2023 Real Woman: Margarita Pineiro

The following is Margarita's story and not an endorsement or diagnosis. Stories have been edited down for time.

After experiencing a spontaneous coronary artery dissection (SCAD) at age 42, Westchester, New York, resident Margarita Pineiro is learning to slow down and put herself first.

A wife, mother of two and director of a nonprofit school, Margarita Pineiro has a lot to balance.

In addition to her often-hectic work schedule, she handles meal prep, helps her sons with their homework and transports them to extracurricular activities — just a few of her many responsibilities.

“I am the facilitator of everything,” said Pineiro, describing herself as their personal assistant.

She wonders now if such day-to-day stress might have caused her to miss the early warning signs of heart disease.

One morning last year, Pineiro, then 42, was getting her sons ready for school when she had the sensation that the wind got knocked out of her. 

Along with increasing exhaustion, her chest started hurting like bad heartburn. Within minutes, pain started shooting down her left arm, and her jaw went numb.

“That’s when I knew something was awry,” she said.

Her sister had suffered a heart attack the previous year, and Pineiro was hyper aware that heart disease ran in her family.

Increasingly concerned that something was wrong with her heart, Pineiro called her aunt, who agreed to drive her to the emergency room. She asked her husband, Robert, to drive the children to school and then meet them there. 

The hospital staff took Pineiro’s vitals and assured her that everything was fine. An EKG also showed no cause for concern. But she knew in her gut that something was wrong. So she requested further testing and another EKG. 

Ultimately, a blood test confirmed she was having a heart attack, her artery 99% blocked. 

Her husband started crying.

“It was like my worst nightmare just happened,” Pineiro said. “I was in such a vulnerable position. I remember saying, ’If this is it, I just want it to be peaceful.’”

Doctors rushed Pineiro to the cath lab to insert a stent to restore blood flow. As it turned out, she had suffered a spontaneous coronary artery dissection (SCAD). A tear in the artery created a flap, where a hematoma had formed. Because the stent kept collapsing, the procedure took about 90 minutes — three times longer than it should have. 

While doctors successfully placed the stent, it was a long road to recovery. The medications doctors prescribed left her exhausted and out of sorts, like she had brain fog.

“The biggest thing was that I was very low energy, and I’m not a low-energy person,” she said. “It forced me to slow down.”

It’s been an adjustment mentally as well. Sometimes she feels something akin to an electric shock, like a lightning bolt in her chest, or pins and needles in her hands. Her cardiologist assured her that her symptoms are normal, but she continually worries that she’s having another heart attack. 

“If I let my mind take over, I could be in the emergency room once a month,” Pineiro said. “Anything that remotely feels like that morning is a trigger for me.”

Since her SCAD, Pineiro has connected with other survivors via social media. And eager to raise awareness about heart disease, particularly among Hispanic women, she has shared her story at an American Heart Association event and appeared on a local news segment. Her message? “Listen to your body, and if you need to advocate for yourself, be persistent,” she said. “No one knows you better than you.”

While she remains goal oriented, Pineiro has made changes since her SCAD, setting clear, healthy boundaries in her personal and professional life. Her children, for example, have agreed to enroll in one sport rather than participate in multiple activities. Indeed, they’re her biggest cheerleaders, reminding her to take her medication and accepting that she can’t do it all. 

“I always needed to be this overachiever,” she said, “but now I’m trying to fill my own cup.”

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