A spirit of gratitude: Austin mom shares journey from childbirth to heart transplant

Kristen Patton was 40 when she gave birth to her fourth child. She felt great afterward and went home from the hospital with no idea that she'd be right back there within 24 hours.

On the third day of her daughter Hattie's life, she sat down to breastfeed her daughter and was planning to get presents ready for Santa to put under the tree for her other three children. It was Christmas Eve 2015. 

Patton felt a sudden pain radiating from her jaw across her face, down her neck, to her left side and her chest. It was like nothing she had ever felt before. 

She put Hattie in the bassinet and crawled on the floor of her bedroom to the other side of the bed to get help from her husband or her phone.

She says she thinks it was instinct to get down on the floor in case she passed out.

Her husband, Steve, heard her drop and called 9-1-1 when he found her on the floor. He had to start CPR before the emergency medical team from the ambulance arrived and took over.

Pregnancy and giving birth can create life-threatening cardiac complications such as preeclampsia and eclampsia, cardiomyopathy, an amniotic fluid clot, or, in Patton's case, a tear in her coronary artery. 

"In the cardiac world, we only see pregnancy as a vehicle for disaster," said Dr. William Kessler, a  cardiothoracic surgeon with Cardiothoracic and Vascular Surgeons and Seton Medical Center. "It's a frightening thing to a heart surgeon."

Doctors really don't know why there is a link between pregnancy and heart events, and it happens in a small subset of patients seen by cardiac teams. "It's very rare, but it can rob you of the important times in your life," Kessler said. 

Sometimes symptoms of heart failure can be confused with regular post-pregnancy recovery or even COVID-19 symptoms. These symptoms include shortness of breath or not being able to catch your breath; swelling in the hands or feet; fatigue that isn't getting any better; belly bloating or fluid around the abdomen; and heart attack symptoms such as chest pain, sweating, nausea, vomiting or passing out. 

Patton had no warning symptoms before she felt the symptom of the heart attack caused by the tear. Her pregnancy, including her blood pressure, had been normal. She didn't feel any different leaving the hospital with this baby compared with when she had the other three. 

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When Patton was brought back to the hospital, they tried to figure out what had happened to her and ran many tests but didn't find the answer. Five days later, she was waiting to be sent home with either a portable defibrillator or a LifeVest, which is a wearable defibrillator. Then it happened again. She began sweating, her jaw began to hurt and the pain began to radiate. 

"I thought I was drowning," she said. "I could not catch my breath."

This time the tear was extensive and she lost a lot of blood and blood flow to her left ventricle, which began to die. She had a giant heart attack.

Because she was at Seton, the team got to her immediately. This time they could watch what was happening to her. They tried to do a triple bypass, but that wasn't going to hold. She ended up on an extracorporeal membrane oxygenation machine, which did the work of her heart and lungs for her. The hope was that it would give her heart time to heal, but ECMO isn't sustainable, and her heart wasn't healing. 

Kessler then inserted a left ventricular assist device into Patton to help her heart do the pumping. 

Patton doesn't remember any of this. She was basically asleep for a month after her second heart attack. When she woke up, her husband explained what happened to her. "I couldn't even speak or lift my head off the pillow," she said, but her husband did say, encouragingly, "A year from now, this could all be a distant memory when you get a new heart."

That was how Patton found out she needed a heart transplant.

Working toward heart transplant

The LVAD was a bridge to get the rest of her body healing and in better shape for a heart transplant. It comes with its own risks and involves carrying around a backpack for the battery, remembering to recharge the battery and changing the sterile dressing around the connection points each night.

"I was a mom of four young kids and an infant to pick up," she said. At the time, Emmy was 6, Lilly was 7 and Clay was 10. 

Patton did what she needed to do. She got stronger. She followed doctors' instructions to the letter, and she got listed for a new heart. Even having the LVAD was not a guarantee she would be able to rehabilitate her body well enough to make it to the next step.

"I worked really heart in cardiac rehab, which helped me get my heart and the rest of my body in the best condition it could be for transplant," she said.

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On her 41st birthday that fall, she had an amazing day with cake. She remembers being "super grateful," compared with turning 40. "I had been a brat about my 40th," she said. For her 41st, "I had a better attitude." 

She put all the kids to bed, and she and Steve got into bed themselves. The phone rang, and they made a joke that it was probably just another call about the upcoming 2016 election because it wasn't a number they recognized. 

"We think we have a heart for you," she was told. 

They called her sister and her sister-in-law to come over to take care of the kids. Working with the nonprofit organization Wonders & Worries, she had prepared her children for the fact that after everything they had gone through, there was more to come with the possibility of a heart transplant. She woke up each kid and told them, "They think they have a heart for Mommy."

That night, "when we said goodbye, they were optimists," she said. "They hugged me and said, 'I love you.' 'This is going to be amazing.' 'You're going to get a new heart.' And 'You'll be back.'" Even though there was fear, they were her cheerleaders, she said.

Saying goodbye to the kids was hard, but even harder was saying goodbye to her husband. There's a line in a hospital where family can't follow you, where you say goodbye before going into the operating room. 

"He and I had tears in our eyes and shaky voices," she said, but he gave her a firm kiss and said, "You've got this."

When she woke up, the first thing she asked was if it had happened. She knew it was possible that something could have fallen through at the last minute. Her husband told her, "Yes, you have a new heart." Her nurse let her listen to it through a stethoscope.

One of the things she and other people who have had a transplant notice is how loud a new heart sounds. "It feels very strong at first," she said. "I can hear it in my ears. ... It's a little disconcerting at first." 

Eight days later, she was home. 

Life after a heart transplant

Today, she is down to taking 20 pills a day, "which doesn't seem much," she says. She does regular, disciplined exercise. And, she said, she works hard at managing stress.

She's competed in the Transplant Games both in Salt Lake City in 2018 and in the world games in the United Kingdom in 2019.

"Both experiences were phenomenal and inspiring," she said. Donor families, living donors, adult and pediatric recipients all attend. "Overwhelmingly, the spirit is one of gratitude."

The games are not a joke. "It's very competitive," she said. She goes for anything she can, which has included cycling and tennis, as well as the softball throw and the 200-meter sprint. "I attempted golf," she said. "It was comical, but fun." 

She plans to attend the U.S. Transplant Games in July and the World Transplant Games in Perth, Australia, in 2023. 

She's met other moms like her who have had a devastating heart event after giving birth. Sometimes they have to go back repeatedly to get doctors to listen to them and understand that what they are feeling is not normal post-pregnancy symptoms, she said. 

She was lucky because her symptoms were obvious, her husband knew CPR, the ambulance arrived quickly, and her second heart attack happened in the hospital. 

"We just stole her back from jaws of death," Kessler said. "She's a cumulative miracle. I'm even surprised."

For Patton, her life now is about one of gratitude to her team at Seton and to the donor family. She has sent a letter to the family, thanking them, but they have not sought out a further connection.

She now does a lot of public speaking promoting organ donation. She reminds us that in the U.S., 22 people die a day waiting for an organ transplant, according to Donate Life America.

"You have the ability to be a hero and leave a legacy that is far beyond anything you can imagine by being an organ donor," she said. Donors have the ability to save eight people. And for families who have to make the tough decision, "You have the ability to save another family from a loss that you are enduring, which is hard and awful and devastating, but it might be the one single redeeming thing that comes out of it."

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Patton has been on the other side of the decision. The year she had her LVAD, her mother had a devastating heart attack and they donated her corneas and tissues. 

"It's a really hard thing," she said, "but we were able to make a difference in some lives. It's what she would have wanted. It doesn't bring my mom back, but there is some comfort." 

Patton and her family know that a heart transplant is a treatment and that eventually she might need another one. 

"I don't spend a ton of time on it," she said. "It's kind of foolish to look too far in the future. Our time is spent living the fullest this day."