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New Ulm Medical Center

New Ulm Emergency Department proves to be a lifesaver

By all accounts, Jean Nielsen shouldn’t be alive.

Had it not been for the swift care she received at New Ulm Medical Center’s emergency room and at Abbott Northwestern Hospital, she would not be — of that, she is certain.

It was around 12:30 a.m. on Monday, Aug. 26. Nielsen, who at age 52 was in excellent health, was at work. She started feeling ill.

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Jean Nielsen (left) worked with athletic trainer Scott Mangen, MS, ATR, HFS, during a recent cardiac rehabilitation session. Nielsen experienced an extremely rare and often fatal condition known as spontaneous coronary artery dissection, the result of a spontaneous tear in the coronary artery wall. “The Abbott cardiologists have told me that had New Ulm not prepared me so well, I wouldn’t have made it,” Nielsen said.

“I started having shortness of breath and was all sweaty, which at my age isn’t anything unusual,” she said. “I just thought it was hot flashes.”

When her symptoms got stronger, she called her manager at Orchard Hills, an assisted living facility in New Ulm, and asked if someone could come cover her shift. At first, she thought she just needed to go home. But whatever was wrong seemed serious and wasn’t going away.

Nielsen decided she had better call 911. An ambulance crew arrived within minutes.

“I remember someone asking me if I had been out in the heat that day,” Nielsen said. “Maybe it was something stupid like that. It was 95 degrees. But no, I had not.”

After that, Nielsen doesn’t remember much.

Receiving emergency care

Jeff Rayl, MD, the Emergency Department physician on call that day at New Ulm Medical Center (NUMC), had been alerted that a patient who was having a heart attack was on her way. But when Nielsen arrived, Rayl was surprised. She was not overweight. She did not smoke. And she had had normal cholesterol levels, he later learned.

“But she looked like hell,” he said. “She was dying.”

Nielsen’s heart began to beat extremely rapidly, racing as fast as 180 beats per minute. Nielsen had to be shocked back into normal rhythm twice while she was in the Emergency Department.

Rayl reached out to an interventional cardiologist, who recommended drugs to slow her heart down. The doctors also decided she needed to be flown by helicopter to the Heart Institute at Abbott Northwestern Hospital in Minneapolis for further treatment in its catheterization lab.

“They told my husband it would take about 40 minutes to fly me there,” Nielsen said. “I got there 10 minutes faster than they said.”

While Nielsen was aboard, she had to be shocked back into normal rhythm a third time.

More than a heart attack

As it turned out, Nielsen wasn’t having just a heart attack. She had an extremely rare condition known as spontaneous coronary artery dissection, the result of a spontaneous tear in the coronary artery wall.

The artery wall has three layers. When a tear occurs, blood is able to pass through the innermost layer. It gets trapped and bulges inward. The bulge narrows or blocks the artery. The blockage can cause a heart attack because blood cannot flow into the heart muscle.

Nielsen underwent stenting at Abbott to open her artery and allow the blood to flow to her heart normally again. She woke up in the hospital two days later.

“Her heart had taken a pretty big hit,” Rayl said.

Nielsen has started cardiac rehab and is recovering nicely. Because she didn’t have risk factors for a heart attack, Nielsen doesn’t have to change her diet other than watch her salt intake. She also takes some preventive medications and has to follow up with her doctors every six months.

Symptoms can hide

Nielsen didn’t have a lot of pain before her spontaneous dissection. Instead, her biggest problem was nausea.

“Sometimes that can happen,” Rayl said. “Some people who are having a heart attack have horrible pain and some people have no pain. Some get nauseated and some are short of breath. But you can have a heart attack and have no symptoms.”

Nielsen knows that had the doctors and staff at NUMC Emergency Department not acted as quickly as they did, she wouldn’t have survived. Her life-threatening condition has made Nielsen very grateful that she lives in New Ulm. “The Abbott cardiologists have told me that had New Ulm not prepared me so well, I wouldn’t have made it,” Nielsen said.

“New Ulm Medical Center is more than just a small community hospital,” she added. “I say we’re fortunate to be in New Ulm and have such a great facility with such an efficient Emergency Department.”