The Hollywood version of a heart attack arrives with a thunderclap of pain striking the victim, who clutches his chest, staggers about and gestures toward the heavens before collapsing.
As is so often the case, a real-life heart attack rarely follows such a script. Its warning signs can often be subtle and easy to ignore. But in the end, each and every heart attack in the real world carries far more drama than a movie reenactment because the actors are the leading characters in their own lives.
Just ask Tom Grimmond. Around 3 a.m. late last January, the 48-year-old father of two lay tossing and turning in bed in his Longmont home, alternately freezing and burning up. He thought he had the flu or some other very unpleasant but short-lived infection, and nearly decided to just roll over and try to go back to sleep.
“There was no chest pain,” Grimmond recalled. But as he continued to sweat and feel dizzy, he woke up his wife, Stephanie. “I just said something doesn’t feel right in any fashion.”
He and Stephanie drove to the emergency room at nearby UCHealth Longs Peak Hospital. Shortly before they arrived, Grimmond began feeling tightness in his chest and he walked into the hospital buckled over from the pain.
The clock was running
He didn’t know it at that point, but Grimmond was near death. He had a 100 percent blockage of the left anterior descending (LAD) coronary artery, which typically supplies 45 to 55 percent of the blood flowing to the left ventricle. The LAD is generally considered the heart’s most critical vessel in terms of blood supply, said Dr. Lynn Carlyle, an interventional cardiologist at Longs Peak Hospital.
“The LAD is often referred to as the “Widowmaker,” Carlyle said. “He had zero flow across the lesion.”
Carlyle was part of a UCHealth team who helped prevent Stephanie Grimmond from becoming a widow. The emergency room team used electrocardiography to quickly determine that Grimmond had suffered a serious heart attack known as a STEMI (ST-Elevation Myocardial Infarction). That triggered an alert that brought Carlyle to the hospital while staff prepared a Cardiac Cath Lab room where she would start a procedure to open Grimmond’s blocked LAD.
Grimmond arrived at the Cath Lab at 4:48 a.m. Carlyle and her team prepared to thread a stent-bearing catheter through his femoral artery to the blockage. Twenty-three minutes later, she crossed the lesion, and positioned the stent in place to open the artery. In another five minutes, blood flowed through the LAD. The quick action was critical.
“The best predictor of a good outcome is the time it takes us to open the vessel, and that went very well,” Carlyle said. Plenty of people contributed to the lifesaving success, she added, including Grimmond and Stephanie, who got to the hospital quickly.
“It’s really a team approach. The patient getting to the hospital, the ER recognizing the symptoms, recognizing the ECT, activating the cardiac team, having the interventionist get there … every minute counts,” Carlyle said. “Each of those minutes is important to keep the patient away from hemodynamic collapse and cardiac arrest.”
Grimmond spent five days in the hospital, four of them in the ICU. He went home with a life vest – an external defibrillator to guard against potentially deadly irregular heart rhythms. He no longer has to wear that, but he continues to take anticoagulant medication because of a lingering blood clot in the left ventricle of his heart. He’ll get an echocardiogram in the coming weeks to see if the medications have dissolved the clot, Carlyle said. He also takes a daily regimen of nine medications for his heart disease, blood pressure and cholesterol.
A heart attack is by definition a life-changing event, but Grimmond has taken it upon himself to make crucial adjustments that reduce the risk of having another one. He’d smoked for more than 20 years, but hasn’t had a cigarette since Carlyle opened his artery.
“She told me to quit, and I told her, ‘Done,’” Grimmond said. He’d long leaned to a plant-based diet, but said his meals are now 100 percent vegan, as are Stephanie’s. He completed his cardiac rehabilitation and stays active by pedaling 6 to 10 miles a day on his bike. “I’ve built the habit of exercise,” he said.
Smoking wasn’t the only thing that put Grimmond at risk for heart problems. He lost his father at age two, the result, he was told, of an aneurysm related to high blood pressure. His brother, who lives in Florida, has had two arterial stents implanted, the second, incredibly, just a day before Tom’s own procedure.
As Carlyle noted, the strongest predictor of premature cardiac disease is family history. Grimmond can’t do anything about that, which is what makes his choice to quit smoking so important.
“Without family history, tobacco is the largest predisposing factor of cardiac disease for him,” she said. She noted that smoking causes inflammation that increases the risk of a plaque rupturing. “Quitting is the best thing that patients can do for themselves.”
His brush with death sharpened Grimmond’s appreciation of what he might have lost. He and Stephanie have been together since he moved to Colorado from Florida in 1997 as one stop in a long career in the restaurant business. They have two sons: Connor, 19, and Cameron, 17, who has graduated from high school. They loomed large in his mind while he recovered in the ICU.
“That’s what hit me a lot when I was in the hospital,” Grimmond said. “It wouldn’t take anything to make my eyes water. If I wouldn’t have made it off the [operating] table, I wouldn’t have seen my son graduate. I’d have missed just BS-ing with my kids and my wife.”
He’d also have missed the crazy world of working, managing and – most of all – cooking in restaurants. He started with a routine fast-food job at 16, just to earn some pocket money. An Achilles tendon injury ended his two-year stint in the Marines, after which he got a job at a restaurant where he’d previously worked. That launched a series of positions at eateries in Florida and Colorado, including TGI Fridays, Carrabba’s Italian Grill, Cheesecake Factory, Buca di Beppo, and many more. He also squeezed in a year at a culinary school.
The common denominator was cooking. “I’m a jack-of-all-trades, but my heart was always in the kitchen, playing with food,” Grimmond said.
Now that he’s fully vegan, a big source of satisfaction is taking recipes for crowd-pleasers like traditional comfort food and writing meatless alternatives that people will still find satisfying. He’ll soon start a new position as executive chef with a brewery/restaurant in Longmont, but he said a future goal is opening a specialty grocery store featuring plant-based items.
Despite his love for the business – “you never have the same day twice” – Grimmond acknowledges that years of 12- and 14-hour days took a physical toll. “You’re always on your feet,” he said. Looking back, he remembers moments of shortness of breath and fatigue and wanting to go to sleep. He’d find himself smoking more and not exercising because of the demands of work.
“Little by little I stopped doing the things that I needed to do and it caught up with me,” he said.
He’s grateful to the hospital for giving him the chance to get back on track. He recalled, for example, getting a surprise visit in the ICU the day after his procedure from two ER staffers who had been part of the team helping him and wanted to check to see how he was.
“Usually after you’ve been there, they walk away and nobody bothers to talk to you again,” Grimmond said. “But that was how pretty much everybody treated us.” Simple expressions of concern – offering Stephanie and the kids a cup of coffee or a blanket, for example – were the rule.
“I’d send everybody there,” he said. “It’s not just a job to them. I’ve been in and out of hospitals all over the United States, and besides my sister, who is a nurse, I haven’t seen people like this before. Dr. Carlyle is phenomenal, not just because she saved my life. She gets on the same level and talks to you as a person, not as someone who is another notch in her belt.”
For her part, Carlyle emphasizes how important it is for Grimmond to adhere to his regimen of medication, exercise, healthy diet and abstinence from tobacco. With those things taken care of, his prognosis is excellent, and he’s ready to write the next chapters of his life.
“He is a guy who will determine his own destiny,” Carlyle said.