At first Glen Greta thought it was just a muscle strain.
He and a friend had just finished loading a trailer packed with parts for an antique military vehicle, packed in 100-pound boxes.
It was the end of December 2017.
Greta had just cleared snow from the deck of his cottage overlooking Big Blue Lake, about 20 miles north of Muskegon.
“After I put the shovel away, I felt the strange feeling of something in my chest pushing out,” he said. “I had read about heart attacks, so I knew this was another pain. I thought I had strained something, so I decided to sleep on it.”
The next day his chest still ached.
He called Spectrum Health Integrated Care Campus in North Muskegon and they asked him to come in. He arrived quickly and underwent testing.
An electrocardiogram confirmed that something was seriously wrong. He didn’t have a heart attack, but he needed to see a cardiologist ASAP.
Greta went straight to Spectrum Health Butterworth Hospital in Grand Rapids, where the emergency department team was standing by.
They began additional testing to determine the cause of his intense pain.
‘Must be ready’
A CT scan showed that Greta had developed a hematoma in his ascending aorta, the arcuate part of the body’s largest and most vital artery.
At 9 p.m., the surgical team rolled him into the operating room.
Even after doctors informed him about the procedure, Greta couldn’t quite recognize the sheer magnitude of the surgery.
“When I went in, I said to Penny, my wife, ‘I’ll see you on the other side,’” he said. “I meant I’d see her when I got out of surgery. She thought I meant on the other side of life. I didn’t know I was going to panic her.”
Greta had no idea the extent of his problems.
Acute aortic syndrome kills an estimated 10,000 people each year, according to the American Heart Association.
“I usually describe cases like Glen’s as the one and only cardiac emergency,” says Stephane Leung, MD, a cardiothoracic surgeon who specializes in acute ascending aortic disease. “If not repaired, it has a death rate of about 1% to 2% per hour.”
Greta’s age, then 76, posed an additional risk.
dr. Leung started repairing 6 inches of damaged tissue using a graft.
It is an incredibly complicated and time-consuming operation.
The aorta, shaped like a candy cane and about a foot long and 1 inch wide with multiple layers, is the largest artery in the body and supplies oxygenated blood to the brain and muscles.
dr. Leung had to cool Greta’s body to about 64 degrees Fahrenheit, to protect his brain from damage.
The aortic repair took about three hours, said Dr. lean.
But the evening was far from over.
During the operation, Dr. Leung quickly determined that in addition to the bulging weak spot in his aorta, Greta also had significant coronary disease and blockages, some of which blocked up to 98% of the arteries.
“His heart was weak,” said Dr. lean. “And he needed a triple bypass.”
Bypass surgery is one of the most common procedures in the US, but Greta’s case presented additional challenges.
“Because Glen came in as an emergency, we didn’t know his history,” said Dr. lean. “We didn’t have a good preparation. It’s very much like a box of chocolates, because you never know what you’re going to get.”
dr. Leung prepared for the work ahead.
“We have to be ready to do anything and everything from an aortic root repair to replacing the entire arch,” said Dr. lean.
For the bypass surgery, he used a vein from Greta’s leg. Greta’s heart wasn’t going to start beating again on its own, either, so Dr. Leung and his team worked to restore his heartbeat.
From the start of the surgery until his heart started pumping again, Greta had spent 10 hours in the operating room.
Greta, a retired engineer and lifelong repairman, continues to marvel at the fix-it nature of the surgery that saved his life.
“I asked Dr. Leung why he didn’t just give up,” he said. “Here he is called at 9 p.m. for emergency surgery, with operations lasting 10 hours. Why continue?”
He remembers Dr. Leung’s sober response – it left a lasting impression on him.
“He told me, ‘I never give up. I always have a Plan A and a Plan B. And I think we talked about Plan E with you.’”
Greta spent the next two days in acute care. He stayed in the hospital for 42 days while his healthcare team worked to tame the atrial fibrillation that caused his rapid and irregular heartbeat.
At one point, his heart rate shot up to 222 beats per minute.
“It set off alarms and people came rushing into the room,” he said.
As his health improved and he returned home, progress was gradually made.
“I was supposed to walk, but I could only walk 25 steps at a time,” he said.
He also had trouble remembering things.
“The most basic things, like how many square inches are in a square foot,” he said.
Mentally, that period was very difficult. “I don’t know what I would have done without the emotional support I received from Penny, as well as the care team in the cardiology department,” he said.
Greta later returned to the hospital, where the team determined that he had no blockages and that his heart was working fine mechanically. But he needed cardioversion, a procedure that returns the heart to a normal rhythm.
Additional tests revealed significant sleep apnea, associated with a higher risk of heart disease.
He now has a pacemaker, which helps control his irregular heartbeat.
“I’m finally getting back to normal,” Greta said.
The mental journey, not just the physical recovery, continues to present challenges. This means that we recognize that some body parts wear out even with the best maintenance.
‘Go straight to the hospital’
Greta sees many analogies between the moving parts in his chest and those in the 300 antique military vehicles he has had throughout his life.
“Here I was, then 76, enjoying what I consider to be a great life,” he said. “In everything I did, I could be very strong. I could lift my weight. Heck, I’d still even fit into my Vietnam Army uniform.
Today, he is not allowed to lift more than 50 pounds.
A former runner, he has to content himself with walks through his Grand Rapids condo, the Blue Lake cabin, and his expansive store.
“It has taken its toll,” he said. “My brain still thinks I’m 40, but then my body says, ‘Yeah, you’re 80.’”
He remains deeply grateful to his surgical team.
“If it weren’t for Spectrum Health and Dr. Leung and his associates, I wouldn’t be here,” he said.
Greta hopes others can learn from his experience.
Dr. Leung also urges people to stay alert for symptoms.
“People usually describe it as the worst chest pain they’ve ever had — a tearing, tearing pain,” said Dr. lean. “It often radiates to the back. And it’s the kind of pain that most people just can’t ignore.”
It can even cause a person to lose consciousness. If you see this happening to someone near you, call 911 and go to the nearest emergency room.
“Don’t wait,” he said. “Call right away. I wish I had realized this was an emergency. I would tell someone else to go straight to the hospital.”