From Nursing Student to Needing Nursing

Myocarditis patient recovers after being placed on ECMO

Carmen Darien of Tremont was diagnosed with COVID-19 in October of 2021.

“I wasn’t very sick at all. I was tired, but overall, I was okay,” she said. At the time, Carmen had an 11-year-old son and graduated from nursing school the previous summer.

About a month later, Carmen developed several strange symptoms including swollen lymph nodes on her neck, a sore throat, and abdominal discomfort. She was seen at a local emergency department and was treated with antibiotics, which did not help. Her symptoms worsened and soon after, she developed progressive shortness of breath, even during rest.

By mid-November, her condition worsened further. She was seen at University Hospitals (UH) Parma Medical Center, and was diagnosed with myocarditis, a condition of cardiac inflammation. Her condition rapidly deteriorated with a heart rhythm disorder and severe drop in blood pressure. She was then transferred to UH Cleveland Medical Center.

“Our team discovered Carmen was in cardiogenic shock, a life-threatening condition in which your heart functions so poorly that it can’t sufficiently support the body’s needs,” said Dr. Eiran Gorodeski, Medical Director of the Advanced Heart Failure & Transplant Center at UH Harrington Heart & Vascular Institute.

“Technically I was dying by the time I got to the hospital and I didn’t even know it,” she said.

“Carmen’s heart function was failing and she required emergent intervention to ensure she did not suffer irreversible damage to her vital organs, such as her liver and kidneys,” said Dr. Kelsey Gray, a cardiac surgeon at UH specializing in heart failure and mechanical circulatory support.

Dr. Gray and the cardiac surgery ECMO team placed Carmen onto veno-arterial extracorporeal membrane oxygenation (ECMO).

“This essentially takes over the work of a patient’s heart and lungs by oxygenating the blood and then helping to circulate it throughout the body. This intervention is reserved for patients in profound cardiogenic shock who, without this support, would not survive,” said Dr. Gray.

It took more than a week, but Carmen’s condition improved, and her heart began to recover.

“I had the full patient experience. I had to use a bed pan. I couldn’t walk when I came out of the coma. It was a lonely time. I’ve always had empathy and sympathy, but going through this will help me be a better nurse. I’ve actually been through what patients are going through. I lived it,” she said.

Myocarditis is a rare condition that is often caused by an infection in the body. The infection causes inflammation and when the heart muscle becomes inflamed it cannot adequately pump blood to the rest of the body. Recovery from myocarditis can vary from weeks to months depending on the underlying cause.

“With myocarditis, it’s not unusual for patients to become critically ill, but then stabilize quickly with appropriate care. In Carmen’s case, the cardiology team, the cardiac surgery team and the ICU team all worked together to stabilize her on ECMO which supported her circulation while her heart rested and recovered,” said Dr. Gray.

Carmen’s doctors don’t know what caused Carmen’s myocarditis but think COVID-19 could have contributed to the condition.

“She spiraled down so rapidly. We took every necessary step to support her, and we’re thrilled that she had a positive outcome,” said Dr. Gorodeski.

Several weeks after leaving the hospital, Carmen says she feels great and practically back to normal, although she’s taking it easy for a few months to let her body fully recover.

“Age, health and everything else are on my side,” said Carmen. “I’m hopeful this can be fully reversed. I’m grateful I can get healthy, continue being a mom to my son, and return to work caring for patients.”