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Sanjay Gupta MD

One Teen's Heart Attack; Gabrielle Giffords on a Path to Recovery; A Doctor's Survival Story

Aired February 13, 2011 - 07:30   ET

THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.

SANJAY GUPTA, M.D., HOST: Good morning. I'm Dr. Sanjay Gupta and welcome. First up, a picture of this woman a year ago, high school graduation and she was 19. Just one year after this picture was taken, her doctors told her she had a heart attack. How could that possibly happen? We figured it out.

Also, a big surprise in the world of breast cancer. A very common, a very wildly accepted treatment they find may not help. We'll explain that.

Plus, something I'm dedicated to. Our 2011 fit nation triathlon challenge is off and running, quite literally. Meet the rest of the team that I'm going to be competing with this summer. Let's get started.

Nothing about the story you are going to hear now is typical. A young, pretty girl, shopping for Christmas lights and then suddenly clutching her chest. She wasn't a smoker. She wasn't a drinker. She was not overweight and she was just 19 years old.

We talk about heart disease all the time on this show, and this is heart health month. We talk about how to prevent the classic symptoms of heart disease and we talk about how women are more affected by this than men.

But sometimes the stories are just plain unusual and sometimes they are rare. Would you know what to do if you found yourself in this situation?

(BEGIN VIDEOTAPE)

DANIELA RODRIGUEZ, STUDENT: Hi. I'm Daniela Rodriguez. I'm 19 years old and a college student. Everything started on Thanksgiving day. I was at the table eating dinner, and I started feeling really hot. It was a feeling I had never felt before.

Two days later, I was shopping with my friends. I started feeling like the pain that goes through my throat. It was like this part over here. And then a few minutes later, I started feeling my arm. It t was like I just -- it was horrible.

I didn't feel well. It was pain. It was like a little pressure in me. I felt like I couldn't breathe. It was horrible. UNIDENTIFIED FEMALE: I didn't want to scare her, but I knew something was wrong.

RODRIGUEZ: But my friend, she kind of knew because she is older than me? If that hurts, those are symptoms of a heart attack and I was like no, no way, this cannot be happening. She actually took my jacket, and where do you feel the pain? And she said this is not normal.

UNIDENTIFIED FEMALE: She started crying and she's like, you know what? The pain is really strong.

RODRIGUEZ: Let's go. Call your mom, call your dad, and I'll take you over there.

CECILIA VILLARREAL, FRIEND: I dropped her in the car and they took her right away to the hospital.

ROBERTO RODRIGUEZ, DANIELA'S DAD (through translation): I was very emotional. I knew something was not normal because she was immediate, within 10 minutes. My wife was with her and when she came out, she told me there was a problem with her heart.

RODRIGUEZ: I was like wow. I had a heart attack. And I just -- I was surprised because how come I had a heart attack? I'm 19 years old. That never happens to somebody. I'm pretty young. I heard OK, you know, old people have these, 60, 70 years old. It was something not normal.

(END VIDEOTAPE)

GUPTA: It was so startling to look at those images. She's 19 years old and she's complaining getting classic signs of a heart attack. I will tell you she is doing better. She is taking medications at home and resting.

But we really want to sort of dig down this a little bit. So joining us is her doctor, Dr. Jason Reingold. He's a cardiologist at St. Joseph's Hospital.

What happened? A 19-year-old essentially with heart attack symptoms, what happened to her?

DR. JASON REINGOLD, CARDIOLOGIST: This is, you know, an exceptional story and what Daniela had is let's call it a spontaneous coronary infection. And to be honest, this is a rare cause, but it's actually one of the more common causes in young, healthy females.

GUPTA: How common is this or how rare?

REINGOLD: Well, we don't have a good estimate, but we think it's anywhere from .3 to 1 percent. And there's about 220 cases that have been published in the literature.

GUPTA: So exceedingly rare, but, you know, we do have this model here and my understanding is, if you take a look at the model, we're talking about these blood vessels here on top of the heart, coronary arteries.

REINGOLD: Yes, and these are the arteries that actually provide the heart with oxygen and nutrients and most of these happen in what's called the LAD or the main artery. This feeds all of her heart. So damage to here really has the potential to jeopardize the heart.

GUPTA: It essentially just dissected so she wasn't getting enough blood flow to the muscles of her heart anymore.

REINGOLD: Exactly, one of the walls actually tear apart and split open and when that happens blood went down the wrong pathway.

GUPTA: Is there any way she could have known that she had this condition?

REINGOLD: No, I think, you know, she had the classic symptoms, the chest pain, the radiation down to the shoulder into her arm, that's the signal of a heart attack.

GUPTA: Yes, one of the things, Jason, is that we heard a lot about Ambassador Holbrooke, several years ago. We heard about John Ritter, the actor both subsequently dying from dissections. And again, it was said they could had no idea that it was happening. What happened in their case?

REINGOLD: It's a similar pathology. This time you are involving the aorta, the main artery that feeds blood to all the organs and in both cases, there's a weakness in the wall of the artery that predisposes it to tearing and splitting apart.

GUPTA: When someone is having these sorts of symptoms. I mean, a 19-year-old. You heard she says I got pain in the throat. I'm feeling hot. Most teenagers would blow this off. Thinking it's nothing. How do you know if something is a problem?

REINGOLD: Well, the answer is you have to go to a doctor. That's the problem. We have to educate people that if they have the signs, they have to seek medical care.

GUPTA: Chest pain, obviously, one of them.

REINGOLD: Yes. She had the chest pain. She had the shortness of breath. She couldn't catch her breath. She was sweating. She had really all of the classic symptoms.

GUPTA: How dangerous was this for her?

REINGOLD: Actually 50 percent of patients who have this died immediately of sudden cardiac death. She is extremely lucky that she actually had a second chance.

GUPTA: And she's fine now.

REINGOLD: She's doing great now.

GUPTA: We talk about heart disease all the time on this show. People don't realize this, but women actually have a greater chance of dying from a heart attack than a man. Are there specific things women should be looking for?

REINGOLD: Yes, and I'm glad you brought that up. This is one of the stereotypes that we really have to get rid of. So in women they often have atypical symptoms and that means that instead of having the crushing chest pain, they may have shortness of breath, weakness, nausea, sweating. It is hard for patients or physicians to know that they are actually having a heart attack in that early critical period.

GUPTA: If something like that is happening, get it checked out. The good news, most of the times it's not a heart attack, but it's worth getting checked out.

REINGOLD: Right, I'm not saying that everyone with these symptoms is having a heart attack, but let your doctor decide.

GUPTA: Thanks for joining us. Heart health month obviously something we're really dedicated to. Appreciate it.

And we've got some good news this week about Congresswoman Gabrielle Giffords, still fighting back from the gunshot wound to the head and now more than a month later, we heard this.

(BEGIN VIDEO CLIP)

PIA CARUSONE, GABRIELLE GIFFORDS' CHIEF OF STAFF: She's having oatmeal and yogurt for breakfast and asked for toast. She sounded great. Very clear to understand, and I said absolutely and we asked the nurse to call the cafeteria and get some toast.

(END VIDEO CLIP)

GUPTA: I'll tell you why this is so important. So far we've known that she is able to understand. She was following commands, heard something, and executed the command.

Now we know she's able to express herself through speech, asking for something specific. Toast in this case. Also heard from chief of staff that she's eating solid foods.

She also says she's very aware of things, including the fact that her husband is planning a trip to space in April. So this is a really remarkable recovery. Keeping our eyes on it then we're certainly bring more details to you as they come to us.

I want to introduce you to someone else now this is Lynn Holden. It was a TV show that actually originally inspired her to become a doctor and then it was a close call, in fact, a real brush with near death that inspired her to have others become doctors themselves. You will meet her, next, stay with SGMD.

(COMMERCIAL BREAK)

GUPTA: And we're back. As you know, we always want to introduce to you ordinary people doing some extraordinary things. Dr. Lynn Holden fits the bill.

She was living her dream really as a successful doctor when she came down with a rare heart condition that landed her in the same emergency room where she worked.

The saying is a pretty common one, it says, what doesn't kill you, makes you stronger, and for Dr. Holden, nearly dying was an inspiration to give back. Here is her story.

(BEGIN VIDEOTAPE)

UNIDENTIFIED FEMALE: Well, I always wanted to be a physician, since I can remember, since I was six years old.

GUPTA (voice-over): Dr. Lynne Holden has achieved her dream. She has been a physician in one of the busiest emergency rooms in the United States for the past 15 years.

UNIDENTIFIED FEMALE: What brings you into the hospital?

GUPTA: Without any doctors in her family to look up to, it was Dr. Marcus Welby, from the '60s TV series who inspired her.

DR. LYNNE HOLDEN, MONTEFIORE MEDICAL CENTER: I admired the way Marcus Welby went in and he took care of patients, and made them feel better.

GUPTA: Another driving force Grey's Anatomy. No, not the current TV show that's probably inspiring a whole new generation of doctors, but the book "Gray's Anatomy," which she first saw on Marcus Welby and then under the Christmas tree.

HOLDEN: The book for me was a constant reminder of what my goals and what my dreams were.

GUPTA: A dream achieved only to be surpassed by the arrival of her daughter in 1997. But a week after the birth of her baby, Holden became seriously ill.

HOLDEN: I started to experience shortness of breath. Twelve hours later, I realized that something was really wrong. I had to seek attention.

GUPTA: The diagnosis? A rare and serious condition called peripartum cardiomyopathy. After a year of therapy, she overcame the heart problem and went back to work in the ER and that's not all that happened.

A chance meeting led Holden to inspire young people with the same dream she had as a child. She was on the subway, reading the book "Gifted Hands" by brain surgeon Ben Carson when a woman looked down and saw the cover.

HOLDEN: I was sitting down. She was standing up and she said to me, you know, my baby had to read that book for his sixth grade class and I said really? She said yes, and now he wants to be a brain surgeon. And I said really? Yes. But you know, I work three jobs and I don't know how to even start.

GUPTA: A light bulb went off in her head.

HOLDEN: The mentoring program really was started out of the need to help students who have a dream, but don't know how to attain that dream.

GUPTA: Now she's helping the next generation of health care professionals realize that dream.

(END VIDEOTAPE)

GUPTA: Now, there's another thing I should point out as well. Dr. Holden is a very lucky woman. About half the women that develop this heart condition don't survive. Today, she's in perfect health, a really remarkable story.

Coming up, there's a stunning finding on breast cancer. Everyone needs to pay attention to this. Here is what we're talking about. There's a common treatment out there that simply may not help. We'll sort it out. Stay with us.

(COMMERCIAL BREAK)

GUPTA: Imagine this. You're diagnosed with cancer. You undergo an invasive and painful procedure, and then you find out later maybe it wasn't necessary after all. Well, that's the exact reality hanging over tens of thousands of women today.

When breast cancers found early, often surgeons are going to cut out these things over here. They're called lymph nodes. They're located in this part of the body. Try to clear out cancer before it spreads at least that was the idea.

But a new study in the Journal of the American Medical Associations finds that removing these lymph nodes does not necessarily save more lives. As long as the rest of the cancer treatment, radiation and chemotherapy is all the same.

Well, joining us now is Dr. Otis Brawley, Chief Medical Officer of the American Cancer Society and Kris Moss who had this exact procedure done 2-1/2 years ago. Welcome to both of you. We hear your health is good.

UNIDENTIFIED FEMALE: Yes.

GUPTA: You had the lymph node dissection first after you were diagnosed with breast cancer as part of this clinical trial.

UNIDENTIFIED FEMALE: Correct.

GUPTA: What was it like first of all, I mean, obviously, it's surgery, but how painful was the procedure itself?

KRIS MOSS, BREAST CANCER SURVIVOR: It's horrific. I went in and had the nuclear dye injections the day before. GUPTA: Injecting dye to see, you know, which lymph nose.

MOSS: So the dye leads directly to the sentinel node. I wasn't prepared for the pain of that procedure.

GUPTA: This is 2 1/2 years ago, the fluid, the lymph fluid, constantly supposed to be circulating through your arm. But since you had so many of these lymph nodes taken out, what does your arm feel like?

MOSS: I have no sensation whatsoever in the back of my arm from my shoulder to my elbow. I have occasional bouts with swelling. I have a lymphodema sleeve, which goes from my wrist to my shoulder -

GUPTA: The compression sleeves?

MOSS: The compression sleeves.

GUPTA: OK. MOSS: As well the gauntlet for my hands that when I start to feel the pressure, so it's basically I compare it to a water balloon. You're feeling a water balloon as the pressure builds against the latex is what I feel in my arm.

GUPTA: Are you right handed?

MOSS: I'm left handed.

GUPTA: How hard is it to do things with your right hand?

MOSS: I have my moments. Some days I'm really good and I can go to the gym and work out. Other days, I can lift a laundry basket and a bag of groceries.

GUPTA: Part of the reason I'm asking these questions because, you know, we do stories on breast cancer all the time. But this is a reality. If you have these lymph nodes removed and a lot of patients say this is the worst part for them afterward in the long run.

MOSS: It was worst than the mastectomy.

GUPTA: Does this surprise you first of all, what she's describing?

DR. OTIS BRAWLEY, CHIEF MEDICAL OFFICE, AMERICAN CANCER SOCIETY: No, unfortunately, it's common. It's very, very common that women who have lymph node dissections have especially lymphedema. They can have pain in their arms. We actually have problems and that they can't have blood pressures taken from that arm again. They can't have blood drawn from that arm. It actually is incapacitating.

GUPTA: You know, the thing about it is that obviously we have been hearing about the new study saying does it make a difference, could it have made a difference if she didn't have all these lymph nodes taken out versus maybe -- AHMID SHAFIQ, EGYPTIAM PRIME MINISTER (through translator): -- has been put on a map, but it has its priorities. So I will touch upon some other subjects, which might be questions and without putting them in sequence. If there are any questions touching on these subjects, we will cover them again.

The delay in appointing some ministers, this is the question because we are quickly (ph), the 24 hours there (ph) not all working. The opposition given my colleagues in relation to the nominated names, I don't want to rush. The ministry which has not got a minister is still operational.

I don't want the issue to make it larger than it is. So we take these statements and we make sure that the appointment of the minister is guaranteed because we are trying to avoid. So don't worry about that. So we do not want to elaborate that issue. So when I look at the nominated names, me and my colleagues, so we will not delay it when we appoint someone to that ministry. In relation to ministry of information, yesterday in one of the programs -- and it might -- we might have rushed in appointing a minister, but that did not happen.

No. There was no rush. So we cannot -- guarantee everything to be perfect because we have to make sure. Otherwise we might be asked to come forward and give evidence. So this doesn't mean that the study was not adequate or the scrutiny was not enough or the files were not impacted. But it means that the Ministry of Information Al Fahi submitted his resignation so there was not enough time. I'm not talking unless it is exactly correct.

And I accepted his resignation, which will be submitted and there are some other officials to look into the resignation. So the colleague said that he would attend -- yes, I said you can attend the council of ministers because your resignation has not been accepted. OK, and you can't travel, but you can attend the council of ministers. But I was told yesterday that his resignation was accepted.

So I informed him that, so -- so if -- so if he is required for any inquiry, that has nothing to do with his resignation. So my belief is that I am very frank and I say the bad points before I say the good things. And I would say we are all subjected to inquiries. So I have to reduce the -- so I would say in relation to the other ministries, which have not been appointed with ministers.

REGGIE AQUI, CNN ANCHOR: All right, you have been watching as the Egyptian prime minister addresses state television, of course, the public at large. Every word that is said from any of these members, either of parliament who are members of the military who are now in charge of the government there are being watched very closely. Of course, not just in Egypt but across the region and across the world.

We didn't hear a lot of new information there, but we did hear as the Egyptian prime minister was saying was that the ministry of information ministry stepped down and he accepted his resignation and he does not want to rush replacing these people as soon as resignations come in. They want to find the right people for the job. Of course there was a question about whether anyone in parliament will have a job as there have been demands from the same protesters who ousted the president to get the parliament out in the same way.

We'll be watching the information as it continues to develop in Egypt and throughout the region. For now, for our U.S. visitors who are watching right now and our international viewers we'll return to your regularly scheduled program. I'm Reggie Aqui, CNN Center. More information as it breaks from Egypt.

(BEGIN VIDEO CLIP)

JOAQUIN BRIGNONI, FIT NATION ATHLETE: I'm entering the tri- challenge for three reasons. Here are my three reasons.

NINA LOVEL, FIT NATION ATHLETE: I want to do it for my generation. I want to show all of us that even though we're getting older we can still get better.

KAS SEERLA, FIT NATION ATHLETE: When I was younger sports and athletics was not encouraged and I felt that I missed out. I'm adventurous and I want to be part of the triathlon because it will be a challenge for me.

(END VIDEO CLIP)

GUPTA: Joaquin, no question, but three girls -- and I have three girls, so I kind of know what you mean by this. Tell me about that moment when you decided to do this. Did you talk to them about it? What did you tell them?

BRIGNONI: I didn't really talk to them about it, but I had been noticing my habits, my eating habits weren't really anything that I felt was setting a good example for them. I was drinking a lot of soda with every meal.

So I was noticing that my kids although we were teaching them to have good habits, healthy habits. I was noticing that they were really watching what I was doing. My 6-year-old would ask me, why do you drink so much soda, Dad? And that's kind of what - kind of hit me.

GUPTA: What are their ages?

BRIGNONI: 6, 5, 1.

GUPTA: Let me tell you real quick, but your kids will watch you do this as well. And at some point you will feel guilty about the time it takes to train, but keep in mind your kids are watching this and it's going to be a good example for them. Nina, 58 is the new 28.

LOVEL: That's right. It really is.

GUPTA: I love it.

LOVEL: We're living longer and we may as well be as healthy as we can be.

GUPTA: Obviously, you can get a sense of your attitude and optimism and your attitude toward age specifically, but what inspired this?

LOVEL: Well, I just started running last summer. I had a friend who inspired me because she had never moved a muscle before and she started running. I just felt so much better. I just felt great.

Then we had a speaker at rotary one day. He does iron man triathlons and he showed us a video. I left there thinking I might like to do a triathlon. I don't what came over me and then it wasn't a week before I found the contest.

GUPTA: And six months from now, how do you want to be different?

LOVEL: I want to be healthier than I am and I want feel even more energetic than I already do.

GUPTA: Good for you. Welcome. Kas, you know, one of the things that really struck us was you said when you're growing up in India and Malaysia, sports especially among girls was really not encouraged. You're going to do this. A lot of people will watch you as an Indian woman doing this. Besides for yourself, what other examples or messages are you trying to send?

SEERLA: Well, that sports and athletics can be a part of your life, hand in hand with academics. I have two girls myself. I want them to have a balanced education. I want them to see me and see that, you know, you can do sports and study and you can do both and be good at it.

GUPTA: What did they say when you told them you were doing this?

SEERLA: When I told them I was going to swim in the Hudson River, my daughter said, are you going to be swimming with fish?

GUPTA: Among other things.

SEERLA: She said, I want to swim, too.

GUPTA: That's sweet. Maybe we'll see her at the finish line.

SEERLA: Yes, yes. She said she wants to make a flag and wave it.

GUPTA: My mom did the same thing for me.

A lot of girls here, by the way, three girls, two girls, three girls. Congratulations to all of you. It will be an exciting six months. You will be transformed as I was.

And for those of you at home who want to join in, we encourage you to do so. Join with our training. We'll be posting workout, nutrition plans every week on our web site, Cnnhealth.com and all six tri-athletes and the coaches will be blogging. They will share videos of the journey every step of the way.

Thanks for watching. I'm Dr. Sanjay Gupta. More news on CNN starts right now.