A sudden collapse
April Frezza was riding her bicycle, on her way home at the end of a 22-mile ride with her husband. Less than half a mile from her house, April collapsed. Her heart had completely stopped.
Luckily, a retired sheriff's deputy happened to be driving by just then—he ran over and performed hands-only CPR until the paramedics arrived. With a defibrillator, the paramedics got April's heart beating again. At the hospital, she received two stents, and doctors worked on resuscitating her organs that had started to fail.
"I don't remember anything," April says. "When I came to, my husband told me what had happened. I just shook my head and thought it was a bad dream. I felt violated. I didn't believe it at all."
April kept hearing that it was a miracle she survived—and it was. The survival rate for out-of-hospital cardiac arrest is less than 10%.
Cardiac arrest is different from a heart attack. Cardiac arrest is when the heart stops beating unexpectedly; it's an electrical problem. A heart attack is when blood flow to the heart is blocked; it's a plumbing problem.
Recovery was long and difficult. April spent two months in the hospital altogether, spending the last two weeks in intense physical therapy. She learned to eat, shower and walk again. April then enrolled in a cardiac rehab program. Because it was in a gym and she enjoyed the camaraderie of the group, April was motivated to get stronger each day.
A faint flutter
April often gets asked, "Were there any warning signs?" The only thing that was a bit unusual was that April had been feeling a flutter in her chest. She went to the doctor, and the tests came back fine. Her blood pressure and cholesterol were good. She was fit, didn't smoke, ate a healthy diet and exercised frequently. April was diagnosed with acid reflux and sent home. Six days later, she had the cardiac arrest.
"Looking back, I would have immediately sought the opinion of a cardiologist," April says today. "But I would've never known to do that then. It was so subtle."
Later, three years after the incident and after multiple angiograms, April was diagnosed with coronary artery spasms, a condition that's very hard to detect and is more common in women than men.
Be brave, be an advocate
Because there weren't any real warning signs—and because she did the right thing and went to the doctor—you might think April would say there's nothing you can do to prevent cardiac arrest. But this is exactly the opposite of her message.
"You have to be an advocate for your body," April says. "Be brave and go to the doctor. Pay attention to yourself, make time for yourself and go check it out. And if you don't like the first answer, get a second opinion."
April's healthy, active lifestyle helped her survive—but she still encourages people, even fit people, to be aware. "Don't assume because you're in such great shape that something may not happen," April says. "I don't want to put fear in people, but you need to be aware. Don't be afraid to speak up if you think something's not right."
The chain of survival
April is grateful for the man who stepped in and performed CPR. Early CPR is one of the links in the chain of survival, a series of actions that can improve the chances of survival and recovery for victims of cardiac arrest.
More specifically, hands-only CPR is what saved April's life. Hands-only CPR is CPR without mouth-to-mouth breaths—it's good for the first few minutes someone is in cardiac arrest and has been shown to be as effective as CPR with breaths.
"Knowing you don't have to do the breathing is huge," April says. According to the American Heart Association (AHA), hands-only CPR can double or even triple a victim's chance of survival. And, it takes less than a minute to learn how to do it. See how with AHA's Hands-Only CPR Fact Sheet.
Today, April is back to being active. Hiking has been a big part of her recovery. She sometimes gets scared that the intensity of her hikes might cause her heart to stop again, but April says that's where living fearless comes in. "Fearless means walking through your fear," she says. "Talking to yourself and saying it's OK—that definitely gets me to the top of the mountain."