Kristene’s Story: From Cardiac Arrest to a Second Life

Kristene Zwiebel’s clock started ticking when she felt pain in her chest in March 2013. A previous cardiac arrest in July 2012 likely had caused a malignant arrhythmia in her heart, which festered for seven months before Kristene, then just 32, experienced a heart attack. She was rushed to the University of Cincinnati Medical Center’s Emergency Department and treated by doctors of the University of Cincinnati Heart, Lung and Vascular Institute.

Kristene Z

After a history of struggles with her heart, Kristene is happily expecting another child this summer.

Imran Arif, MD, director of the Cardiac Catheterization Lab at West Chester Hospital and professor of clinical medicine and interventional cardiology for the UC College of Medicine, diagnosed her with a coronary vasospasm, or a sudden narrowing of one of the coronary arteries—a condition not uncommon in women Kristene’s age.

The next step was to prevent the spasms from returning. “Dr. Arif performed a number of diagnostic tests and a review of medications before he zeroed in on the medication I needed,” Kristene says. The medication worked. Kristene hasn’t had a spasm since 2013.

Then, Kristene and her husband, Eric, began to consider having a second child. Their first, Emily, now 4, was born 18 months before Kristene’s first cardiac arrest. But the medication that effectively stopped Kristene’s spasms from recurring would have made another pregnancy risky—for both Kristene and the new baby.

“Any pregnancy predisposes patients to a greater risk of cardiac complications,” explains Mouhamad Abdallah, MD, associate director of the Cardiac Catheterization Lab at West Chester Hospital and assistant professor of medicine for the UC College of Medicine.

“Some of the hormones produced in pregnancy can induce coronary basal spasms. Moreover, we don’t know how the medicines we use to treat conditions like Kristene’s affect babies, so continuing the medications presented another kind of risk.”

“The stress of pregnancy on Kristene’s heart could potentially have made her condition worse,” says Dr. Arif. “It was a difficult decision.”

Kristene and her husband, Eric, met with Dr. Arif, Dr. Abdallah and a team of UC Health OB/GYN specialists to better understand the issue. “We discussed the pros and cons of proceeding with a pregnancy,” says Dr. Arif. “This level of collaboration and deep thought process was quite unique, but it was also necessary to ensure we achieved the best outcome for Kristene.”

“It was a great opportunity for all of the doctors to come together to create a complete medical plan,” says Kristene. “Ultimately it was decided that my pregnancy would be safe. It would not be without some risk, but that risk wouldn’t be so extensive that the doctors would advise against the pregnancy.”

“The ultimate decision to have a baby was her choice, and we just tried to help her as best we could,” says Dr. Abdallah. Once Kristene and Eric decided to pursue the pregnancy, Dr. Arif developed a care plan to wean Kristene off of her medication. To date, her pregnancy has been healthy, happy and according to plan, and Kristene is due to deliver this summer at West Chester Hospital’s newly opened maternity unit.

Kristene says big sister Emily is just as excited for her little brother to arrive as the rest of the family. “At night she puts her hand on my belly and reads to her baby brother.”

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