Evergreen student comes to grips with surviving sudden cardiac arrest

By Patty Hastings, Columbian Social services, demographics, faith


photoHeidi Stewart, 18, a senior student at Evergreen High School, holds a paper heart with her name printed on it. She collapsed at school in February after suffered sudden cardiac arrest. Helping her that day, from left to right, are Eric McCaleb, Dianna Lynch, Reuben Dohrendorf and Marshall Pendleton. Nurse Debbie Fowler, who was instrumental in Heidi's rescue, is not pictured.

(/The Columbian)

Free youth heart screening

Fort Vancouver High School is hosting a heart screening for young adults that consists of a survey asking about possible signs or symptoms and family history of heart conditions, a physical exam, blood pressure measurement and an electrocardiogram. In some cases, a limited echocardiogram is conducted.

Students also will learn the importance of bystanders performing CPR and using AEDs in an emergency.n When: 9 a.m. to 3 p.m. Wednesday, May 22.n Where: 5700 E. 18th St.

Online Resources

Nick of Time Foundation

Quinn Driscoll Foundation

Spencer's Heart Strong Foundation

Parent Heart Watch

County looks to train thousands in CPR

Clark County looks to train 30,000 people in CPR over the next two years through large group trainings.

Currently, the county's survival rate for cardiac arrest that occurs outside of a hospital is 17 percent, said Dr. Lynn Wittwer, medical program director for Clark County EMS. It's above the U.S. average of 9.5 percent, but Wittwer looks to bring up the number of survivors.

When someone calls 911 to report a cardiac arrest, the dispatcher asks the caller if he or she knows CPR. If they don't, the dispatcher walks them through the steps. In an emergency, however, time is critical and people may be under too much stress to quickly learn CPR over the phone.

In the few minutes before emergency responders can get to a collapsed patient, cardio-pulmonary resuscitation can make the difference between life and death.

"The average person doesn't know CPR and it's our job to improve that," Wittwer said.

The effort kicks off May 17 at Evergreen High School -- the poster child for cardiac arrest response -- where the senior class will learn compression-only CPR. Next year, the county aims to teach every student at Evergreen.

"When you train kids, they teach their parents too," Wittwer said.

A mass training open to the public is set for later in May, although the details and location have not been finalized.

An Oregon state bill introduced on behalf of the American Heart Association would make training in CPR and the use of automated external defibrillators a requirement for high school graduation.

Other states have introduced or adopted similar measures, but there's no bill being considered in Washington.

Heidi Stewart describes death as nothingness. She did not hover above her body, or walk through a tunnel of light. It was as though the 18-year-old simply went to sleep and never dreamt. Except, when she awoke on the office floor at Evergreen High School, she was terrified, sad and in pain.

The high school senior suffered sudden cardiac arrest at school Feb. 12 and was later diagnosed with a rare heart condition, arrhythmogenic right ventricular dysplasia/cardiomyopathy, found in 1 out of every 5,000 people in the U.S.

The odds say she shouldn't be here.

Heidi remembers feeling lethargic that day. She can recall the day's events in bits and pieces, but her memory of the entire month prior to the incident is gone.

In her third period leadership class, she was helping hang 1,950 pink paper hearts for Valentine's Day -- one for every student in school. Around 10 a.m. she walked down the sophomore hallway, a shortcut to the student center, when she started to feel herself passing out. Heidi couldn't hear anything and had tunnel vision before it all went dark. The last thing she remembers seeing was her hand reaching for the door handle to Dianna Lynch's office.

"She was very direct about getting candy," said Lynch, sophomore academy secretary. During previous fainting spells, Heidi's dad, William Stewart, advised her to eat candy if she felt one coming on.

She collapsed sideways onto the carpet, just missing the counter and the copy machine. Lynch radioed the school nurse, Debbie Fowler, who said she was on her way with an automated external defibrillator, a portable life-saving device, and 911 was called.

Associate Principal Reuben Dohrendorf arrived first, finding no pulse. Dean of students Marshall Pendleton prepped the AED while Fowler started performing chest compressions. Heidi's parents, meanwhile, got the call no one ever wants to get.

Clinically dead

Their daughter was clinically dead for eight minutes.

"You can do a lot of things in eight minutes," Heidi said in an interview.

Run a mile. Walk her Airedale terrier. Swim 16 laps.

While Fowler continued chest compressions and the AED administered shocks, Fowler recognized the signs of a young body shutting down. Agonal breathing, the last gasping breaths that can continue after the heart stops, and blood coming out of Heidi's mouth.

"I thought we were going to lose her," Fowler said. School Resource Officer Eric McCaleb took over the chest compressions. With continued CPR and three shocks from the AED, life pulsed back into Heidi Stewart's body. She survived.

"In my eyes, it's a miracle," Lynch said.

Medics rushed her to the emergency room at PeaceHealth Southwest Medical Center. Her mother Ann Stewart, a special education staff assistant at neighboring Cascade Middle School, had a co-worker rush her there as well. As Heidi was rolled out of the ambulance at the hospital she remembers hearing her dad's voice and calling to him.

Why can't I see? Why can't I see?

Her vision and consciousness fully returned later that day.

Sudden cardiac arrest among youth athletes

A seemingly healthy young person suffers sudden cardiac arrest every three days in the U.S., nurse Fowler said. It is not only the leading cause of death among exercising young adults, it's also the leading cause of death on school property.

Sudden cardiac arrest is the first symptom to many undiagnosed heart defects and, unfortunately, in many cases it's the last.

It's two to three times more likely in young athletes, often occurring during vigorous exercise. The heart, like any muscle, tears as it expands and grows with use. In young athletes with heart conditions, scar tissue can form in these tears. Heidi swam competitively for seven years, on a club team and for Evergreen through the fall season, retiring from the sport because it hurt her shoulders. Physicians say swimming didn't cause her heart condition or her heart failure. She wasn't even exercising when she collapsed.

In PeaceHealth's Cardiac Care ICU, cardiologists performed an echocardiogram, an electrocardiogram and a cardio MRI that showed fibrous scarring on her right chamber. This part of Heidi's heart is larger than the left due to scar tissue that blocks signals from the brain to the lower chamber.

Surgeons implanted an internal defibrillator with a built-in pacemaker, leaving behind a dark scar on her chest. The device is her safety net, shocking her heart if she goes into cardiac arrest again.

For the active, ambitious high school senior, it was all so unexpected.

"I could take on the world in a day and I would be fine," she said.

A lifesaving device, a life changing diagnosis

The AED that saved her life was donated by the Quinn Driscoll Foundation, named after a 13-year-old student-athlete at Wy'east Middle School who died in 2009 after suffering cardiac arrest while running on the track during gym class.

"Thanks to him, I'm here today," Heidi said.

Evergreen has two AEDs, one in the main hallway and one by the gymnasium.

"I feel very fortunate to work in a high school with AEDs and with people willing to help students or anyone in need," Associate Principal Dohrendorf said.

The school had a previous incident in 2011, where they had to use an AED on a 14-year-old girl who also survived. Zoll, the medical corporation that designed the device, said Evergreen High School has more experience using the AED than any other school in the country.

Dean of Students Marshall Pendleton made his new mantra: "Go to school. It will save your life."

When Heidi went home from the hospital Sunday, Feb. 17, the reality and gravity of her diagnosis started to sink in. She questioned why she lived when her chances of survival were slim to none. There is no known cure for ARVD/C. She's not allowed to get too stressed out or get her heart rate too high; beta blockers help lower her blood pressure. She can no longer lifeguard at the Firstenburg Community Center, so she'll be a swim instructor instead. Doing activities alone is off limits.

"I hate having to be dependent on people," Heidi said.

She's realizing that no one is a lone soul. People need people, whether they want to admit it or not, and she couldn't do what she does today without everyone in her life.

They're the people who make her life precious, too precious to let it get away.

At her hospital bedside, her parents kissed her forehead and stroked her hair, reassuring her that she would be OK.

"Don't let it go by," Heidi's mother, Ann Stewart, said. "Don't let a day go by that your kids don't know they're loved."

People can get hung up on busy lives, neglecting their family and the time they have with them. Time, after all, can run out without notice.

What if Heidi never got to graduate? Attend senior prom? Walk down the aisle? Or snorkel the Great Barrier Reef, like she dreams to?

The future

Instead of leaving for Eastern Washington University in the fall, she'll stay local and study at Clark College. She hopes to be a delivery nurse and be there when life begins.

Her parents thanked Quinn Driscoll for providing the device that saved their daughter's life, and they're incredibly grateful to the supportive community and the school officials who didn't just stand by.

A genetic lab on the East Coast is analyzing Heidi's blood to determine whether her condition has a genetic link or was caused by a mutation. In the meantime, the Stewarts pulled Heidi's younger sister out of sports just to be safe.

Heidi is trying to find balance and continues fighting the odds by volunteering with the Quinn Driscoll Foundation and Spencer's HeartStrong Foundation in Longview to spread the word about sudden cardiac arrest among youth. She's learning to deal with her unexpected brush with death, her diagnosis, and most importantly, she's living for the moment.

Every morning when she wakes, Heidi wiggles her fingers and toes and says, "I am so blessed to be here."