Fatal heart defect passed down in one family plagues a fourth generation — and counting
When Monica Manrique was four months pregnant with her first child, her feet got so swollen with fluid she took to wearing slippers because her bulging ankles wouldn’t fit into regular shoes.
At first, the doctors told her the swollen extremities — it was in her hands, too — were just a normal side effect of pregnancy.
But two months later, with her baby soon on the way, her condition worsened, and Manrique couldn’t sit up in bed without running short of breath, and her heart began beating irregularly.
Manrique’s husband, her boyfriend at that time, convinced her to make the emergency trip from their home in Clyde to Mission Hospital in Asheville. There, she underwent various medical exams, and the result was not what she was expecting.
That was the day Manrique went from being a 29-year-old expectant mother to a woman with a broken heart.
“That day they told me I had a blood clot in my heart, congestive heart failure and cardiomyopathy,” Manrique said, tossing out a string of clinical medical terms that somehow don’t quite do justice to the tragedy of a failing heart. “And that’s when I told them about my dad and brother.”
A family vein
Manrique wasn’t the first in her family to hear the startling diagnosis.
Her father also had the disease and went through a heart transplant in his 50s. Her brother was diagnosed in his late 30s, and now holds on to see what will happen.
The discovery of her brother’s condition came only a year before Manrique’s diagnosis and was the first clue that there was likely a genetic link passed down from the father. Manrique’s heart further cemented that supposition.
“At first, they thought it was a virus; I thought it would only affect me,” said Manrique’s father, Hector Bermudez. “Then, come to find out, it got them, too –– come to find out, it’s genetic.”
Looking back, Bermudez said the condition is most likely what killed his own father. Although never diagnosed, he dropped dead at the age of 29 in his native country of Puerto Rico.
Bermudez, a county solid waste employee, first noticed his own heart problems while working as at the landfill in Canton. His muscles were sore at the end of the day; he had trouble breathing; and eventually, his heart rate dropped from 60 to 40 beats per minute.
Bermudez was referred to Duke University Medical Center where doctors told him his heart was swelling and would eventually fail. He needed a heart transplant.
Within a week he had the surgery. Two days later, the middle-aged man drove himself home from the medical center with a teenager’s heart pumping in his chest.
Although he now lives a normal life, working and taking daily anti-rejection drugs following the organ transplant, the hardest part for Bermudez is the guilt he feels that he passed the bad heart along to his own kids and the nagging question: who’s next?
One of his two sons, Anthony Bermudez, a Jackson County deputy, already has the condition. But his youngest son recently had his heart checked and so far is OK — although he’s only 22.
“It’s a wait and see game,” Bermudez said. “Hopefully, he didn’t inherit it, and then you’ve got the grandchildren to worry about.”
Shortly after the diagnosis, Manrique was sent to Duke University Medical Center for treatment. It was determined that the stress from the growing baby inside of her had likely accelerated her heart condition.
She was told if she carried through with the pregnancy she and her baby could die. Doctors kept Manrique in the hospital until she reached 32 weeks, then performed an emergency C-section. Her baby BreeAnna was born on Sept 25, 2009 — two months premature — and spent a few weeks in neonatal intensive care at Mission Hospital.
Now a lively toddler, BreeAnna just turned three. It’s her mother who is having difficulty keeping up.
“BreeAnna come here, let’s go inside,” beckoned Manrique, sitting on the back stoop of the family’s apartment in Clyde as her daughter ran circles around the backyard. “You know I can’t come and get you.”
Manrique sat with her intravenous pouch draped around her neck — a constant companion and just one of the many treatments she has received since learning about her heart’s condition three years ago.
Since then, her state has only worsened. It’s now hard for her to get around and anything doctors give her she feels is only postponing the inevitable: a heart transplant like her father.
And that day may come soon, yet, two things stand in her way. After undergoing a cardiac catheterization in August at Duke, she was told she would be eligible for a heart transplant.
But first, she was told she needed to lose weight. Second, although her insurance company Humana would cover the medical procedure, she had to show she had enough money to pay for two years of anti-rejection drugs so the new organ would take. That means coming up with about $12,000.
Her and her father started a charity fund and have posted flyers to try to raise the sum. But so far, since December 2011, they have only $2,500 to show for their efforts.
“Slowly, but surely,” she said.
And, even after raising the money, Manrique could sit idle on the transplant list for a while more — while the clock is ticking.
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