Natasha Karn: Familial Hypercholesterolemia

Natasha Karn’s advice to other women is simple: “Take care of yourself. Because if you don’t, you can’t take care of your family and your career and all those things that you always prioritize. Take care of yourself first, because I sure didn’t, and it nearly cost me my life.”

Natasha, a Twin Cities attorney, was 36 weeks pregnant with her third child in February 2018 when she suffered a heart attack and received a stent to treat a blockage. After the procedure, Dr. Retu Saxena, a Minneapolis Heart Institute® (MHI) cardiologist and Minneapolis Heart Institute Foundation® (MHIF) researcher, diagnosed Natasha with a congenital condition called familial hypercholesterolemia (FH). Affecting about one in 250 people in the U.S, FH is a family-based genetic disorder where people have much higher cholesterol levels than expected, at much younger ages. It produces aggressive plaque buildup in the arteries and can significantly increase a person’s risk for heart disease.

Although Natasha had been diagnosed with high cholesterol and prescribed a cholesterol-lowering medication when she was 25, she never started it, explaining that she continually “put it on the backburner” because she was either pregnant, nursing or trying to get pregnant.

Dr. Saxena noted that doctors are seeing more and more women with heart disease and heart attacks during pregnancy, likely due to women having children at older ages. And, like Natasha, they’re also seeing a significant increase in women who have survived their childhood with a congenital heart condition, but then experience serious heart problems when they are pregnant. Pregnancy is often thought of as a woman’s first “stress test” that can unmask underlying heart and vascular problems and future risk.

In November 2019, the Minneapolis Heart Institute Foundation received a transformational $5 million gift to establish the Penny Anderson Women’s Cardiovascular Disease Science Center, which will further MHIF’s commitment to conduct innovative, evidence-based research, and then translate that evidence to enhance patient care as well as to educate providers and patients on women’s heart health. Researchers are planning to conduct research into all areas of women’s heart health, including pregnancy-related heart problems.

“Looking back, I ignored a lot of the symptoms that I think I had throughout the pregnancy and probably even before the pregnancy,” said Natasha. “I was always out of breath; I would get exhausted just doing the dishes. You blame it on everything else … I’m just tired, I have kids … I didn’t sleep well last night. I think a lot of women just ignore those symptoms because they’re too busy taking care of everybody else.”

Natasha, then 39, had chalked up her chest pains to being an older mom and nearing the end of her pregnancy, and thought perhaps it was just heartburn. After the pain got worse over a couple days, she finally called the doctor and was expecting that they would tell her it was nothing, but instead, she was told to go to the emergency room.

“Of course, I was irritated and didn’t want to go in,” said Natasha. “I was at work, and you know, you’re busy. Like a lot of women, you just want to ignore it and push through your day. You think everything will be fine. I had kids to go home to and a million things on the to-do list.” 

After some initial testing at the hospital, Natasha was about to get discharged when her significant other, Steve, asked the doctors whether they knew about her family history. Natasha kept insisting that it wasn’t important and she just wanted to go home. When the doctors prodded, Natasha shared that her dad had died of a heart attack when he was about her age. They insisted on admitting her for the night.

About an hour later, she was in her hospital room getting settled. “I was just mad that I was there when I suddenly felt extreme, excruciating, someone-standing-on-my-chest pain,” said Natasha. “I was so thankful at that moment that I was exactly where I needed to be, because I was terrified.” 

When the angiogram revealed her blockages and she was told about needing a stent, Natasha said, “It was terrifying, it was shocking, it was so much to take in. It was really emotional. I  thought, I’m 39 years old, I’m pregnant … this doesn’t make any sense, but yet I probably should’ve known because of my family history of heart disease.”

She continued, “The baby was being monitored and she was fine. Her heart rate was solid the whole time; the care we received at the hospital was amazing. So I was never really scared for the baby, but more scared of, ‘Am I ever going to meet this baby?’ And my significant other was absolutely terrified that night that he was going to lose me and have to raise the baby by himself.”

The morning after receiving the stent, Natasha met Dr. Saxena, who worked as part of a well-orchestrated care team along with staff from the Mother-Baby Center at Abbott Northwestern Hospital doing everything they could to keep both Natasha and her unborn baby well.

“I was very grateful; Dr. Saxena was so kind,” said Natasha. “I was so upset because I was about to have this baby and I wanted to nurse the baby like I did my other children and that was not going to be an option.”

Doctors explained that the plan was to not deliver her baby for at least the next three weeks so she could be on the blood thinners needed to keep the stent open, and then she would go a week without medication so that she wouldn’t have any bleeding problems when she delivered the baby via C-section.

On March 9, 2018, Natasha and Steve joyously welcomed a healthy baby girl, Carmela. Since then, despite her busy life, Natasha has committed to adopting a healthier lifestyle that can supplement the work of her cholesterol-lowering medication. She now works out at a gym three times a week and walks on other days. She has also modified her diet by avoiding red meat and eating a lot more nuts, salmon and different kinds of fish. 

In 2019, Natasha also began helping MHIF in its efforts to increase awareness and educate more women about their risk for heart disease. She shared her story along with Dr. Saxena on Twin Cities in Motion’s Move. Together. podcast — available below. You can also watch the video where MHIF celebrated Natasha’s story and its happy outcome at its 2019 Heartbeat Gala below.

“I encourage women not to ignore any symptoms and not to just procrastinate and think they’ll deal with this when they don’t have X,Y and Z to do,” said Natasha. “There’s never going to be a good time to go into the doctor, so just go.”

Hear Natasha tell her story in the video below: