PA - Pregnant Woman Dies After Shoveling Snow Outside Pottstown, Pennsylvania Home

Discussion in 'Up to the Minute' started by los2188, Jan 25, 2016.

  1. los2188

    los2188 North Carolina Tar Heels..your NCCA Champs!!

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    Briahna Gerloff with little Kayliana 1998-2016
    [​IMG]

    Pregnant Pennsylvania teen and expected daughter die during monster blizzard, days before planned C-section

    A Pennsylvania teenager who was eight months pregnant died Saturday after shoveling snow outside her home during the monster blizzard that slammed the East Coast.

    Relatives of Briahna Gerloff, 18, said she insisted on shoveling the family’s Pottstown home in the morning, brushing off warnings about the wicked weather, according to NBC Philadelphia.

    Once she finished her work, she came back inside around 9 a.m., police said. Soon afterward, her younger brother found her in the kitchen, unresponsive, and called 911.

    Gerloff could not be revived. Her expected daughter, Kayliana, died with her.

    http://www.nbcconnecticut.com/news/...-366312161.html?_osource=SocialFlowFB_CTBrand

    http://www.nydailynews.com/news/nat...ies-shoveling-snow-blizzard-article-1.2508812
     
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  3. jjenny

    jjenny Well-Known Member

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    Pregnant woman with heart defects shouldn't be shoveling snow.
     
  4. los2188

    los2188 North Carolina Tar Heels..your NCCA Champs!!

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    I'm still in shock. I mean I know we don't know all the details, and whether or not she was even aware of this, but, even if she didn't have a heart problem, I still don't think she should.
     
  5. SeekingJana

    SeekingJana Active Member

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    The reports I have read all say that she and her family were aware that she had WPW ( Wolff Parkinson White syndrome). This makes sense, as I do not believe she had a pulse when found.
    Also, it appears that she had gained quite a bit of weight during her pregnancy aside from baby weight, which likely put extra strain on a heart with an electrical conduction disorder which can become fatal in a hurry.

    Looking at the known risks of ventricular fibrillation or sudden cardiac death with WPW, she was or should have been noted as a High Risk Pregnancy. Maybe she was, and maybe this is one of those things which couldn't be predicted. I know I wouldn't think to tell a very pregnant teen not to shovel show, because it would never cross my mind that she would attempt to do so. ( Any pregnant young woman, not just this one.)

    I've seen several adult ( non-pregnant) patients during my long career in critical care with either known WPW or idiopathic WPW in the presence of another cardiac cycle disorder. Usually they became unconscious due to a heart rate that can be as fast as 300 BPM, which is incompatible with life. 911 was called, and I saw them first when a " Code Blue "was called in ER. It is very easy for the uninitiated caregiver to mistake WPW for Ventricular Tachycardia, and sustained V Tach is a Code Blue situation.
    The problem with WPW is that it can, under physically stressful conditions, cause poor perfusion, unconsciousness and an emergency treatment situation all by itself when the ventricular contraction rate ( which is measured as the heart rate) gets so high. WPW can be refractory to cardioversion ( a synchronized zap with the defibrillator) and all meds. which treat supraventricular tachycardia, or SVT and lead to the quickly fatal heart quivering known as. V. fib.

    Therefore, it is accurate to state that WPW is fatal when the cardioversion and IV medications do not change the extremely fast ( sometimes too fast to count) heart rhythm back to a normal , or in the case of a WPW patient, a near- normal beating heart with an atrial- ventricular pattern.
    To put it more simply, WPW is an electrical conduction defect in the heart, and can cause extremely chaotic, runaway fast heart beats which can be extremely hard to stop. Cardioversion is the best treatment, usually.

    Thus, it would be an understatement to say that it would not be unusual at all for a pregnant young woman with known WPW to be in a very precarious condition with or without emergency treatment after the exertion of shoveling snow. Exercise in the cold was probably what pushed her heart into a fatal abnormality which was not self- correcting. Also, there is a fairly high chance that if a trained medical team had been right beside her the second she began having problems, her life could not be saved due to the extreme existence of adverse cardiac factors, which are around 4 separate often- deadly risk factors all on their own.

    Since this is an opportunity to teach, I'd like to end this very sad and also complicated cause of death with the following message to all my fellow WSers regardless of age, sex, or general- well being or perceived good health.
    If you have had episodic chest pain or any other sign indicative of possible heart disease, of if you have a known heart disorder or disease, please do not over- exert yourself in extremely cold conditions. Leave your snow to melt on its own if you can, pay someone who works outdoors frequently in the cold weather to shovel your snowy walkway, or buy a snow blower if you live in a cold environment. It could save your life.

    Likewise, if you doctor has prescribed sublingual Nitroglycerine for angina, keep it with you, make certain it hasn't expired and take one at the first sign of discomfort, and also a regular aspirin unless you have been told not to, and go to the hospital ER if rest, a warm indoor environment and 2 NTG tablets under the tongue do not relieve the pain in 20 minutes. If you are having some heart issues, please try very hard to stay OUT of the cold weather as much as possible. More deaths from heart attacks and sudden cardiac death occur in the winter time than any other time, and both vasoconstriction and exercise are serious contributing factors.

    This is not meant to be " bossy". I don't walk that way. It is an opportunity to use a very tragic loss of a young lady and her unborn child to illustrate both the dangers of uncontrolled ( or uncorrected cardiac conduction defects) as well as the increased stress, thus increased risk, to every heart in severe cold and exertion.
    I love you all dearly, and want you to be around for more years than i can count. :)

     
  6. MsFacetious

    MsFacetious What a Kerfuffle...

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    Had she had the extra pathway ablated or were they unable to do so?

    My 12 year old daughter had WPW diagnosed at age 2.
    She didn't have an episode of SVT until age 10.
    Her episodes were not exercise induced, just the opposite actually.
    She had it ablated that same year. A 1 hour procedure that turned into 7 hours...
    She still has another that causes "harmless SVT" occasionally.
     
  7. Zuri

    Zuri New Member

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  8. MsFacetious

    MsFacetious What a Kerfuffle...

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  9. SeekingJana

    SeekingJana Active Member

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    WPW, as you obviously know better than I do, as a mom dealing with this for all your daughter's life, is often very unpredictable. I've seen medications given to slow the rate of SVT ( often felt as palpatations) cause v. fib, when the same medication or medications do not cause v. fib in any other clinical setting. WPW is baffling in its paradoxical reaction to medications, and as you pointed out before your daughter's ablation, either exercise or inactivity. It's like that pesky bundle of Kent has a " mind" of its own!!

    I have seen pediatric patients post- ablation of the bundle of Kent, where WPW originates, develop a secondary abnormal conduction pathway. I hope very much that your daughter
    does well, has a great cardiologist, and is tested for some genetic conditions which predispose children to the development of a secondary abnormal conduction pathway.
    I hope she has a great, healthy, long life, in other words. :)
     
  10. Curiosum

    Curiosum Verified physician

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    *Ventricular Fibrillation (and Ventricular Tachycardia without a pulse) should not be treated with synchronized cardioversion. These non perfusing rhythms should be defibrillated.
    *There is no moral, ethical, or legal issue with defibrillating (or giving adult code doses of ACLS protocol drugs for that matter) a pregnant woman (let's just presume no DNR is in place for the sake of discussion) who has a non perfusing rhythm. This patient is in a cardiac arrest anything which has a chance of saving her life can only be better for the baby than her death.
    *Modifications to the standard ACLS protocol for pregnant women revolve around the importance of manual left uterine displacement (to release/prevent aortocaval compression), a lower threshhold for volume infusions, requirement for IV access above the diaphragm, and progression to emergent c-section if spontaneous circulation is not achieved after four minutes. [CPR and maternal resuscitative efforts should be continued during c-section and in some cases (predominantly where arrest was due to compromise of venous return) maternal ROSC may be achieved after delivery of the infant.]
     
  11. SeekingJana

    SeekingJana Active Member

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    Family members may think this because of the many different clinical presentations of WPW at different times, It seems that if she had multiple cardiac disorders, she wouldn't have been shoveling snow due to cardiac dysfunction and decompensation. However, there's always a possibility of almost anything congenital, and another disorder or disorders may be the reason she wasn't a candidate for ablation treatment. I don't know and I doubt we ever know the exact clinically correct presentation if multi-factorial causes were present. We know she had an abnormal heart conduction defect which can be fatal, and that's really enough.

    It's just so sad for her, her baby, and her family, of course.
     
  12. MsFacetious

    MsFacetious What a Kerfuffle...

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    We have an amazing pediatric electrophysiologist.
    Meds were never even suggested for my daughter.
    Since she could have SVT at anytime it wasn't predictable.
    She only had 3 episodes in 10 years.

    It didn't make sense to do meds that likely wouldn't work.
    Plus we'd have no way to really know if they were working.
    We'd always have to worry about the risk of sudden death.
    A cardiac ablation was the only real option.
     
  13. wendybtn

    wendybtn Well-Known Member

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    No one should shovel snow that does not participate in at least a moderate exercise program 3-5 days a week. No pregnant woman should shovel snow. All of the stress goes into the upper body, magnifying any minor heart or chest problem 100 fold.
     
  14. MzOpinion8d

    MzOpinion8d On Time Out

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    One of those news stories says she was found when her brother came downstairs, and the other says a "family member" had gone across the street to relax after show shoveling, then when he came back the front door was locked and he had to go in through the basement and then found her on the kitchen floor.

    I hope LE double checks that this was truly natural causes, just on the off chance that someone caused her harm. The basement door being unlocked when the front door is locked concerns me - like someone made sure people couldn't get in the front, and they went out the back.

    I'm probably just too suspicious!!
     

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