Heart to heart
Joyful birth leads to cardiac failure, surgeries and lucky transplant for one S.A. nurse.By Lauri Gray Eaton

Sandy Elizardo will be celebrating this Valentine's Day with her new baby andher new heart.

Photo: Photo By Lauri Gray Eaton / SA

There will be no need for flowers, candy or heart-shaped balloons this Valentine's Day in the Elizardo household.

Sandy Elizardo already has two far-more-precious gifts. One lies breathing softly in her arms. The other beats steadily in her chest.

Sandy's husband, Andrew, has his thank-you notes to write as well. He has a new baby and a wife back from a frightening brush with death.

Hearts are the motif du jour each February, but they are always in season at Methodist Specialty and Transplant Hospital, where Sandy, 39, works as a resource nurse, going where she's needed.

She unexpectedly became the needy one as a patient this past fall when, merely days after giving birth to a long-awaited baby, she was back in the hospital with a case of heart failure that had her doctors sequentially stunned and puzzled.

“Sandy's story is unique in that she suffered a spontaneous dissection of her cardiac arteries,” said Dr. Michael Kwan, the director of the MSTH heart failure and transplant program. Her arteries essentially disintegrated.

Such an event is rare — so rare that her heart surgeons said they'd never seen anything like it in their collective decades of practice.

“All the hormones that relax the bones for delivery (of a baby) made the arteries more susceptible to tearing,” Kwan speculated, noting that they are still not sure, and Sandy's excised heart has been saved for further study.

Sandy, who has been married to Andrew for seven years, said they had tried to conceive for the first six and a half years of their marriage and finally adopted the attitude that “If it happens, it happens.” Serendipitously, then, it happened.

Her gestational period was unremarkable, as was the late-September delivery, which was remarkable in itself in that Sandy is a tiny woman who stands 5-foot 1 inch and weighs a scant 90 pounds and was having her first child somewhat late in life.

But shortly after the birth and at home, Sandy began experiencing chest pains, and the couple went to the emergency room.

Noted San Antonio cardiologist Dr. Robert Schnitzler performed a catheterization —a procedure in which a thin tube is threaded through an artery in the groin up to the coronary arteries and dye is injected to allow radiological imaging of the heart's function—and found that Sandy had some abnormally shaped heart vessels. He determined that there was no real cause for alarm.

“There wasn't significant disease,” said Sandy.

Schnitzler was going to bring her back for a stress test, a treadmill exercise that increases the heart rate and through electrocardiogram monitoring helps determine how well the heart is working, Andrew recalled, but before that could be scheduled, Sandy started to deteriorate.

“I felt dizzy” she said of the October events. They called emergency services, paramedics stabilized her and brought her to the cath lab, where her doctors now discovered some dissection in her left vein. The vessels were spontaneously tearing apart.

Sandy underwent two open heart surgeries — coronary artery bypass grafts with three vessels and then four — and was placed on the UNOS (United Network for Organ Sharing) heart transplant list.

While the average wait for a donor heart is about six months, Sandy was in the hospital only a few weeks when a heart match became available.

“The wait was only three weeks,” said Sandy. “I know that the average wait is more than five and a half months.”

“She flew through the surgery and is doing well,” said Kwan, who has regular visits with his post-transplant patient.

“Sandy got lucky twice,” said Kwan. “She wanted a baby. She got a baby and got a heart.”

Sandy received her transplant in early December and is now back at the Elizardos' northwest side home, recuperating and enjoying being a new mother.

The baby boy, Joseph Angelo Elizardo, is now 15 pounds, fully a sixth of his mother's weight.

“We were separated for the first two and a half months of his life,” said Sandy, stroking back silky black strands of hair from Joseph's rosy forehead. “Right now, I don't even want to be away from him for even a second.”