A pregnant Scotby woman spent three days in pain before she realised she’d suffered a heart attack.
Ciara Wannop, 34, was 26 weeks pregnant and believed the pain in her chest and breathlessness was down to heartburn.
It started on a Friday afternoon with indigestion-like pain and worsened that night and over the weekend while she helped on the family farm, mucking out her horses’ stables and walking the dogs.
When she returned to work the following Monday as a pharmacist at the Cumberland Infirmary in Carlisle, she asked her medical colleagues for help.
Blood tests ordered
Doctors did not believe it was a heart attack because of Ciara’s age and apparent good health, but they organised an ECG and blood tests.
The blood results showed raised cardiac enzymes called troponins and together with an abnormal ECG indicated something had happened to her heart.
Ciara was immediately sent for an angiogram, a procedure in which dye is injected into blood vessels while in a scanner, which confirmed a heart attack.
This showed a blood clot blocking an artery and an extremely high level of cholesterol – 10.8 – was causing 80 per cent blockage of her coronary arteries.
Advice was taken from experts at heart centres in Manchester and Newcastle and Ciara was referred to Newcastle’s Freeman Hospital, undergoing an angioplasty, to clear the blockage and insert a stent, a tiny tube to keep the artery open.
During her three days in hospital, she was again found to have very high cholesterol and subsequent genetic testing confirmed Familial Hypercholesterolaemia (FH), a genetic condition that meant she was born with an abnormal level of cholesterol in her blood.
Prescribed tablets
She was prescribed cholesterol-lowering tablets but was unable to take them while pregnant or while breastfeeding her new son Odin, so the treatment was deferred until early 2021.
Since then, her cholesterol level has fallen to a safer level, 6.0.
Ciara said: “I was really, really lucky and I know that in a way, I was saved by Odin because being pregnant in addition to having the blocked artery triggered the heart attack – and I wouldn’t have known I had FH until much later otherwise – when it would probably have been much worse.
“When I was having the burning pain in my chest I didn’t consider for a minute that it was a heart attack; I was fit, going to the gym and continued horse riding while pregnant; I had never smoked and ate healthily – and I was only 34. Even my doctor friends and my midwife didn’t think it was a heart attack.
“It shows that just because you are healthy and fit doesn’t mean you are safe; you could be a professional athlete and not realise you have FH and a dangerously high level of cholesterol.
“It was the worst time of my life when I was told there was a problem and it might have been a cardiac abnormality; I was worried when I was told it could be a coronary artery dissection and I would have to give birth at 26 weeks; it was very scary. When I was told it was a heart attack it was actually a relief.”
Family history
Ciara was questioned about her family history and after consulting relatives at home in Ireland she discovered not only did her dad have a heart stent and was on medication for high cholesterol; seven out of his nine siblings and their mother were also taking tablets to manage high cholesterol.
Tests revealed Ciara’s 31-year-old sister also had FH and she is now taking statins; some of her 32 cousins have been tested and so far two of them, both in their 20s, have been identified as having FH.
“I know that I was really lucky that FH was discovered and I was looked after in an unbelievable way, everyone was brilliant in Carlisle and in Newcastle,” continued Ciara.
“After the procedure, I went for cardiac rehab in Carlisle and they had never had a pregnant patient before, there were no studies about FH in pregnancy and in providing rehab, but the cardiac rehab team were fantastic, they helped me get my confidence back to start exercising again and they kept doing check-ups and keeping a close eye on me.
“I was amazed when I discovered how many of my family were on statins; no one talked about it so no one realised there were so many with high cholesterol. Now that we know, we can get our children tested and if they have FH they will be able to control it.”
It is thought that one in 250 people have FH – just eight per cent have been diagnosed.
A new national programme has been launched by England’s 15 regional Academic Health Science Networks (AHSNs) and NHS England and Improvement, to raise awareness in primary care of FH and other inherited cholesterol conditions for which effective treatments are available.
The aim is to increase cholesterol testing and make the best use of lipid-lowering treatment, based on National Institute for Health and Care Excellence guidance.
