Four Heart Attacks, an Answer, and a Plan
Jessica Biggs was scared to go to sleep at night. At 32, she had her first heart attack, then a second, third and fourth within a few months. The Smith County schoolteacher couldn’t find answers about the underlying cause until she came to Vanderbilt.
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At age 32, Jessica Biggs was scared to go to sleep at night. Her mind wouldn’t stop: “What if I don’t wake up?”
The wife, mother and schoolteacher suffered four heart attacks within a few months without knowing why.
It wasn’t until she was transferred to Vanderbilt that she finally got an answer: In the emergency department, a Vanderbilt cardiologist diagnosed her with a rare condition called spontaneous coronary artery dissection and put her on a path to appropriate, specialized care. Jessica soon became the first patient in the new Arteriopathy Clinic at the Vanderbilt Heart and Vascular Institute and is now under the care of director Esther S.H. Kim, M.D.
“I feel normal again and I feel safer now,” said Jessica, 34. “I have gone from taking twelve pills a night to four. I am no longer scared to fall asleep for fear I might not wake up. I finally have someone who is looking out for me.”
No Risk Factors
Jessica’s four heart attacks weren’t triggered by the usual factors. She had no underlying disease and no high blood pressure. She was a healthy woman in her early 30s, a former basketball player, and an active schoolteacher who taught English, pitching in on PE class and coaching.
She had a second job that required travel, a third grader of her own (son Jackson) and an active social life.
Then during a business trip to Ohio in June 2016, Jessica began having her first heart attack symptoms, which lasted on and off for three days before they intensified.
“The first time I had symptoms, I ignored them,” Jessica said. “I didn’t know what it was. I bent over, sneezed and when I stood back up, all of a sudden I felt like I had the flu, bronchitis and a pulled muscle all at the same time.”
Her online search of her symptoms returned heart attack, but she just kept thinking, “I am 32 years old. I don’t have high cholesterol. I don’t have high blood pressure and I am in great shape and athletic. I am not having a heart attack.”
Even after the pain became so severe that she decided to go to a local emergency room, Jessica waited an hour to call her husband David to take her. Her second heart attack came 12 hours later while she was still hospitalized.
In August, four days into the start of the new school year, the pains returned. She was experiencing her third heart attack. Then came a fourth. For almost a year, Jessica rotated through hospitals around her home in Smith County, Tennessee, as she endured four heart attacks and six stent placements. Once, she was told to say her goodbyes to her husband David before being whisked away by helicopter to Nashville.
David, who himself has since had open-heart surgery and stent placements at Vanderbilt in 2017, said he was more frightened during Jessica’s experience than during his own.
“She’s my life. It scared me to death to think I was going to lose her. She’s the foundation for our family,” said David, 47. “I tried not to show much fear in front of her, but it was a scary situation.”
As Jessica was diagnosed with SCAD, Vanderbilt was on the verge of opening Tennessee’s only Arteriopathy Clinic to treat complex arterial disorders like SCAD and had recruited one of the country’s premier SCAD physicians to direct it: Dr. Kim. Her arrival, David said, “was a blessing.”
Dr. Kim continues to manage Jessica’s care. SCAD disproportionately affects women, producing heart attacks prompted by spontaneous tearing in the coronary artery wall. Typically, SCAD patients don’t have other risk factors for heart disease. They are otherwise healthy, and may even be young women who have recently given birth. Limited research has been conducted on SCAD, something Dr. Kim and her colleagues are working to change.
“I feel normal again and I feel safer now.”
“Jessica had been through so much with her multiple heart attacks, with her multiple heart catheterizations, her multiple stents, not really understanding why it was happening and not really understanding the diagnosis that she was ultimately given,” Dr. Kim said.
“You can’t help but feel like there is so much that is on the line. Jessica’s a mom. She’s a teacher. I’m a mom. I work outside the home. She and I are similar ages. We could be friends. I know what her life is like outside of being a patient, so I can’t help but relate to her on that personal level. I feel a lot of pressure as a doctor, because I know so much is at stake. When I treat Jessica, it’s not just her. It’s her son and it’s her husband, too.”
Jessica said she sleeps like a baby now.
She no longer has a “go bag” by the door in case she has to rush to an emergency room. Jessica now lives a normal life but with some common-sense activity restrictions for patients with "weak" arteries (for example: no roller coasters, scuba diving or lifting heavy objects).
Though she knows there’s a one-in-five chance this could happen in another artery within five years, Jessica said, “I’ve got my old life back again.”
Except for one thing: Things that once seemed important, don’t matter as much.
“To-do lists don’t seem as important anymore,” Jessica said. “Family time does. I kind of feel like I have more control over my life now. My priorities are in order. I don’t really take on things I don’t want to do. The answer is ‘no’ a lot.”
She appreciates the little things more, like the warmth of sun on her skin and the light streaming through beautiful flowers in the spring: “I’m a whole lot happier now.”