When Sonia revealed to her father over dinner that she was seven weeks pregnant with her second child, he was so overwhelmed with joy that he bought wine for the entire restaurant.
The following morning, his excitement quickly turned to terror.
“The next call he gets from me was from the ambulance telling him I’m having a stroke,” she said.
Sonia, 39, was visiting her grandmother at a nursing home when she suddenly began experiencing feelings of numbness and faintness, symptoms she brushed off as typical for the early stages of pregnancy. But as she walked into the hallway to retrieve a nurse for her grandmother, she lost control of the left side of her body and collapsed.
“Very quickly, there was a line of paramedics outside the nursing home,” she said. “They scooped me up and took me straight to the Emergency Department at Hoag Hospital in Newport Beach. I still replay that day in my mind. I’m so beyond grateful for how fast they were. I know that if I had been at home, I would have thought that I was just dizzy from pregnancy. I would have gone to bed, and I wouldn’t be here right now.”
Nationally recognized for its stroke care, Hoag is a designated DNV Comprehensive Stroke Center. Hoag’s stroke team does more than move quickly. It works with a level of expertise that comes with being one of the busiest stroke centers in California. This was key for Sonia, who was no ordinary stroke patient.
At Hoag, Sonia would require experts from several institutes and specialties – neurology, interventional radiology, hematology, cardiology, obstetrics, the Obstetrics Emergency Department and maternal fetal medicine.
“It was phenomenal,” she said. “Everyone was so warm and expeditious. They were candid that there was a risk to my baby, but calmly and consistently reassured me that they were doing everything they could to ensure a positive outcome.”
Stroke patients typically receive medication to dissolve blood clots in the brain, but neurologist Jason Muir, M.D., program director of Hoag neurophysiology services, determined that this was not an option for Sonia while pregnant. Instead, Christopher Baker, M.D., director of Interventional Neuroradiology at the Pickup Family Neurosciences Institute at Hoag, and Alexander Misono, M.D., chief of Interventional Radiology at Hoag Hospital Irvine, performed a minimally invasive procedure to remove Sonia’s blood clot within 45 minutes of her arrival at the hospital through a small incision made in her leg. Anesthesiologist Stephen Skahen, M.D., and critical care intensivist Neema Aghamohammadi, D.O., played instrumental roles managing her condition during and after her procedure.
Sonia awoke feeling like herself again, but her medical journey was not over. Subbarao Myla, M.D., Dr. Joel H. Manchester Endowed Chair in Interventional Cardiology, medical director of Cardiac and Endovascular Labs and Cardiovascular Research at the Jeffrey M. Carlton Heart and Vascular Institute at Hoag, visited her in the recovery room.
“Through Dr. Myla, I learned I had a hole in my heart.”
Sonia had never struggled with heart problems, but while treating her blood clot, doctors discovered she had a Patent Foramen Ovale (PFO), a hole between the upper left and right heart chambers. This hole exists in everyone before birth but usually closes in infancy. Sonia’s never closed, leading to a tendency for migraines and eventually, her stroke.
Dr. Myla explained a 10-minute, minimally invasive procedure involving the use of an Amplatzer™ occluder would permanently close the hole. However, Hoag obstetrician and gynecologist Zhanna Pinkus, M.D., determined the procedure couldn’t be completed until after Sonia’s first trimester.
“Dr. Pinkus advocated for the baby, saying that we needed to wait 14-16 weeks to do the surgery because vital organs were still in the process of formation,” Sonia said.
One week following her heart surgery, Sonia was cleared to resume her normal activities, though she continued to receive additional monitoring by members of her care team including perinatologist, David Lagrew, M.D., chief of service, maternal fetal medicine at Hoag; hematologist Pooja Motwani, M.D., neurologist David Brown, M.D., and primary care physician Jill Panitch, M.D.
“It’s a symphony, not jazz,” Dr. Myla said. “Everyone at Hoag plays their part with precision and coordination, ensuring the best outcome for the patient.”
Sonia also received prenatal care from Hoag obstetrician and gynecologist Jody Lai, M.D., throughout her pregnancy.
“I made sure Sonia felt heard,” Dr. Lai said. “It was still her pregnancy, and our job was to balance her vision with what was medically safe.”
Later that year, Sonia was back at Hoag to deliver her baby boy.
Reflecting on her 8-month journey from a pregnant stroke patient with a heart defect to new parenthood, Sonia said, “Having a baby at Hoag, and a stroke and a heart surgery at Hoag, I can say that Hoag is the only place I want to be for my care.”
Learn more about the Jeffrey M. Carlton Heart and Vascular Institute here.
Learn more about the Women’s Health Institute here.
Learn more about the Pickup Family Neurosciences Institute here.
