After recovering from a potentially fatal heart condition, a mother promotes the lifesaving value of intuition.
Erin Sargent is healthy and happy to be alive.
The mother of two young children also wants to spread an important message: Listen to your body.
Sargent, now 36, experienced daily fatigue and fever shortly after the delivery of her son more than five years ago, but her doctors couldn't make a proper diagnosis.
"I knew something was wrong," recalls the resident of Canton, Michigan, "despite the fact that no one could determine what it was."
After enduring three months of symptoms, Sargent was ultimately diagnosed with infective endocarditis by her referring physician, infectious disease specialist James Gordon, M.D.
An inflammation of the inner tissues of the heart, the condition can lead to a life-threatening infection of the heart valves.
She was referred to the University of Michigan Frankel Cardiovascular Center for treatment.
Finding the source
Sargent was born with a bicuspid aortic valve, an abnormality that predisposes some people to certain health problems, including heart valve infection.
A normal aortic valve has three leaflets that open and close to control the flow of blood into the aorta. But a bicuspid aortic valve has only two leaflets, which prevents the valve from functioning properly.
People with a bicuspid aortic valve over time can develop aortic stenosis — a narrowing of the valve that makes it difficult for the leaflets to open sufficiently. They also can be susceptible to aortic regurgitation, an inability of the valve leaflets to close properly, allowing blood to flow back into the heart each time the heart contracts.
Infective endocarditis, likewise, is more common among patients with bicuspid aortic valve. It is thought that bacteria in the bloodstream can stick to the aortic valve because of the abnormal structure of the leaflets — or possibly as a result of more turbulent flow of blood across the valve.
The condition is typically treated with intravenous antibiotics for several weeks.
Despite a regimen of antibiotics, Sargent's infection worsened and led to life-threatening complications.
A sudden, severe headache ("the worst of my life," says Sargent) led to a diagnosis of subarachnoid hemorrhage, or bleeding around her brain. The bacteria had destroyed her aortic valve, which led bits of the infection to travel up to her brain and cause the bleed.
Sargent says she felt "10 times better" just two weeks after surgery. She has steadily improved since.
A new chapter
With a second pregnancy underway in 2015, Sargent and her bioprosthetic valve were monitored by Melinda Davis, M.D., a U-M cardiologist who specializes in cardiovascular disease during pregnancy.
"This was something we watched closely," Davis says. "Prior to becoming pregnant again, Erin's artificial valve was evaluated to ensure it was working properly."
Such valves require long-term observation. They may start to deteriorate after about 10 years, Davis says, noting that the scenario could happen earlier in younger patients.
Artificial valves also can develop blood clots or become too tight. And they're more prone to infection, a central concern, given Sargent's health history.
With input from a multidisciplinary team of cardiologists, obstetricians and anesthesiologists, Davis followed the case carefully to ensure all aspects of Sargent's well-being were addressed.
"Erin's second pregnancy went smoothly, without any cardiac complications," says Davis, who will continue to follow her case.
A stable echocardiogram during a recent routine appointment was great news for Sargent, whose children now are 1 and 5½ years old.
Meanwhile, she continues to spread a survival message that enabled her own: Listen to your body.
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