Diagnosis: Heart Tumors
Treatment: Open Heart Surgery
When 39-year-old Alexis Day came to EvergreenHealth’s Emergency Department with severe abdominal pain, it took detective work worthy of an episode of CSI to figure out what was causing the problem.
It was detective work that would save Day’s life.
A CT scan showed that part of Alexis’ spleen had died because the blood flow to it had been cut off.
That answered the question of what was causing the pain, but the mystery remained regarding what had cut off the blood flow in the first place.
It was very unusual to see this in an otherwise healthy young woman without any trauma or injury to the spleen.
“It was a puzzle that needed to be solved,” recalls cardiologist Dr. Ed Kim. “The ED team put their heads together to brainstorm possible causes, and the first thought was that a blood clot from Alexis’ heart might have broken loose and clogged the artery leading to her spleen.”
An echocardiogram – an ultrasound of the heart – was ordered to take a closer look. That’s when the case took a surprising twist.
Echocardiographer Stacy Bautista was able to identify the problem as she performed the echo and knew right away that something was wrong.
“It wasn’t a blood clot – but two large tumors – inside her heart,” Bautista says. She called for Dr. Kim to take a look.
“Cardiac tumors are pretty unusual, but it definitely explained what was going on,” Dr. Kim says. “When people have tumors in their heart, either small pieces of the tumor itself or blood clots that have formed on the tumor can break loose and wreak havoc on all sorts of body parts. A clot could travel to the brain and cause a stroke, or it could travel to a kidney and kill part of the organ.”
Luckily for Alexis, this initial clot went to her spleen – and while losing part of the spleen is pretty painful, it’s not life-threatening.
With the mystery solved, Alexis was scheduled for open heart surgery the following day to remove the tumors before any other pieces could break loose and cause potentially life-threatening complications.
“This type of case is very unusual,” Dr. Kim says. “I doubt any of us will see a case like this again. It’s fortunate she came into the Emergency Department when she did.”
But there was more than luck involved in cracking this medical case – it took experienced medical detective work.
“An echocardiogram is not a standard test for a patient with abdominal pain,” Bautista explains, “and you don’t normally think a problem with the spleen is connected to the heart…so sometimes you have to do some sleuthing, because it can be a matter of life and death.”
“Everyone involved really did save my life,” Alexis says. “They were so on top of everything and were very aggressive about following their hunches, thank goodness. I’m just so glad their detective work paid off!”