October 10, 2003

Heart walker saved by brother

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Jared Stiefel and his sister Alyson share some time together at their home in Franklin. Both will be participating in the Heart Walk held at Vanderbilt Oct. 19. Dana Johnson

Heart walker saved by brother

For years, Jared Stiefel practiced CPR as part of his routine as a lifeguard in his hometown of Chicago. He was well versed in what to do. But never had he used the procedure as a life-saving tool — until July 18.

The situation was more stressful because the unconscious patient was his younger sister Alyson.

The summer day started as usual — a trip to the neighborhood pool. Minutes after splashing around, Alyson, 17, began feeling dizzy and developed a headache.

Thinking nothing of it, Jared, 19 at the time, continued his pool play while his sister relaxed in a chair poolside.

A quick glance over at his sister caused grave concern.

“She just wasn’t looking so good,” he said. “She was not responding to me when I called to her. Then she was unconscious.

“And I’m panicking.”

Thankfully another swimmer at the pool ran to call 911.

“It’s weird because at first I didn’t know what to do,” he said. “My brain was overloaded. But as soon as the other guy asked me if she was OK, it all snapped. I knew I had to help her, save her.”

Doctors credit Jared’s CPR know-how with saving Alyson’s life.

Once the EMTs took over, life-saving measures were continued for nearly one hour.

“It is rare that someone has CPR administered that long and does relatively well,” said Dr. Prince Kannankeril, assistant professor of pediatrics at VUMC. “But it appears that she has no permanent heart damage but there are subtle cognitive changes that we saw from her heart being stopped for so long.

“The most important thing is that CPR was started seconds after the event started. It was really a lifesaving action.”

Kannankeril said the medical team first thought Alyson suffered from long QT syndrome, a rare genetic disorder that classically presents with lethal arrhythmias while swimming, but after further testing he discovered she had an even rarer heart condition called Arrhythmagenic Right Ventricular Dysplasia (ARVD).

AVRD is a slow progressive disease of the right ventricle of the heart where the tissue is replaced with fatty tissue. This results in susceptibility to lethal arrhythmias in which the heart is squeezing so fast that blood is not able to exit.

By the time the medical crews were able to administer aid to her, she was experiencing ventricular fibrillation, said Kannankeril.

“Basically, she dropped dead. With no warning symptoms. Thank goodness her brother knew CPR, “ he said.

During her nine-day stay at Vanderbilt, Alyson received an Implantable Cardioverter Defibrillator (ICD). In case of another arrhythmia, this device will shock her into a normal rhythm. She is also taking beta-blockers to help quiet the arrhythmias.

In AVRD, if enough muscle is replaced by fatty tissue, patients may develop signs of congestive heart failure.

Kannankeril said AVRD is genetic, but there are no tests to prove it. Alyson’s siblings have been tested. Her parents will soon follow.

For now, the 17-year-old Centennial High School senior will continue follow-up visits with her cardiologist as well as limit her activity while she is recuperating.

But she will venture out to the Heart Walk on Oct. 19. Prior to this episode, the family was not aware of the long-standing fundraiser. But now, it has moved to the top of their list.

Jared participated in the Murfreesboro walk Oct. 2 where he was enrolled at Middle Tennessee State University.

Mary Ann Stiefel said the events of this past summer really awakened the family.

“The whole time the medical team was preparing us for Alyson’s death,” Stiefel said. “It just wasn’t looking good. Thank goodness she wasn’t ready to go.

“It definitely has been impressed upon us that we are very lucky she is alive and in such good condition. My son is a hero because without him there I really don’t think Alyson would be here today. This second chance is a real gift for her. CPR really saves lives — she is a testimony to that.”

Stiefel said she too is certified in CPR and can use an Automatic External Defibrillator (AED).

“We know we were lucky. It’s interesting because I find myself saying ‘Wow, I really did raise them right.’”

Alyson, who suffers from a mild form of short-term memory loss due to the length of time her heart was stopped, is also grateful for her big brother’s skills.

“It really scares me, all that happened,” Alyson said. “It bothers me that I am not able to be active. But I am here. I’m just glad it was one of the days he was at the pool with me.

“Now, I am hoping to learn CPR. It’s just something you don’t think about until something happens.”