Jessica Seward, then 22 years old, felt severe chest pain while working the night shift as a cardiac nurse in April 2023. She didn’t pay much attention to it at first, but the pain lasted for 30 minutes, so her coworker encouraged her to seek help. After multiple tests, Seward learned that she had a slow heartbeat and needed treatment.
“I just started crying. They were like, ‘It’s OK, it’s OK,'” Seward, now 23, of Dayton, Ohio, told TODAY.com. “I had a gut feeling that I was going to need a pacemaker.”
Unexpected results from health checkups
Seward had known for some time that she had a heart condition. The former college soccer player underwent a physical exam and an EKG to ensure she was healthy enough. During the EKG, doctors discovered she had first-degree heart block.
Heart block occurs when something prevents the heart’s electrical system (also called the conduction system) from working properly, says Dr. Robert Kowal, a cardiac electrophysiologist and general manager of cardiac pacing therapies at Medtronic. There are three types of heart block: first-, second- and third-degree. First-degree is the mildest, and third-degree is the most severe. Doctors couldn’t figure out why Seward developed heart block at such a young age.
“The general consensus is that it’s probably genetic and that it was discovered by chance,” Seward says. “People can have first-degree heart block their whole lives and never have any symptoms.” But Seward experienced signs of heart block, such as shortness of breath during exercise, frequent fatigue, and numbness in her hands and feet. After exercise or practice, she sometimes felt like she was “going to die.” Still, she didn’t worry, and didn’t tell her doctor.
“Part of me didn’t want to accept that something was wrong, and that things were probably worse than I knew they would be,” she says.
Seward went to the emergency room after the pain hit him while he was at work, and doctors, not expecting second-degree heart block in someone so young, quickly performed three EKGs.
She was admitted to the hospital but released the next day because “they couldn’t do anything.” She still saw a doctor, who recommended a sedated electrophysiology study, a series of tests that examine the heart’s electrical system. According to the Mayo Clinic, doctors then told her they would perform a cardiac ablation, a procedure that uses a catheter to deliver heat or cold to the heart to fix its abnormal rhythm. They hoped that would address her problem.
“I remember waking up and asking, ‘Did you do the ablation?'” she recalled. “(The doctor) said, ‘No, we couldn’t do that.'”
Doctors admitted Seward to hospital for further tests to determine the cause of the heart block, but found nothing and recommended immediate treatment with a pacemaker.
“The doctor said, ‘I don’t know what it is, but we can either wait for more scans or we can put in a pacemaker,'” she said. “I said, ‘Yeah, let’s go ahead and try it.'”
At that point, Seward suspected doctors wouldn’t find an underlying cause and that he would end up needing a pacemaker.
Heart block and its treatment
To understand how the heart works, Kowal thinks of it as a car: Just as a car has an electrical system that powers and coordinates the cylinders in its motor, the heart has an electrical system that helps all the chambers pump blood at the same time.
“[The cardiac conduction system]actually has two jobs. One is to make sure that your heart rate, or how fast you’re beating, is appropriate for what you’re doing,” he told TODAY.com. “The other is to make sure that all the ventricles are beating in unison.”
When you experience heart block, something prevents the electrical impulses from passing through your heart, and your ventricles can’t pump properly. In Seward’s case, his heart couldn’t keep up.
“Some of the signals between the ventricles were being blocked, causing the heart to slow down,” he says.
In many cases, mild heart block does not progress.
“Most people who have first-degree heart block don’t go on to have anything worse,” Kowal said. “Especially someone as young as her, we need to keep a close eye on her.”
While heart block is “part of the aging process” for most people, younger people can develop it, too. People with a family history of heart block may experience it at a younger age, and in rare cases, some people develop it due to something like a Lyme disease infection. The latter can be cured by treating the underlying Lyme disease, Kowal notes. For younger people with heart block, it can also be “a little tricky” to pinpoint the cause, Kowal says.
People with heart block often experience the following symptoms:
Fainting, shortness of breath, fatigue
“Chest pain is actually a very rare symptom,” Kowal said, “and Seward is a little bit atypical in that he’s young and has some unusual symptoms.”
Treating heart block often requires a pacemaker, Kowal said, unless it’s a “reversible type,” such as heart block caused by Lyme disease.
“Think of a pacemaker like a luxury watch,” he says. “It sits under the skin in your chest and has two wires that go from there to your heart, and it basically monitors your heartbeat. If it’s seeing a heartbeat every second, which is 60 beats per minute, the pacemaker doesn’t do anything at all.”
When the heart struggles to beat regularly, the pacemaker delivers a slight shock to “restore normal rhythm.” Kowal says the system works so seamlessly that people rarely notice the pacemaker is there.
Living with a pacemaker
After the pacemaker was implanted, Seward woke up and felt a change. He recovered quickly and only had to take a month off work. After that, the doctor told him to “go about his daily life as normal.” Sometimes he forgets he has a pacemaker until he sees the scars. The pacemaker has changed Seward’s life, allowing him to enjoy hiking and other activities with his dogs more.
“Very quickly, I started to notice that I wasn’t getting out of breath. I wasn’t getting tired,” she says. “I was able to exercise for much longer periods of time without feeling like I was going to die.”
Having a pacemaker gave Seward “peace of mind” and meant he didn’t have to worry about his heart.
“In some ways, this has been a blessing in disguise,” she says, “and it has given me a lot of great opportunities to educate patients who may be receiving pacemakers, and I feel like this may ultimately be the career path I want to take.”
By sharing her story, Seward hopes to encourage others to “be their own advocate” and “keep seeking answers.”
“You know your body best,” she says, “and my experience has taught me how to educate others.”
