Without CPR, Mary Gordon likely wouldn’t be alive today.
The Falls Church resident was diagnosed at age 20 with mitral valve prolapse, a condition that can cause blood to leak backward into the left atrium of the heart. A prolapse is typically not life-threatening and affects roughly 3 percent of the U.S. population, including at least three of Gordon’s family members.
For most of her life, it wasn’t much of an issue, even after her doctor ordered an echocardiogram five years ago due to an abnormally loud heartbeat.
“[The doctor] said, ‘You’re a two out of a 10, nothing to worry about,” recalls the government contractor. “He’s like, ‘But it could [cause complications] tomorrow…or you could live till 90 and never have any issues.'”
In December 2019, the then 37-year-old seemed to be thriving physically. She was using her office Peloton a few days a week and enjoyed running and hiking. Then things quickly changed.
“I went to an ugly sweater party Friday night, the week before Christmas. I woke up Saturday morning [and] I just felt off,” she says.
Though she didn’t know it at the time, her heart rate was spiking close to 200 beats per minute. Days later, she had a severe “dizzy spell” while driving with her boyfriend (now fiancé), Matt Costakis, to the Roanoke area to visit family over Christmas. Over the course of 10 days, she had multiple, brief spells of near syncope, or a temporary loss of consciousness. “Everything just kind of flashed off for a second. A split second.”
On New Year’s Eve, the couple was preparing for a trip to Colorado, but Gordon could barely muster the energy to get off the couch. She scheduled an appointment at her primary care doctor’s office, PMA Health in Falls Church, for the afternoon. When she went in, her blood pressure was extremely high, though her EKG was normal. Faith Saunders, the attending physician’s assistant, told Gordon to cancel her trip and ordered blood work on another floor to gather more information. Gordon headed out to complete the testing and made it as far as the elevator.
“That’s when I went into cardiac arrest,” she says.
Gordon has no memory of the incident. After she collapsed, a receptionist heard her gasping for air and called for help. Saunders and physician Timothy Muir began administering CPR (short for cardiopulmonary resuscitation), while others went to grab an automatic external defibrillator, or AED. After six minutes of CPR and two shocks from the defibrillator, Gordon regained consciousness.
“It’s emotional to think about what those people went through that day,” she says. “Even though they work in the medical field, like how terrifying that had to be.”
Each year, an estimated 436,000 people in the United States die from cardiac arrest. For nine out of 10 people who experience it, the event is fatal. But the use of CPR can double or triple the chances of survival.
So what exactly is cardiopulmonary resuscitation and how does it work?
“We’re talking about a situation in which the heart has stopped pumping, which acutely is obviously very bad, because blood is no longer being pumped to your brain or your organs,” says Raymond Vlacancich, a general cardiologist with Virginia Heart.
Each year, an estimated 436,000 people in the U.S. die from cardiac arrest. The use of CPR can double or triple the chances of survival.
Vlacancich sees patients with an array of heart complications, including arrhythmias, arterial blockages and high blood pressure. “CPR is a way that we can kind of help continuously pump blood through your system by pushing down on the sternum with your hands,” thereby delivering oxygen to your organs and tissues in the short term. “By no means is it equivalent to the heart beating,” he says, “but it can sometimes just supply enough blood that we can get to the next step.”
Regardless of where cardiac arrest occurs, Vlacancich says CPR is the the go-to response.
“It is the standard of care whether you’re in or out of the hospital,” he says. “If your heart is to stop, the only way that we can restart it is either with CPR—which is manually squeezing the heart for you so hopefully the heart can recover enough to start on its own—or with something called a defibrillation, which is a shock, that we apply externally from the skin.”
In a hospital setting, medical staff can determine whether defibrillation is needed and apply shocks accordingly. But for those without medical training, an AED (automatic external defibrillator) is an additional line of defense that anyone can pair with CPR. Using sensors that detect a patient’s heart rhythms, an AED will tell the user whether they should administer a shock. These devices can be found in public places such as schools, offices, grocery stores and airports.
After her cardiac event, Gordon spent the first two weeks of 2020 at Inova Fairfax Hospital, undergoing surgery to install an implantable cardioverter-defibrillator (ICD), which monitors her heart rate and can deliver an electrical current if necessary.
She then had a second surgery to repair mitral annular disjunction, a condition that cardiologist Paula Pinell-Salles of Virginia Heart diagnosed during a medical test. The condition is linked to sudden cardiac death and is common in patients with mitral valve prolapse.
Now 41, Gordon takes medication to slow her heart rate and has made some lifestyle modifications to stay healthy, including drinking half-caffeinated coffee and trading high-intensity workouts for walking or stretching.
“You start working and you get mad in traffic and all the normal things that everyone does. And then it hits me like, Oh, wait. I haven’t had a normal life. I’m lucky to be here.”
While she enjoys daily physical activity, including hiking with fiancé Matt Costakis, she has learned to pace herself.
She doesn’t dwell on her near-death experience, but it does provide perspective. “Life, you know? You start working and you get mad in traffic and all the normal things that everyone does,” Gordon says. “And then it hits me like, Oh, wait. I haven’t had a normal life. I’m lucky to be here.”
What should the average citizen do if they witness someone experiencing cardiac arrest outside of a medical setting? Vlacancich recommends starting chest compressions while simultaneously telling someone else to locate an AED and call 9-1-1. (Ideally, those tasks should be assigned to two different individuals if multiple people are at the scene.)
Training in CPR and the use of AEDs is a high school graduation requirement in the commonwealth of Virginia, and now across much of the country as a result of recent legislation. In states with these laws, the rate of bystander-administered CPR is higher, Vlacancich says, citing a 2022 study in the Journal of the American College of Cardiology.
He stresses that CPR training isn’t just for doctors. It’s also critical on-the-job knowledge for babysitters, restaurant workers and scores of other professions, as well as anyone living with someone at risk of cardiac arrest.
“Everyone really can benefit from knowing CPR. You could be the one helping the person you love the most.”
“The majority of people that have cardiac arrests are in their home. So if you have anybody that has heart disease, or you have an elderly parent, or you have someone that you interact with on a daily basis, you’re doing the training for them, in case they ever need it,” Vlacancich says. “Everyone really can benefit from knowing CPR. You could be the one helping the person you love the most.”
Today, Gordon is an active advocate of CPR training, working with the Fredericksburg-based organization Gwyneth’s Gift. She recently emcee’d the organization’s Mom Prom, a women-only event that raises funds for “programs designed to save hearts and lives” across Virginia. “It’s my passion now,” she says.
Last year, she organized a local “hands-only” CPR training for friends and family led by the nonprofit.
For those with hesitations about viral transmission in the time of Covid, she notes that CPR with chest compressions only has been shown to be as effective as “mouth-to-mouth” CPR with compressions during the first few minutes of cardiac arrest. This may make bystanders more likely to help in a life-saving situation.
Confidence gained through practice with CPR is crucial, Gordon says, and community trainings can be just as effective as formal certification.
“Though certification is wonderful, you don’t have to be certified to save a life,” she says. “You just have to recognize the signs, jump into action, dial 911, and start pushing.” Signs that someone may need CPR include unresponsiveness and gasping or lack of breathing. “There are so many resources these days that show how anyone can do that and be successful.”
For more on how you can learn CPR in-person or virtually, visit these sites:
American Heart Association CPR & First Aid Emergency Cardiovascular Care