Surviving the Widow-maker

James Cullefer survives “widow-maker,” thanks to Dr. Hubbuch and St. Francis Hospital

Volunteer firefighter James Cullefer had never even heard of a “widow maker” until his almost killed him.

Last March, James was doing some work at the fire station when he felt some discomfort in his chest.  So he stopped exerting himself, and the pain went away.  He started working again and the pain came back. He knew something wasn’t right so he called his friend Cindy Davis, who works for Cardiologist Dr. Sebastian Hubbuch, and they scheduled an appointment for the next day. After an exam, Dr. Hubbuch set up a stress test for the following day.

“I got on the treadmill and knew they were going to raise the speed and incline level every three minutes (to get my heart rate up),” James explains.  “But I never made it to the first incline.  I felt pain in both feet, my heart rate shot up to 180, the pain shot up to my head, and I passed out.”

Technically, though he didn’t know it at the time, James had gone into cardiac arrest. Because he had a 98% blockage in the left coronary artery that supplies blood to his heart, he had gone into ventricular fibrillation (or v-fib for short), which is the most serious cardiac rhythm disturbance.  V-fib causes the heart’s lower chambers to quiver rather than pump blood.  The vessel is called the “widow-maker” because most of the time, people don’t survive the heart attacks they cause as treatment is needed immediately to save the heart muscle.

Dr. Hubbuch’s staff acted quickly, using a cardiac defibrillator to shock James’ heart back into rhythm.

“As I came to, I saw Cindy there and she was saying ‘James, please talk to me.’ And I said ‘What do you want me to say?’  I knew exactly where I was and what had happened.  They said I was out for a minute to a minute and a half.  Of course, I didn’t know I had coded; I just thought I’d passed out.”

James was immediately taken to St. Francis’ Cardiac Catheterization Laboratory where a team had already been called in and was waiting for him.  There was also a team on call for surgery, in case he needed open-heart surgery. He underwent emergency cardiac catheterization, in which it was determined that a stent he’d gotten previously was blocked. Dr. Hubbuch dilated the affected coronary artery and placed a larger stent that allowed for adequate blood flow to the heart.

     Dr. Sebastian Hubbuch   

Dr. Hubbuch explained:  “Having immediate access with the Rapid Response Team at St. Francis Hospital and a quick transport to the Cath Lab to render definitive care after a life-threatening event during a stress test helped save Mr. Cullefer’s life.”

James was out of the hospital within a day, and back to work within days.

“Thanks to Dr. Hubbuch, his staff and St. Francis, I am able to continue to serve my community as a volunteer firefighter.”

What’s a widow-maker?

This term “widow-maker” is used because the left main coronary artery or the left anterior descending (LAD) artery is a major supplier of blood to the heart. If either of these arteries is suddenly blocked, it will cause a massive heart attack that will likely lead to sudden death. The type of blockage that kills is made up of platelets streaming to the site of a ruptured cholesterol plaque. Even a small amount of plaque in this area can rupture and cause death. An example of the devastating result of a complete occlusion of the LAD artery was the sudden death of former NBC News Washington Bureau Chief Tim Russert at age 58.

James Cullefer was just 50 years old at the time of his cardiac arrest.

How about a widower-maker?

The term widow-maker discriminates against women.  That’s because it could just as easily be called a “widower-maker” since heart attacks are the number one cause of death for women as well as for men.  Although the cause of this type of heart attack is the same for both genders, the symptoms can be extremely different. What’s more, when a woman experiences an LAD heart attack, she may not realize how sick she is. While she may have telltale chest pain or pressure during a heart attack, she also may experience symptoms that seem more like those of a virus coming on.

Signs of a heart attack

Don’t wait to get help if you experience any of these heart attack warning signs. Although some heart attacks are sudden and intense, most start slowly, with mild pain or discomfort. Pay attention to your body — and call 911 if you feel:

  • Chest discomfort. Most heart attacks involve discomfort in the center of the chest that lasts more than a few minutes, or that goes away and comes back. It can feel like uncomfortable pressure, squeezing, fullness or pain.
  • Discomfort in other areas of the upper body. Symptoms can include pain or discomfort in one or both arms, the back, neck, jaw or stomach. 
  • Shortness of breath with or without chest discomfort. 
  • Other signs may include breaking out in a cold sweat, nausea or lightheadedness.

As with men, women's most common heart attack symptom is chest pain or discomfort. But women are somewhat more likely than men to experience some of the other common symptoms, particularly shortness of breath, nausea/vomiting, and back or jaw pain.