Medical City Healthcare - September 06, 2016

Sometimes, the psychological effects of an illness are just as damaging as the physical. When a young soccer star was diagnosed with ventricular tachycardia, she needed a different kind of team to get her back in the game — the adult and pediatric health professionals at Medical City Dallas and Medical City Children's Hospital. Together, they're helping her beat heart disease, but that's just the beginning of her emotional journey back to health.

By sharing Kendal's story, her mom hopes others will understand the importance of treating children's minds as well as their bodies.

Unlike most incoming high school sophomores, 15-year-old Kendal Daniels couldn't wait for summer to be over. That's when she would find out if her heart is healthy enough for her to resume playing soccer — a sport she's loved and excelled at since she was seven. In January 2016, Kendal was diagnosed with a congenital anomaly called ventricular tachycardia — an irregular heart rhythm she was born with but was unaware of until a cardiac event brought her into the care of Bruce Bowers, MD, an interventional cardiologist at Medical City Dallas.

As if adolescence isn't hard enough, Kendal's family had recently moved from Indiana, so her freshman year was also her first year acclimating to a new school, new teachers, new friends and, of course, a new soccer team and coaches. It was hectic, but Kendal breezed through soccer tryouts and by winter break was practicing twice daily with the team.

That's when the "episodes" intensified.

Kendal would experience periods of dizziness, shortness of breath and heart flutters. When they were over, she would be exhausted.

"Kendal had been having these episodes — she called it loss of breath — for about a month," said Andrea Daniels, Kendal's mom. "But there were so many things going on — a new school, her freshman year, soccer tryouts and then two-a-day practices. We just thought she was stressed out and tired, so we would tell her to drink more water and try to get some rest."

Any parent would do the same.

"We should have listened more closely to Kendal," Andrea said. "She's our middle child, just a rock. Our other girls couldn't stand to lose a tooth, but Kendal is tough."

Not long after winter break ended, Kendal was sitting at the kitchen table doing homework. Mom, I'm having that episode of dizziness again. It lasted about five minutes and left Kendal so tired she had to lie down.

"She got really flushed and her pulse slowed way down," said Andrea, who has a medical background. "We took her to see Dr. Bowers the next day, which was a Friday. He said her EKG showed abnormalities, but it could be anything."

Kendal was given a strap-on cardiac monitor to wear through the weekend and was told to skip soccer practice until the results came back. Monday at 4:28 p.m. — Andrea remembers the exact time — Dr. Bowers called and told her to drop what she was doing, grab Kendal and meet him at the Medical City Children's Hospital emergency department NOW.

The results from Kendal's cardiac monitor showed that she had experienced more than 500 beats of ventricular tachycardia (V-tach; a rapid, abnormal heart rate) and ventricular fibrillation (a more rapid and chaotic heartbeat, often resulting in death) over the weekend. Emergency staff immediately hooked her up to an echocardiogram and found she was in near-constant V-tach. She was admitted to the ICU and seen by a number of pediatric and adult specialists.

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That's when things really got interesting.

Kendal was only 15, so the children's hospital was the appropriate place for her. But she was also 5 feet 9 inches tall and suffering from a condition that overwhelmingly affects adults over 40.

"Medical City Children's Hospital was the exact right place for Kendal," said Andrea. "She definitely needed a pediatric unit and would have had a totally different experience in an adult hospital. There are specially trained staff called Child Life Specialists who can relate to kids and have great compassion for them. They had animal therapy, played games and explained things in a way she could understand.

"On the other hand, the doctors who deal with this condition in adults have a lot of expertise. One reason Kendal was able to do so well is that Medical City Dallas has adult and children's specialists. She was able to get the best care possible from both types of specialists."

Doctors worked for six days and administered a myriad of tests to figure out the problem. They thought it was a congenital condition, but weren't sure if it was one of two scenarios.

  • Worst-case scenario: Kendal's weakened, enlarged heart was causing the abnormal rhythm "“ or "“
  • Best-case scenario: The abnormal rhythm led to the weakening of her heart.

By this point, Kendal couldn't get out of bed without having major V-tach. She desperately wanted to take a shower, and weighing the risks and benefits, the hospital staff helped her get cleaned up.

"That shower made all the difference," Andrea said. "The hospital staff understood the importance of doing normal things and how showering and shaving your legs can make you feel better and have a more positive outlook."

Good news followed the shower: MRI results confirmed the best-case scenario. Kendal's medical team located the abnormality, decided the adult electrophysiologist, Rajeev Joshi, MD, would perform the ablation and began the six-hour, minimally invasive procedure. Dr. Bowers was called in to insert a heart catheter so the surgeon could better visualize the area. Once they started burning the abnormal tissue, Kendal's heart rhythm immediately began to normalize.

"Hopefully, this will be a cure for Kendal," said Tracy Laird, MD, Kendal's pediatric heart specialist.

Recovery has been slow but steady. Kendal was given medications to regulate her heart and had to wear a "life vest" — a heart monitor with a built-in defibrillator — for two weeks following surgery. During that time, she had to miss school.

"The whole experience was really isolating for her," said Andrea. Her friends couldn't relate to her in the same way because she couldn't do a lot of the activities. Between that and the medications, she was often tired and depressed. She's really not the same person she was before, and it's been really difficult. The operation was much harder emotionally than physically."

Thankfully, the vest monitor and follow-up echocardiogram showed no abnormal heart rhythms and improving heart function. In June, she was tapering off her medications and wearing a new monitor that allowed her to swim and perform light exercise while transmitting real-time data to her physicians.

Meanwhile, Kendal found her own therapies — things she could do that gave her a purpose and that she was able to do with friends, including archery and adult coloring books.

"She's really anxious about her next testing," Andrea said. "It's like someone who has cancer and all they can focus on is the next set of test results. It's been hard, because she didn't really notice her condition until after the operation, and now it's the main thing she deals with on a daily basis. But she's hoping after the summer she can get back to normal activities, including soccer. With her heart condition fixed, she can be better at it than she ever was."

UPDATE ON KENDAL: Kendal was released back to normal activity in time to make the 2016 JV soccer team! Go Kendal!

Do you know how healthy your heart is? While heart disease symptoms can vary widely, it's important to note that most heart attack sufferers had no previous symptoms. Take our fast and free Heart Risk Assessment today so you can know and manage your personal risk factors.

If you or a family member — regardless of age — experience any of the symptoms that Kendal had: heart flutters or palpitations, dizziness and shortness of breath followed by extreme fatigue, call 911 or have someone drive you to the closest ER right away.

Get fast, emergency help in any situation at one of our many Medical City ER locations across North Texas. With average wait times posted online, if you do have an emergency, you can spend less time waiting and more time on the moments that matter most.

Find a fast Medical City ER near you or call our free 24/7 Ask-A-Nurse hotline.

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Revised 1/3/2018

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