Toms River Woman Reunites With Ocean Medical Center Cardiac Team Who Saved Her Life

BRICK, NJ — When 2024 began, Eva Maravelias was living a busy, seemingly healthy, happy life.

The 45-year-old Toms River resident was traveling extensively for her work as the vice president of visual merchandising for a luxury department store chain, along with being a wife and raising two children with her husband, Brian. The family was mourning the death of Brian's mother, too.

In early March, it became Maravelias who found herself fighting for her life.

On a rare day when she and Brian were both working from home, Eva Maravelias a serious cardiac event — one that could have left Brian a widower and their children without their mother. The speedy response of the EMTs and medical flight crew along with the skills of the cardiac staff at Ocean University Medical Center in Brick kept her alive and helped her heal.

Maravelias had the opportunity to thank those who saved her life on a recent visit to Ocean University Medical Center, including Dr. Arthur Okere, the interventional cardiologist who led her case.

It began when Maravelias felt herself losing consciousness as she finished a work-related conference call, the couple said.

Eva called out to Brian, who was in his upstairs office, and Brian called 911. The EMTs who responded had to restart Eva's heart. Then they rushed her to Ocean University Medical Center in Brick, where Okere and the cardiac team soon determined that she was not dealing with a heart attack but something far more serious: tears in three arteries in her heart.

It's called spontaneous coronary artery dissection, or SCAD, Hackensack Meridian Health officials said. SCAD is a tear in a wall of a heart artery that can impede blood flow to the heart, cause a heart attack, or even sudden death.

It’s a rare but very serious condition that accounts for up to 4 percent of cases of acute coronary syndrome. While SCAD can occur at any age to anyone, it typically affects women in their 40s and 50s and causes about 25 percent of heart attacks in women younger than 50.

It is often brought on by high levels of emotional stress, hormone changes, or systemic inflammation, and it requires immediate attention even at the slightest of symptoms, officials said.

Maravelias had experienced two brief episodes of an odd, uncomfortable sensation in her chest in the weeks leading up to the attack, but had ignored it, the family told Hackensack Meridian Health.

As a result of the attack, she was in extremely critical condition when she arrived at Ocean University Medical Center, Okere said.

"Her heart was barely moving, and she was in cardiogenic shock," he said. "Typical SCAD does not necessarily cause the level of 'cardiac chaos' we saw in Eva with cardiogenic shock, cardiac arrest, and severely reduced heart function, but the number of vessels involved made it so in this case."

To help her heart heal, Okere inserted a small device called an Impella, a tiny heart pump designed to help pump blood through her heart. The device is designed to take blood from the heart and circulate it to the rest of the body, allowing the damaged heart muscle to rest and heal without surgical intervention. It's used instead of stents that help open up arteries for blood flow, officials said.

Okere quickly determined the tiny pump would not be sufficient for Maravelias's needs.

"Her heart muscle was barely moving because so many arteries were involved," he said. "And that’s what made it so devastating that we couldn’t just watch, wait and let it heal. We had to act, or she would die."

The Impella is similar to a very large catheter. It is inserted into the leg or groin through an incision, then threaded via the femoral artery into the left heart ventricle, officials said.

The device helped stabilize her condition, allowing Okere and his team to assess the next steps.

"Stabilization in the exact moment of crisis is paramount in order to help the arteries naturally heal," Okere said.

Once Okere and his team stabilized Maravelias and her heart began pumping again, they determined additional help was needed due to the other torn arteries and she was flown from Ocean University Medical Center to Hackensack University Medical Center, where Dr. Mark B. Anderson, chief of the Division of Cardiac Surgery at HUMC, took over her case.

Anderson had to partially open her chest wall and place the Impella directly into Maravelias's aorta, the body’s largest artery. The larger Impella stabilized her further and allowed her heart to circulate blood more efficiently.

By the next day, Maravelias was taken off the ventilator that had helped her breathe and was able to sit up in a chair and greet her family.

After two weeks at Hackensack, Eva’s Impella device was removed and she went home. Along with regular checkups, a combination of medications and cardiac rehabilitation aims to steadily increase her heart’s pumping ability.

"She was really lucky to get to a medical center and a system that has a process like ours, available technology she needed, and the ability to move her quickly to a higher level of care," Anderson said. "Our multidisciplinary, team-based approach allowed us to optimize her care in what was otherwise an extremely critical situation."

"The stars were aligned," Okere said. "As SCAD is a rare condition, interventional cardiologists don’t see many of these cases throughout their career. I feel fortunate that I received extensive training on how to address this condition — and given the severity of the situation, there was no time to waste."

Maravelias, too, knows how fortunate she was to have survived.

"There was a domino effect," she said of the events from Brian calling 911 to her initial treatment at Ocean University Medical Center. "Everything had to go perfectly the way it did for me to be alive."

Her doctors are optimistic she’ll have a robust recovery.

"We expect her to do very, very well," Okere said. "She has a very bright future."

Maravelias, who said she was able to hear what was happening around her even while she was unresponsive, has leaned heavily on her faith and family during the crisis. It also has changed her approach to life.

"I’m really focused on the present," she said. "I’m in a different mindset, just grateful for the day I’m getting today."