Nicole Schadler, a loving wife, mother and long-standing Registered Nurse and Certified Diabetes Care and Education Specialist at St. Elizabeth Healthcare, lived an active and healthy lifestyle. But one day in March, Nicole began experiencing troubling symptoms – swollen hands, kidney pain and abnormally high blood pressure. Despite multiple doctor’s visits and new medications, her periodic symptoms continued to worsen, leaving her feeling anxious.
Over the next three months, Nicole made several trips to local emergency rooms, but her symptoms were often attributed to high blood pressure, hypertension and other likely cardiac causes. One day at a school athletic event, Nicole could not catch her breath while walking up steps and called 911. When EMS arrived, they found she was in atrial fibrillation (AFib) – a rapid, irregular heart rhythm. When she arrived at the emergency room, her AFib had resolved leaving another question mark as to what was wrong.
Nicole’s family history added to her risk: her father had died of a heart attack at age 52. Her cardiologist recognized the need for a more in-depth evaluation, her doctor scheduled her for an echocardiogram and CT angiogram.
A Sudden Crisis and a Race Against Time
That weekend in June, Nicole’s journey reached a critical point. While shopping with friends, she collapsed suddenly while on the sidewalk outside a store. Fortunately, Carla – her friend and fellow nurse, immediately began CPR while waiting for EMS to arrive. Nicole was stabilized at a local emergency room in Maysville, KY, then airlifted the next day to St. Elizabeth Edgewood Hospital for advanced cardiac care.
Upon arrival, Nicole was taken directly to the catheterization lab, where she coded for about 40 minutes and was defibrillated more than six times. Interventional cardiologist Dr. Abiodun Ishola quickly identified that Nicole was in cardiogenic shock – a life-threatening condition where the heart suddenly can’t pump enough blood to meet the body’s needs. Dr. Ishola emergently implanted the Impella CP heart pump, a device that takes over the pumping function of the heart to maintain blood flow to vital organs during critical moments.
Nicole was then rushed to the operating room, where the cardiac surgeon performed a coronary artery bypass and placed Nicole on VA-ECMO (veno-arterial extracorporeal membrane oxygenation). VA-ECMO is a machine that temporarily takes over the function of the heart and lungs, oxygenating the blood and circulating it throughout the body – supplying Nicole’s body with needed oxygenated blood.
Coordinated Expertise When Every Second Counts
Over the next few days, Nicole made small but significant improvements. Cardiac Surgeon, Dr. Mario Castillo-Sang and Dr. Mohanjit Brar, an Interventional Cardiologist, brought her back to the operating room. Nicole’s heart needed even more support, so her doctors upgraded her to the larger Impella 5.5 heart pump, which provides greater assistance for the heart during recovery allowing it to rest and recover. Before leaving the operating room, Dr. Castillo-Sang adjusted Nicole’s VA-ECMO so it could be managed through a blood vessel in her leg, allowing her chest to be closed and sending her back to the Cardiovascular Surgical Intensive Care Unit (CVSICU).
“Nicole’s situation was critical from the moment she arrived,” says Dr. Brar. “Her journey shows how important it is to have a team that can respond to every twist and turn. Our ECMO and Cardiogenic Shock programs rely on collaboration—everyone working together to give patients the best chance, even when the odds are long.”
Four days later, Nicole’s heart had recovered enough to be removed from ECMO, and seven days later, her Impella device was also removed. Nicole remained an inpatient for five weeks—spending time in the CVSICU, CICU and a step-down telemetry unit—while she continued regaining strength. After a two-week stay in inpatient rehab, Nicole was discharged home to her family.
Resilience and a Future Renewed
Despite the odds, Nicole had no major neurological or physical deficits following her heart event. She underwent therapy to regain muscle strength after weeks of bedrest and was able to return to work within six months. Nicole is exceedingly thankful to everyone on her multidisciplinary medical team who played a role in saving her life and allowing her to return to her family with her native heart. She is also deeply grateful for the love and support she received from her family and friends – especially for Carla’s quick action and effective CPR.
Listening to Your Body: Why Women’s Heart Symptoms Matter
Nicole’s experience is a powerful reminder that heart symptoms in women can be subtle, atypical and frequently mistaken for less serious conditions. Women may experience warning signs such as fatigue, shortness of breath, swelling or even pain in areas other than the chest. These symptoms are sometimes dismissed or attributed to stress, hormonal changes or other health issues.
That’s why it’s so important to listen to your body and advocate for your health – especially if you have a family history of heart disease or risk factors. For more information about how heart disease affects women, visit Women & Heart Health.
