AHA News: Heart Attack at 46 Led to a New Heart and New Outlook on Life

WEDNESDAY, Jan. 4, 2023 (American Heart Association News) -- Eddie Garcia juggled roles as the chief of staff for an elected official and the president of a school board. The positions seemed to be wearing him down.

At 46, he felt short of breath, his neck was sore and he had chest pain. Could it be a panic attack, he wondered?

Later that day, a trip to a clinic led to a trip to the emergency room, and then to a diagnosis: One of the main arteries in his heart was 100% blocked. He was having a heart attack.

Doctors inserted a stent to restore blood flow and keep the artery open. In the next 10 days, Garcia returned to the hospital twice because he felt fatigued and easily winded. He was diagnosed with congestive heart failure. In the second of those subsequent hospitalizations, Garcia's heart stopped.

While doctors were able to restore a normal heartbeat, he again endured lingering damage. Fluid had built up in his lungs, preventing his organs from receiving oxygen. He developed a condition called acute respiratory distress syndrome, and it's often fatal.

To give his lungs time to heal, doctors placed Garcia in a medically induced coma. Meanwhile, his family and friends sat vigil in the waiting room, saying prayers and telling stories. There were often 25 people there at a time. "I wasn't conscious, but I think I was able to feel that energy coming through the walls from the waiting room into the ICU," Garcia said.

When he woke up nearly a month later, his muscles had become very weak. Once Garcia was healthy enough, doctors protected him against another cardiac arrest by giving him an implantable cardioverter defibrillator, or ICD. The device monitors the heart's electrical activity; if it detects any dangerous irregularities, it shocks the heart back into a normal rhythm.

Garcia's heart journey began in 2010. For the next seven years, he managed his heart failure with medication and lifestyle changes such as eating a low-sodium diet and taking a daily 1-mile walk.

Then he began having trouble completing that walk. He felt tired and winded. Around the same time, his heart rate became so rapid that it triggered his ICD. This happened twice, once when he was sleeping.

"If you start having more and more of these shocks, then not only is it unpleasant and traumatic, but it's also an indicator of a worsening heart," said Dr. Hemal Parekh, an advanced heart failure and transplant specialist who treated Garcia. "It was time to start thinking about advanced therapies."

Parekh said Garcia's positive attitude and resilience made him a good candidate for a heart transplant, but there was one complication: He had developed pulmonary hypertension, or high blood pressure in the lungs. This could cause a new heart to fail. However, it could be controlled over time.

As Parekh began that process, another surgeon implanted a left ventricular assist device, or LVAD, to essentially do the work Garcia's failing heart could no longer do. Although some people live with an LVAD for years, the device is often used as a temporary bridge to transplant.

Once doctors confirmed that his body could tolerate a new heart, Garcia went on the transplant waiting list. After 17 months, the transplant team called. They had identified what looked like a perfect match. A former high school athlete, basketball coach and lifelong sports fan, Garcia compared it to being in the locker room before a big game. "I was super excited and nervous," he said. "Here we go."

Early the next morning, nurses rolled Garcia into surgery. The next thing he remembers is waking up, groggy and in pain – but also breathing more easily than he had in years.

Garcia and his wife, Sandra, returned to their San Jose, California, home early in the COVID-19 pandemic, which meant his legion of friends and family couldn't hug him. So they did the next best thing. They surrounded his house in their cars, beeping their horns, holding up signs and balloons to welcome him home.

"Having this huge system supporting me was magnificent," Garcia said.

As Garcia's physical health improved, his mental health became an issue. He became among the more than 60% of heart transplant recipients to experience anxiety and/or depression during the first year after surgery. Some days he struggled to get out of bed. He agonized over how his inability to work had impacted his family's finances.

"After 10 years of heart failure, I got to the holy land, but I felt like an abject failure," he said. "It was absolutely awful."

With the help of a therapist, his outlook improved. He began looking for ways to raise awareness about heart disease. He spoke at American Heart Association events, for example, and participated in a local Heart Walk with his transplant team.

He also published a book about his experience and subsequent spiritual journey, which centers on faith, hope and love.

Garcia continues to take daily walks, watch his diet and check in regularly with his doctors. Despite those efforts, during the summer of 2021, a test revealed high levels of antibodies in his blood – a sign that his immune system was rejecting the new heart.

He spent 11 days in the hospital. An intravenous infusion of immunosuppressants stopped his body from rejecting the new heart.

Now retired, Garcia has come to realize that taking care of himself means taking it easy and knowing when to say no.

In addition, he's embraced mindfulness, focusing on what's happening in the moment rather than obsessively worrying about the future, as he did before his heart attack.

"You've got to take it one day at a time," he said. "When I'm in the groove of living in the moment, it's pretty great."

American Heart Association News covers heart and brain health. Not all views expressed in this story reflect the official position of the American Heart Association. Copyright is owned or held by the American Heart Association, Inc., and all rights are reserved. If you have questions or comments about this story, please email editor@heart.org.

By Tate Gunnerson, American Heart Association News