Best Doctors 2014: Quick Steps
It was the morning of last year's Cleveland half-marathon, and 45-year-old Richard Strain had just finished his normal breakfast of Frosted Mini-Wheats and blueberries. For added protein, the information technology director decided to drink a nutritional shake before heading to the starting line.
One mile into the race, he was cursing himself for changing up his morning meal.
"I felt like I had this massive case of heartburn," Strain recalls. "And it just kept getting worse."
Strain, who was running his second half-marathon, continued, but the pain spread. "There was this needlelike nerve pain in my shoulders," he says. "It was more like this numb poking feeling, like when your arm falls asleep."
Strain's body began to feel leaden. At mile 7, he stopped at a water station, figuring he'd catch his breath for a bit, then start running again. At mile 8, his footsteps became staggered and by mile 9 he collapsed. Strain was having a heart attack.
Luckily, a cardiology nurse from the Cleveland Clinic and a captain of the Cleveland Emergency Medical Service were both running near him. They began CPR while rescue workers used a portable defibrillator to restart Strain's heart. An ambulance quickly transported Strain to MetroHealth and Dr. Sanjay Gandhi.
"He was coughing up blood," recalls Gandhi. "He couldn't breathe well."
Doctors put Strain on a ventilator and started him on medicines to support his blood pressure. Within minutes, Strain was being wheeled into the hospital's catheterization lab, where doctors found that his right coronary artery was 100 percent blocked.
The team worked to quickly open Strain's artery. To keep his heart beating, doctors implanted a temporary pacemaker. They then removed a blood clot from his artery with a suction catheter and threaded a balloon-tipped tube into his right coronary artery before inflating it at the site of blockage. Doctors then inserted a stent — a tiny mesh wire tube — into the artery to further reinforce and push open the artery walls.
Gandhi could see blood starting to flow into Strain's heart muscle again. "The heart looked like it was going to be OK," he says.
But Gandhi wouldn't know until the next day whether it had caused permanent neurological damage. When Strain awoke, he began thrashing — a sign that his neurological activity was unaffected. Still on a ventilator, Strain signaled for a pad of paper and wrote in large letters: "What happened to me?"
"You suffered a heart attack," Gandhi wrote back.
Gandhi credits Strain's survival and recovery to receiving immediate CPR and getting to the blocked artery less than 90 minutes after it collapsed.
"Because everything was done in such an expeditious manner, the patient was able to walk out of here smiling," Gandhi says.
Today, Strain is back on his feet. As proof of his recovery, he took a CPR class and plans to run the Pro Football Hall of Fame Half Marathon in April.
"My goal is just to make it to the finish line," he says.
12:00 AM EST
February 24, 2014