Faith over fear: Shawna Layland on surviving an aortic dissection

GALION — Shawna Layland doesn’t try to cover up the scar that shoots down from her collarbone like a bolt of lightning.

She wears it like a badge of honor. It’s a reminder of all that she’s survived and the ways she believes God brought her through.

“This is my prop,” Layland said, gesturing to the mark on her chest. “So many people will say, ‘Oh my goodness, you had open-heart surgery.’ It’s my opportunity to tell them about my faith and tell them about what happened to me.”

Just two days before Christmas 2022, Layland’s aorta tore in two places, sending her into heart failure at age 48.

“God is not done with me. I totally believe that,” she said. “I don’t know why or what my purpose is, but if I can save lives by telling them my story . . . That’s why I’m here.”

‘It was the worst pain I’ve ever felt’

The aorta is the largest blood vessel in the body at more than a foot long. Its branches deliver oxygen, nutrients and even hormones to organs and tissue throughout the body.

A dissection occurs when the inner tissue of the aorta tears suddenly, allowing blood to gush through and separate the inner and middle layers. This slows blood flow to other parts of the body. In some cases, dissection causes the aorta to rupture.

Layland still remembers the moment her aorta tore. She had the day off work and her grandchild was over, but she felt too tired to get out of bed. Her husband brought her a pancake topped with applesauce, just the way she likes it.

“I took a bite and I felt like something was wrong. I aspirated it,” she said.

Layland managed to drive herself to the hospital. As she sat in the waiting room, a severe pain tore its way up from her chest through her neck to her left ear. She felt like her insides were on fire.

“My pain was so bad I was pulling my hair out in chunks,” she said. “It was the worst pain I’ve ever felt and I’ve had three children.”

Layland said doctors performed an electrocardiogram (EKG), but couldn’t detect the problem. They gave her a GI cocktail and antibiotics and sent her home.

The pain didn’t subside. Layland returned to the hospital on Christmas Day. Doctors gave her a blood test, then a CT scan. As she lay inside the imaging machine, the tech told her to keep talking.

“I heard someone else say, ‘Get her out of there, she’s not going to make it,” Layland said.

After the scan, Layland’s medical team agreed to send her to The Ohio State University Wexner Medical Center in Columbus. She spent 10 1/2 hours in open heart surgery and 48 hours on life support.

She woke up three days after the operation.

“I”m very lucky to be a survivor of aortic dissection,” she said. “Everybody kept telling me, you shouldn’t be here.”

Faith over fear: the road to recovery

Layland had made it through a life-threatening medical emergency, but the hard part was far from over.

Before she was discharged from the hospital, she was fitted with a life vest — a device that would shock her heart back into action if it suddenly stopped.

“I had to wear that thing 24/7 because at that point, I was 48 years old and in heart failure,” she said.

For months, she wasn’t allowed to lift her arms above her head. She had to use a walker and have friends and family bathe her during recovery.

Even now, she and her husband have a code word in case her blood pressure suddenly plummets.

“If I say ‘woah,’ he comes running,” Layland said. “This summer, I couldn’t lift my hands above my head, or my blood pressure would drop and I would be on the floor.”

Layland is now back to walking three miles a day — something she did before her surgery — but she still experiences back pain and soreness in her bones.

Scans and doctor’s appointments have become a regular part of life. In March, she’ll have another surgery to install a defibrillator.

She continues to cling to her personal motto — faith over fear — during the long road to recovery.

“I have to live by that every day and sometimes I have to say it several times a day,” she said.

Asvin Ganapathi, a cardiac surgeon at The Ohio State University Wexner Medical Center, praised Layland’s perseverance following the procedure.

“Shawna was lucky that (her aortic dissection) was diagnosed in an appropriate time frame, and she was able to get to a center with the expertise to handle her situation,” Ganapathi said.

“Additionally, while surgery went well, Shawna also worked extremely hard to recover.”

Layland has also taken proactive steps to protect her family, urging her children to get echocardiograms and be aware of their heart health.

She hopes to become an ambassador for the John Ritter Foundation for Aortic Health so she can help raise awareness of aortic dissections.

In the meantime, she’s encouraging people to talk about their family’s health history and get screened for heart conditions if they are at risk.

Layland said awareness is crucial, in part because aortic dissections are often mistaken for heart attacks.

One high profile example is John Ritter, who died in 2003. The “Three’s Company” star passed away at age 54 after doctors failed to diagnose his aortic dissection in time.

In aortic dissection patients, swift treatment is essential

An aortic dissection is a serious, life-threatening condition, so quick identification and treatment is crucial.

About 40 percent of patients die immediately from complete rupture and bleeding out from the aorta, according to the Cleveland Clinic.

For those who survive, the traditional consensus in the medical community is that the risk of death from aortic dissection goes up by one percent each hour until a patient receives treatment.

However, Ganapathi said the odds appear to be improving for patients who receive treatment quickly.

“In patients who get to a hospital and undergo an operation, the mortality rate can approach 20 percent, although a recent large study of large institutions had a mortality rate of just under 16 percent,” he said.

“For patients who survive the dissection and operation, the prognosis is excellent. While they usually have other co-morbidities that may limit their life, usually they have excellent long-term survival.

“However, they will need life-long aortic surveillance to ensure other areas of the aorta are not enlarging to concerning sizes.”

What are the symptoms of an aortic dissection?

The Cleveland Clinic states the most common characteristic of aortic dissection is an abrupt start. It can happen at any time, while doing anything, or at rest or when you’re sleeping.

Common signs and symptoms include:

• Sudden severe, sharp pain in the chest or upper back. This may feel like tearing, stabbing or ripping.
• Shortness of breath
• Fainting or dizziness
• Low blood pressure
• A diastolic heart murmur, muffled heart sounds
• A rapid, weak pulse
• Heavy sweating
• Confusion
• Loss of vision
• Stroke symptoms, including weakness or paralyses on one side of the body or trouble talking

There are two main types of aortic dissection. Type A dissections are more common. They occur closer to the heart and often extend the entire length of the aorta. Type B dissections being further down and extend down towards the stomach.

The John Ritter Foundation for Aortic Health notes that aortic dissections often have symptoms similar to those of a heart attack.

“Heart attacks are far more common than aortic dissection,” the organization states on its website.

“If a heart attack or other important diagnosis is not clearly and quickly established, then aortic dissection should be quickly considered and ruled out, particularly if a patient has a family history or features of a genetic syndrome that predisposes the patient to an aortic aneurysm or dissection.”

Ganapathi said heart attacks occur in about 4,400 cases per 1 million people per year, while dissections cases are about 30 cases per 1 million people per year.

Unlike heart attacks, it’s difficult to detect an aortic aneurysm with an EKG.

“Unless the dissection causes an issue with the coronary arteries, the EKG will commonly be normal outside of a tachycardia (fast heart rate),” Ganapathi said.

His advice to others is to speak up if they have concerns about their heart health.

“Be your own advocate. If you have the worst chest pain ever, don’t hesitate to ask your doctor if there is concern for a dissection,” he said. 

“Women commonly have worse outcomes as their pain may not always be the same as men, leading to potential misdiagnosis (similar to heart attacks).”

Am I at risk for an aortic dissection?

Aortic dissection are caused by the gradual breakdown of cells in the aorta walls. Several factors can increase the risk of an aortic dissection, including high blood pressure, family history and certain medical conditions.

Risk factors include:

• Ongoing hypertension
• The buildup of plaque in the arteries (atherosclerosis), high cholesterol and smoking
• An aortic aneurysm
• Aortic valve disease or aortitis
• Congential heart conditions including a bicuspid aortic valve or Turner syndrome
• Connective tissue disorders like Marfan syndrome and Ehlers-Danlos syndrome
• Family history of aortic dissection
• A traumatic chest injury such as a high speed car crash
• Being pregnant and having high blood pressure during delivery

How can I reduce my risk of an aortic dissection?

Ganapathi said researchers are working on ways to predict when a dissection may occur. Doctors may consider a preventative operation in patients with an enlarged aorta or aortic aneurysm.

In the meantime, everyone can be proactive in mitigating their risk.

“Hypertension is one of the leading risk factors for dissection. Keeping one’s blood pressure under good control and close monitoring of cholesterol can go a long way, particularly for patients with aneurysms,” he said.

The Cleveland Clinic lists several recommendations to reduce the risk of aortic dissection, including:

• Lowering blood pressure to a healthy level
• Maintaining a healthy weight
• Wearing a seat belt
• Abstaining from or giving up smoking and tobacco products
• Seeing your medical provider for regular check-ups and any other time you experience a change in your health
• Screening for aortic disease if you have a first degree relative who has/had an aortic dissection or aortic disease