Sara's Heart

Body art may be a whim for some and a fashion statement for others, but the colorful, winged heart spreading across Sara Dunn's lower back means much more than that. It's a symbol of what she's already survived on a journey that's far from over.

The year Sara Dunn graduated from high school marked the beginning of her struggle to hold onto life. A sudden trip to the emergency room led to months of visits to multiple cardiologists, two surgeries and a dim prognosis. Now at age 22, Dunn can only wait for medical advances to solve the mystery of her heart condition. The future may be a struggle, but Sara chooses to look at what she's already survived.

The first indication that there was anything wrong came Sara Dunn's senior year. She was swimming laps at the gym when her heart began to beat faster. More than just the increased heart rate of exercise, her heart began to pound so rapidly that her entire chest hurt. As Dunn walked away from the pool, the beating of her heart was causing a class ring worn around a chain on her neck to bounce against her chest, and it was getting increasingly difficult to breathe. A normal resting heart rate is 85-95 beats per minute. By the time Sara arrived at the hospital, her heart rate was over 260 bpms.

"I was eighteen, I was scared, I wanted my mom," Dunn recalls. Normal measures to control her heart rate weren't working. Adding to Dunn's fear, the doctors told her that her heart would have to be stopped completely and then restarted. And that there was not enough time to call her mother. Dunn recounts how she watched with apprehension as a crash cart was wheeled in just in case her heart didn't restart. When her heart stopped, Dunn says, "It felt like my whole body jumped. I couldn't breathe or move -- it just hurt. Then it felt like I slammed down on the table. It was the most painful thing." When Sara's heart started beating again, the runaway pace had been contained. Sara was allowed to call her mother, but the doctors told her she needed a cardiologist.

Dunn was seen by several cardiologists locally before she was referred to a specialist in Sacramento who was able to diagnose her. Dunn was suffering from supraventricular tachycardia (SVT), caused by a rare congenital heart condition. Specifically, she had Wolfe-Parkinson-White syndrome, a condition in which an unusual electrical connection occurs between the upper and lower chambers of the heart. The treatment is to find the pathway that is carrying the rogue current and to destroy it. "Basically, they go in through the major arteries in the chest and leg. They use a laser and burn off part of the heart," Dunn explains.

WPW is a very rare condition, occurring in about 1.5 of every 1000 people. Out of that fifteen hundredth of a percent, there is a 98% success rate resulting from the surgery Dunn had. In one percent of the cases, the electrical current finds a way to reroute itself -- as it did in Dunn's case. "It wasn't the way I wanted to be special," Dunn chuckles grimly.

Medication after medication proved ineffective at controlling the symptoms. For no discernible reason, Dunn's heart rate can skyrocket out of control. Even her resting heart rate tends to be 119-130 beats per minute. The most common effect of living with WPW syndrome is fatigue. "I get tired really easily," Dunn says. "Just walking down the hall can wear me out, so I watch what I eat and drink, what I put in my body, and what I do."

Dunn wore a heart monitor for over a year in an effort to discern what triggers the episodes. Finally, in 2001, she was referred to Stanford for an exploratory surgery performed in only two places in the United States. Dunn was uneasy about the procedure and even tried to check herself out of the hospital in a state of "pre-op jitters". Dunn remembers, "No one had really told me what would happen, so it didn't go very well." The plan was to send in the ablating tools through the arteries, trigger the out of control heart rate, and then see if destroying various regions of the heart caused the irregular rhythm to stop. This time, doctors entered through the arteries in Dunn's neck, which required her to stay semi-conscious through the painful and terrifying procedure -- something she hadn't been expecting. Mid-way through the surgery, she was in enough distress that the doctors finally put her completely under anyway. "I had a bad feeling going into it," Dunn says. "I remember asking the nurse to tell my mom and sister that I loved them. I was sure I wouldn't wake up. When I did [wake up], I was just in awe, I guess."

That was when she decided she wanted a tattoo. "I knew I wanted something to say that I did this, and that I'm okay. At first I couldn't think of what I wanted that meant enough, or that I'd want on my body for the rest of my life." Some time later, she was in a Modesto shop called Talisman's Tattoos by Chow watching her fiancé have a tattoo finished when the pieces fell together. Dunn's mother had given her a charm while she was in the hospital with the second surgery, a heart with wings. Dunn knew she wanted the dates of her surgeries, and lots of color. "I didn't want it to be a sad thing," she explains. Her fiancé suggested band aids to symbolize the surgeries, with the date of each surgery alongside. Chow, a long time friend of Dunn's fiancé and a tattoo artist of considerable renown, did the rest, creating a beautiful eight inch memorial across the small of Dunn's back. "I wanted something to show that it was still broken," Dunn says, "but it's in the process of being fixed. I'm getting there."

Dunn may be in the process of fixing her heart, but she still has a long way to go. The second surgery was as little help as the first, leaving Dunn with two choices: to have a pacemaker put in, an option which would require major surgery every four to five years for the rest of her life, or to take the risk to wait and see what medical science comes up with in the next ten years. She's 22 now, too old to be covered under her mother's health insurance, and although she enjoys tending bar at Applebee's in Manteca, her medical benefits there won't cover the cost of everything she's most likely going to need. Dunn is keeping her fingers crossed and hoping for a breakthrough in WPW research.

"I'd like to say I'll never have another surgery," Dunn says thoughtfully, "But I know I'll probably have to. It's hard to imagine living with this condition for the rest of my life." It's a long fight that deserves a memorial, and Sara Dunn is proud to wear the symbol of her victories. Two battles down, an entire war yet to go.

This article first appeared in the Manteca (Calif.) Bulletin.