A Woman’s Search for Answers Leads to Lifesaving Heart Surgery

Marianela Betancourt remembers that even as a kid she was often short of breath when she played soccer or basketball or ran track. She always chalked it up to being a little overweight. But as time went on the breathlessness became more noticeable and seemed to happen more often.

About 15 years ago Marianela, who is now 60 years old, woke up in the middle of the night feeling her heart beating “out of control.” Scared and worried she was having a heart attack, she took another dose of her blood pressure medication and called 9-1-1. She was taken to an emergency room near her home in Miami and admitted. There she was administered intravenous medication to bring down her heart rate, which had risen to 200 bpm.

She spent four days in the hospital and when her heart rate slowed to normal she was discharged. A heart attack had been ruled out, she was referred to a cardiologist and advised to get tested for sleep apnea.

Things got better before they got worse

Marianela continued to have palpitations occasionally but always shrugged it off as the result of maybe too much coffee or the stress from her administrative job for a fire department. Because healthcare providers often suggested her weight played a role in her health issues, she managed to lose 40 pounds. She was scared to push herself in exercise, however, because without a diagnosis she didn’t know what would trigger the rapid heartbeat again.

In 2015 Marianela went to an annual work conference in Kansas City and said she was “so happy” because she actually felt good enough to be able to socialize and walk around the city with colleagues without getting winded as she had in the past.

However, on the first night of the conference she woke up when her heart started beating rapidly.

“While I was sleeping, again I felt my heart,” Marianela says. “I said to my roommate, who was a very close friend, ‘There is something wrong with my heart.’”

She knew this incident was worse than the last because she had a new symptom along with the rapid heartbeat – wheezing. Her friend called 9-1-1 and Marianela was taken to the hospital again. During the three days she spent there she was diagnosed with pneumonia and put on a higher dose of blood pressure medication and a blood thinner.

Photos courtesy of Marianela Betancourt.

Three years later, she was celebrating her birthday at a hotel resort with family when she fell forward coming out of the shower and hit the sink face-first. She had passed out from what she would find out later was lack of oxygen from her heart condition.

Her health started to decline, she became even more short of breath and weak and passed out and fell more often.

In 2019, still without answers, she asked her son-in-law to drive her to a regularly scheduled appointment with her cardiologist.

“I couldn’t even hold my purse. That’s how weak I was,” Marianela says.

After reading the results of her EKG her cardiologist told her she needed to go to the ER right away. Once there, she passed out in the bathroom and had to have a blood transfusion because of low blood counts.

She told the doctor there “I want answers. I need to know what is happening.”

Finally, answers and relief

The ER doctor who took care of Marianela told her he had been a student of Craig Asher, MD, a cardiologist at Cleveland Clinic Weston Hospital, and that he believed he could help her. He connected Marianela with Dr. Asher’s office, and she soon got an appointment with him.

Marianela said Dr. Asher asked her during her first visit if she had a history of falling.

“When he asked me that, I knew I was in the right place,” she says. “I knew that he knew what was wrong with me.”

Dr. Asher adjusted her medication, which she said helped her feel a little better. After extensive testing on Marianela and consultation with Nicholas Smedira, MD, a cardiothoracic surgeon at Cleveland Clinic’s main campus in Ohio, Dr. Asher determined Marianela would need open-heart surgery to repair her heart. She had hypertrophic cardiomyopathy, a disease that causes thickening of the heart muscle, left ventricular stiffness, mitral valve changes and cellular changes.

In December of 2019, Marianela underwent mitral valve repair and a clipping of the atrial appendage, and myectomy (removal of some of the hardening of the heart muscle) due to a stiffening of her heart’s left ventricle. The surgery was performed through a unique collaboration between Cleveland Clinic physicians in Ohio and Florida, including Dr. Smedira, whose specialties include hypertrophic cardiomyopathy and mitral valve repair.

“I’m doing fantastic. I have not had one episode since my surgery,” Marianela says. “On the weekends I can go to four Disney parks with my grandkids. Before this I couldn’t even think of doing that.”

She has regular follow-up visits with Dr. Asher and says she recommends him and Cleveland Clinic to everyone she can.

“The care and attention I received at Cleveland Clinic is beyond,” she says. “And I’m talking about everyone from the person who checks you in and everyone after. They want to be there. They want to help you. It’s amazing. No one can touch Cleveland Clinic when it comes to their service.”