From Routine Evaluation to Life-Saving Response
Public Health Expert & Cardiology Patient
“From the time that I stepped into the facility until the time I was taken by ambulance to the hospital, everyone on the MyMichigan care teams paid attention to me; I felt seen, heard and cared for. They are my angels. We all deserve angels.”
Pamela Pugh, DrPH, 55, is a public health expert from Saginaw. As such, she is keenly aware of how certain populations may be at greater risk for health issues, the proactive steps that can reduce those risks, and the importance of access to quality care. Recently, her own medical emergency gave her a deeply personal perspective that she will carry forward in both her work and her life.
While undergoing testing for possible cardiac issues ordered by her primary care provider, Lakha Richardson, M.D., Pugh suffered a cardiac arrest. The team at MyMichigan CardioVascular Institute saved her life. Today, she is profoundly grateful for the care she received every step of the way and is determined to slow down and make the most of this second chance.
Pugh has always maintained a strong partnership with Dr. Richardson. She requested an office visit to discuss three brief episodes of spasms near her heart. Although her cholesterol was slightly elevated, her blood pressure was within a healthy range, and a standard electrocardiogram (EKG) showed no concerning findings, Dr. Richardson recommended additional testing.
“Dr. Richardson was very kind and emphasized the importance of getting a nuclear stress test to rule out any issues,” Pugh said. “She knows me well and walked me out of the building. ‘Treat yourself as you did your mother, then come back to see me in one week,’ she said. I made the appointment and told the office I would be gone for just a short time to get it done.”
A nuclear stress test evaluates blood flow to the heart muscle during rest and stress. A small amount of radioactive tracer is injected into the bloodstream, and a special camera captures images of the heart to assess blood flow. The test is completed in stages, with imaging performed at rest and after exercise or medication-induced stress.
Pugh received an initial injection and completed a scan of her heart. She was provided with snacks and water and waited an hour before returning for additional imaging. She changed into a patient gown because the pullover she was wearing contained a zipper. MyMichigan Cardiology Physiologist Joshua Zang served as Pugh’s technologist during this portion of the testing.
“When I first met Josh, he asked me why I was there because I appeared to be in good health,” she shared. “I explained the several brief episodes of spasms I’d had, along with an unusual sensation in my right arm.”
Josh connected Pugh to monitoring leads and she began walking on the treadmill. Josh complimented her performance at the start of the test. However, as the treadmill's incline increased, Pugh felt another episode beginning. “I told Josh the symptoms were starting again and that I needed to stop,” she said.
Josh quickly helped her sit down and calmly explained they would need to use medication instead of exercise to safely increase blood flow to the heart for an accurate evaluation. Josh and another technologist carefully explained the medication, its half-life, expected side effects, and monitored her closely throughout the injection and completed this portion of the test without incident. She then had a second waiting period, which was standard. Pugh—still dressed in the gown—asked if she could remain in a private area instead of returning to the main waiting room.
“Without hesitation, Josh made space for me to wait comfortably in private but close to staff,” she said. “After a little while, I felt an episode coming on. This time it was more intense and wouldn’t stop. I saw a technician coming in with another patient and asked for help, and he moved immediately.”
Within moments, Josh was in the hallway. "I told him I was feeling faint,” she said. “He quickly guided me back into the stress testing room, helped me onto the examination table and began reconnecting me to the cardiac monitor while calling for additional staff. The last thing I remember saying was, ‘I’m going down...’ Then, I heard voices telling me, ‘Pam, stay with us’.”
Pugh had gone into ventricular fibrillation (VFib) and suffered cardiac arrest, a condition in which the heart suddenly stops pumping blood, cutting off circulation to the brain and other vital organs for over five minutes. The care team immediately began cardiopulmonary resuscitation (CPR) and used an automated external defibrillator (AED) to restore her heartbeat. Emergency Medical Services were already on the way and transported her to MyMichigan Medical Center Saginaw for further evaluation.
“The ambulance came quickly, and two nurses, Rachel and Cassie, held my hands to help keep me calm,” Pugh shared. “I really wasn’t clear on what was happening. In fact, it wasn’t until I heard the medics in the ambulance going over my condition that I vaguely understood. Days later I saw the EKG report and could see that I had flatlined.”
Fortunately, a heart catheterization revealed that Pugh's coronary arteries were clear, and an echocardiogram and cardiac MRI showed no evidence of permanent heart damage. Even so, processing what had happened proved difficult. For a time, she became hyperaware of every heartbeat.
Today, Pugh is intentionally slowing her pace. She takes leisurely walks, rests when she feels tired, and is learning not to rush through life. “I am consciously slowing my pace, taking walks and sleeping when tired. I am retraining myself to not be in a rush, and I encourage others to do the same. I also joined a support group to talk with people who have been through similar experiences.”
Pugh’s care team now includes MyMichigan Electrophysiologist Lu Chen, M.D., and Amanda Petzold, P.A.-C., at MyMichigan Cardiovascular Institute. “Today I have an implantable cardioverter defibrillator to detect and stop any irregular heartbeats and I’m following up with my heart care team regularly,” she said. Pugh also recently underwent genetic testing to rule out inherited conditions she and her care team should monitor moving forward.
She is committed to raising awareness about heart health, the importance of following through on physician-suggested testing, individual CPR training and advocating for access to AED devices in public places.
“This was a reality check for me,” she said. “We are all human, and it matters how each of us is treated. What stays with me most is that my care began long before my heart stopped. From the time that I stepped into the facility until the time I was taken by ambulance to the hospital, everyone on the MyMichigan care teams paid attention to me; I felt seen, heard and cared for. They are my angels. We all deserve angels.”
Those who would like additional information about the comprehensive heart care available at MyMichigan Medical Center Saginaw, may visit www.mymichigan.org/mcvi.
