficult, as Cutler didn’t want to be far from her doctors. What if she had another heart attack? 

“People constantly say, ‘You look great’ and ‘You’re feeling better, right?’ because they want you to be recovered,” she says. “They don’t know what it’s like to be physically vulnerable and to not trust your body.”

Perhaps if they did, everyone would do anything possible to avoid a heart attack. That’s why Cutler has become an advocate for awareness about heart health, especially among women. She joined the board of directors of Lankenau Medical Center’s John B. Deaver Auxiliary Women’s Board. She’s also involved with the Lankenau Heart Institute’s Women’s Heart Initiative and its awareness events, which kick into full gear in February, American Heart Month.

First on the list when it comes to education is recognizing the symptoms of a heart attack. They include a rapid heartbeat, dizziness, shortness of breath, extreme fatigue, nausea, a cold sweat or clamminess, and pressure or pain in the center of the chest, the arms, the stomach or other areas of the upper body, including the jaw and neck. 

“You know when something is wrong in your body,” Cutler says. “Listen to the voice that tells you to get to a hospital.”


For more on the Women’s Heart Initiative, visit www.mainlinehealth.org/whi.  


Seniors and cardiac health. 

Source: American Heart Association

65 years: Average age for a first heart attack in men.

72 years: Average age for a first heart attack in women. 

70% … of those 60-79 have cardiovascular disease.

83% … of men over 80 have cardiovascular disease.

87% … of women over 80 have cardiovascular disease.

65% … of cardiovascular deaths occur in those 75 and older.

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