When 23-year-old Madison Thornton left to study abroad in Italy this month, she had no clue an air ambulance would bring her back to the U.S. within days — a medical evacuation that was followed by a startling revelation about her heart.
“My doctors have told me I’m lucky to be alive,” Thornton, who lives in Hattiesburg, Mississippi, told TODAY. “It’s really crazy.”
“She was so fortunate that she survived this. Now we have a handle on what’s going on and we can make sure this doesn’t happen again,” said Dr. Arthur Martin, Thornton’s cardiologist at Forrest Health in Hattiesburg.
The trip started splendidly before turning into a nightmare.
Thornton, a medical student at Tulane University, was attending a food security policy class in Bolsena, a town on the shores of a vast volcanic lake in central Italy.
She arrived on July 3 and started the course on the following day, the 4th of July. During a break in classes, she and other Tulane students enjoyed lunch — with Thornton feasting on two servings of pasta and ice cream — then headed for the lake.
That’s when Thornton collapsed.
“We’d only been walking for one minute and I just I felt so weird. I started seeing spots. I felt so weak,” Thornton recalled.
“I woke up on the ground… I knew something was seriously wrong with me because I’ve never passed out, I’ve never had any health problems.”
She didn’t know it then, but Martin believes she survived a sudden cardiac arrest caused by an abnormal heart rhythm. Her heart stopped, but restarted spontaneously — perhaps because of the impact of her hard fall, he said.
An ambulance transported Thornton to the nearby city of Viterbo, which turned into another frightening experience since she’d never been hospitalized, her entire family was across the ocean, she didn’t speak Italian and no translators were provided, she said. Thornton felt dizzy and nauseous that first night in the hospital, but “completely normal” since then.
Her mom got there two days later. Eventually, the medical staff was able to communicate that tests detected a problem with her heart: elevated troponin levels, which indicated heart damage, and a low ejection fraction, indicating her heart wasn’t pumping well. The incident wasn't just a simple faint.
Air ambulance flight was 'pretty cool'
Given the news, Thornton’s study abroad experience was effectively over, but to return to the U.S., she’d have to be medically evacuated. It turned out she was covered for this option through Tulane University and a flight was arranged on July 12.
The air ambulance was a small plane with room for Thornton, who was lying on a stretcher, her mom, a flight doctor, a flight nurse, a respiratory therapist and two pilots. Thornton was hooked up to an EKG the entire time so the medical staff could monitor her heart rhythm.
The student, who’d only ever flown in economy class, called having a plane to herself “a pretty cool experience.”
From Italy, the air ambulance flew to Iceland and then to Canada to minimize the time it was over the ocean in case Thornton’s condition required an emergency landing. The flight ended in Gulfport, Mississippi, where Thornton rode in an ambulance to Forrest General Hospital in Hattiesburg.
Family history was clue
Now that she was home, doctors tried to figure out what was wrong with her heart.
The Italian medical team suspected acute myocarditis, an inflammation of the heart muscle usually caused by a virus.
But a simple blood test that’s a marker for inflammation was completely normal, so there was no evidence of acute myocarditis, said Dr. Martin, Thornton’s cardiologist.
Looking at the readings from the Italian hospital, he saw that her heart entered a life-threatening rhythm the night she was admitted, but not again after that. He also confirmed her heart wasn’t pumping as strongly as it should be.
Then, Martin received a big clue: Thornton’s family history. Two of her cousins died suddenly at around her age and several other family members died suddenly at around age 40. It pointed to a hereditary heart defect.
The diagnosis now is familial cardiomyopathy, a weakness of the heart muscle that sets the stage for an abnormal rhythm, ventricular tachycardia, which can cause sudden cardiac death. Thornton has had the condition all her life, but it just happened to manifest now at age 23 on a trip to Italy, he said. A lot of genetic disorders manifest later in life, he added.
The student was completely unaware anything was wrong with her heart.
“I’m so lucky this happened when I was with a group of people and I’m so lucky this didn’t happen when I was alone,” Thornton said. “If I had fallen a certain way, I could have hit my head really bad or if it had happened when I was driving, it could have been a lot worse than it is.”
Stress from travel could have triggered the event, but not necessarily since a sudden cardiac arrest can happen out of the blue without any stressors, Martin noted.
Doctors are planning to implant a permanent defibrillator that will shock Thornton’s heart back into a normal rhythm if it ever happens again. Until then, she’s constantly wearing a vest with an external defibrillator that will do the same thing. She’s also taking medications to strengthen her heart.
Thornton can’t drive or exercise for now, but she’s happy to be out of the hospital. She can continue her studies as a medical student and live a normal life with the implanted defibrillator protecting her heart.
“It’s been such a juxtaposition, feeling so normal but having everybody tell you something is seriously wrong with you,” Thornton said.
As for Italy, she has no plans to return: “I’m staying home for now. I’m not going anywhere.”