Tricia Burgess during her post-transplant cardiac rehab stint at the Dayani Center. Photo by Joe Howell
Tricia Burgess thought it was her seasonal allergies acting up again. She walked into the emergency department at a Knoxville hospital on April 1 to find out why she was having difficulty breathing.
The diagnosis: She had end-stage heart failure and was given less than a year to live.
The news was hard to accept for Burgess, at the time an otherwise healthy 39-year-old nurse from Jefferson City, Tennessee, whose only medications were over-the-counter allergy drugs. It set her on a journey that ended up with a heart transplant at Vanderbilt University Medical Center just 24 days later, about 12 hours after she was placed on the transplant list.
“I didn’t even know I was sick,” Burgess said. “I’m thankful that Vanderbilt saved my life.”
Burgess was placed on the heart transplant list at about 4 p.m. on April 24. About three hours later, she got the call – a heart matching her A-positive blood type was found. At 4 the next morning, she was in operating room undergoing transplant.
Burgess works as a nurse at Morristown-Hamblen Hospital in Morristown, Tennessee, and her wife, Donnie, works as a nurse at Jefferson Memorial Hospital in Jefferson City, Tennessee. Burgess had just completed five overnight shifts before taking the weekend of March 30 and 31 to rest. But she was having a hard time breathing while lying flat. After two restless days, Donnie persuaded her to go to the hospital — as a patient.
She had no idea that her wife was very near death.
An echocardiogram and cardiac catheterization showed that Burgess’ heart muscle was extremely weak as a result of severe coronary artery disease. When she was discharged four days later, she wasn’t sure what her next step would be.
Then, early the next morning after leaving the hospital, Burgess had recurrent shortness of breath as well as chest tightness. Donnie had only one thought — she had to drive her to Vanderbilt and drive her there fast. They arrived in Nashville later that morning.
“They saved her life,” Donnie said. “She wouldn’t have been here.”
Burgess was suffering from severe heart failure, said Matthew Danter, MD, assistant professor of Cardiac Surgery. “She essentially didn’t get enough blood supply through her severely diseased coronary arteries to sustain the function of the heart muscle, and as a consequence, it was failing,” he said.
But why her? Doctors were puzzled. Burgess didn’t have any of the common risk factors for coronary artery disease. She didn’t have high blood pressure or cholesterol, she wasn’t diabetic, she didn’t have a strong family history and she didn’t smoke. Her annual physicals were normal and she enjoyed an active lifestyle hiking in the Great Smoky Mountains.
“It’s just so weird — out of the blue,” Donnie said.
After several days of testing at Vanderbilt, the news was grim. Tarek Absi, MD, assistant professor of Cardiac Surgery, informed Burgess that her heart was too fragile for bypass surgery
Her only hope was to receive a heart transplant or left ventricular assist device (LVAD), a pump for patients with end-stage heart failure.
After receiving a battery of tests to confirm she was a candidate for these therapies, Burgess was placed on the heart transplant list at about 4 p.m. on April 24. About three hours later, she got the call – a heart matching her A-positive blood type was found. At 4 the next morning, she was in operating room undergoing transplant.
The success of patients like Burgess is due to the hard work and dedication of many individuals, including critical care nurses and transplant coordinators who help to care for these patients before, during and after transplant.
Danter said the quick turnaround was largely Burgess’ good fortune. Physicians and patients don’t control organ availability; it is determined by the United Network for Organ Sharing (UNOS), based on availability and compatibility. Burgess’ body size and blood type helped with her brief wait time, said Emily Sandhaus, BSN, RN, a heart transplant waitlist manager at VUMC.
Danter cited another factor — the availability of hepatitis C-positive hearts, such as the one that Burgess received. Vanderbilt has led the way among heart transplant centers in using these hearts, because hepatitis C is a virus that can now be cured using newer drugs that are well tolerated by transplant patients.
“The use of hearts from donors with hepatitis C has dramatically increased the donor pool, reducing waitlist times for many patients, and potentially reducing their likelihood of death on the waitlist as well,” said Kelly Schlendorf, MD, assistant professor of Medicine and medical director of Vanderbilt’s adult heart transplant program.
Schlendorf and Danter credit the success of patients like Burgess to the hard work and dedication of many individuals, including critical care nurses and transplant coordinators who help to care for these patients before, during and after transplant.
Burgess is still in shock. Some details of her medical care are hazy to her now. That April morning she rushed to Vanderbilt, she thought she was going for a second opinion, not a heart transplant.
“I didn’t understand any of it,” she said. “I’m just thankful, extremely thankful that they gave me a second chance at my life.”
