“Nobody would know looking at me that I experienced acute heart failure. I have scars, and the internal recovery is a lot more difficult than the physical recovery,” said Hillary Steffen.
The Salem mom of three was a healthy active 33-year-old when she came down with COVID-19 in November 2021. At first, she had mild symptoms, but the next day was in the hospital facing the possibility of a heart transplant.
“I had no idea that somebody could talk to me about a heart transplant — my heart could be completely failing — and then have it completely recover because of the Impella. It’s mind-blowing, like, mind-blowing,” Steffen said.
Her symptoms progressed the next day. She started to throw up and her husband, a paramedic, gave her fluids — thinking she was dehydrated.
He tried to check her blood pressure but couldn’t get a read.
“He was like, ‘We’ve got to get you to the hospital," she said.
An ambulance rushed her to the emergency room, but doctors couldn’t pinpoint what was making her so sick.
“They’re like, ‘You’re young, you’re healthy.’ I was an athlete in college and remained active. Nobody knew,” Steffen said.
She was in cardiac shock. Steffen was brought to the ICU for an echocardiogram, which measures how much blood is pumping through the body. A normal echocardiogram is 55-70%.
“Mine was 8% they said. Yeah, really bad,” Steffen said.
She said there was a 50/50 chance she was going to survive.
Doctors immediately got to work, and she underwent surgery but there was a problem. Because she had been throwing up, she was given fluids, lots of fluid, and that was pooling around her heart.
They had to do a pericardiocentesis to drain all that fluid.
“Then they paused the procedure and called Providence St. Vincent up in Portland and asked the heart failure doctors there what they should do.”
She needed an Impella device — a heart pump.
Doctors in Salem put one in, but she needed a better solution. She was moved up to Providence St. Vincent Medical Center.
Steffen had myocarditis, an inflammatory condition of the heart which can be caused by any virus.
“Other types of viruses, but also COVID, and that can lead to dysfunction of the heart, weakening of the heart function, which can lead to low blood pressure or shortness of breath, chest pain, and if it becomes very severe, it can become life-threatening as it was in her case,” Dr. Jacob Abraham said.
Abraham is the section head of the Advanced Heart Failure Program at Providence St. Vincent Medical Center.
“Fortunately, severe cases are rare, but probably myocarditis occurs more frequently ….because a lot of people don't seek medical attention,” he said. “So the cases that do actually come to us do tend to be more serious. Fortunately, even the most severe cases, like Hillary's, do tend to improve given time, but oftentimes, as in her case, patients can become very, very ill to the point that if they're not in a setting where they can receive appropriate care, they could actually pass away. Hillary was fortunate to get timely care and aggressive care."
Hillary received a larger heart pump but was told that if she didn’t recover using this option, she would need a heart transplant.
“I felt a little overwhelmed by that, but I also felt like I was already in survival mode, and I couldn’t start processing that,” she said. “One — I didn’t know if it was going to happen, but I didn’t want to think about someone having to die in order for me to live. That was really difficult."
Luckily, It didn’t get to that point.
“What’s incredible is that after about two weeks with the Impella, my heart fully recovered,” Steffen said.
They did another echocardiogram and the doctors were amazed.
“She [a cardiologist] was like, ‘Look at your heart. It’s beautiful and we’re going to get this out.”
Just a few days later her heart pump was removed and three days after that she was out of the hospital It all happened very fast. She said much of it was all a blur. Especially in the beginning when she was being rushed to the ICU and into surgery.
“I mean I joke with him [husband] a little bit that he had it worse than me because he knew everything that was going on and I was sort of in and out of consciousness through the whole thing and everything was tanking, and he couldn’t figure it out,” she said.
Then when she was moved from Salem to Portland she was put in isolation and away from her husband and three children, because they still had COVID-19. Her youngest, not even a year, was still being breastfed at the time.
It was lonely, but while she was recovering in the hospital, her devoted husband wasn’t far away.
“Through the grace of amazing family friends. They brought their RV trailer to Providence, got a permit through the city of Portland and he parked there, and he stayed there,” she said.
Once she had the strength to get out of bed, she would move to the window in her hospital room to look out at her "hubby." And they would chat on FaceTime.
"That was the best. I looked forward to that every day because it definitely became lonely in there all by yourself,” Steffen said.
Now, she’s sharing her story and hoping others take note to know the signs and symptoms of heart failure.
“I want people to understand that female heart failure symptoms look different than male symptoms, and it’s important that you start recognizing those symptoms to seek help immediately,” she said.
When it comes to cardiac shock and heart attack — symptoms can present differently in women than men. It's not always chest pain. Women are much more likely to have less-common symptoms like indigestion, shortness of breath, and back pain — sometimes even without obvious chest discomfort, which was the case for Steffen.
Steffen has been able to connect with others on social media sharing her story, her knowledge and hope.
“I want them to know that heart recovery is possible and to have hope. Hearing my story and hearing that I was able to fully recover and I’m healthier now than I was before that,” she said. “I’m so grateful that they gave my heart the opportunity to recover. Because it did.”