Sent home twice by doctors, she had a heart attack at home

Barbara Collura couldn't understand why she became breathless and sweaty simply from climbing the stairs to a balcony at a concert.

At 58, the retired attorney from Delmar, New York, ran regularly, ate a healthy diet and had no serious medical issues. Climbing stairs never bothered her before. Why was it a problem now? Maybe, she thought, she caught the flu.

The next day, she felt exhausted. She was again short of breath. And now she also had pain in her upper back (near her shoulder blade) as well as her left arm and jaw. The day after that, she felt a burning sensation that radiated from the center of her chest.

She knew she needed to get to an emergency room. She also knew these were symptoms of a heart attack.

But her? With her healthy lifestyle and risk factors all under control?

At the ER, a battery of tests revealed nothing out of the ordinary. However, while describing her symptoms to a doctor, she also mentioned something else: her family history of heart disease.

Collura's dad survived two heart attacks in his 40s. Her mom received two stents in her early 70s, only to die of a heart attack a year later. Her brother died of a heart attack at 44. She told the doctor this without knowing that family history is a risk factor for heart disease. Still, she was sent home.

The symptoms worsened so she saw a cardiologist the next day. He reviewed the testing done from the day before and attributed her symptoms to anxiety. When she highlighted her family history, he said he could schedule a stress test in a few weeks "if it would make you feel better."

That night, the pain returned. She was so uncomfortable that she went to sleep in the guest room to avoid disturbing her husband.

The following day, she tried going about her normal routine. But breathing was so difficult that she couldn't even walk to the end of her driveway without stopping and sitting down.

Now what? She'd been to the ER and to a cardiologist, and neither seemed concerned. Yet she knew something was terribly wrong. She called her sister, Judy Krupa, a complex care coordinator in a hospital emergency room.

Collura hadn't wanted to burden Krupa. However, "I wanted some confirmation that I wasn't crazy for still worrying about how I felt," Collura said.

Krupa told Collura not only to return to the ER, but to return and "cause a ruckus."

Tests revealed that she'd had a heart attack. An artery in Collura's heart was 99% blocked. She underwent a cardiac catheterization procedure to have a stent inserted into the artery to restore blood flow.

Collura went home soon after and was essentially told to keep up her existing exercise routine. But if she was going to push herself, she'd want to do so under medical supervision. So she requested cardiac rehabilitation. She was told the program was for people who didn't previously exercise.

As she recovered, Collura thought about being essentially turned away by two doctors and then again with her request for cardiac rehab. She began to question her overall treatment. She sought a second opinion from doctors at another hospital.

Once again, her self-advocacy paid off.

Further testing showed that Collura had elevated levels of lipoprotein(a), or Lp(a), a type of cholesterol that is genetically determined and can increase the risk for heart disease and stroke if levels are raised. She's now part of a drug trial to see if she can lower that number and, hopefully, lower her risk.

"I can't control my family history, but I can control my risk factors," she said. She is also advocating for women's heart health locally and nationally and is speaking to researchers at a medical conference about her elevated Lp(a) and family history.

Stories From the Heart chronicles the inspiring journeys of heart disease and stroke survivors, caregivers and advocates.