By Anna Brooks Medically Reviewed by Michael Cutler, DO, PhD
February 28, 2020
Monique Acosta House was tired all the time. At 22, she was taking college classes part-time and also had a job, so she just chalked the fatigue up to being a busy young woman.
Then she started noticing pain in her left arm.
“I decided to go to the emergency room one day because the pain was pretty consistent and I was so tired,” she says.
At the hospital, House’s heart rate was erratic, her blood pressure was up, and she had an abnormal electrocardiogram. Doctors told her she had congestive heart failure and needed to be admitted to the cardiac care unit.
“I was totally surprised,” House says. “I had no idea that was even possible — I had just had a stress test six months earlier.”
Along with heart failure, House was diagnosed with cardiomyopathy, a disease of the heart muscle, which enlarges the heart and makes it harder to pump blood throughout the body, according to the AHA.
It was only the beginning of House’s heart health journey, which would lead her to where she is now: a member of a select group, AHA’s Real Women of 2020. Along with eight other women, House is sharing her story and promoting the national AHA Go Red for Women campaign, which aims to educate and spread awareness about cardiovascular disease in women.
The Importance of Clinical Trials — and Why More Women and Minorities Need to Enroll
When House was diagnosed, doctors encouraged her to enroll in a clinical trial. Because she was a student, she didn't have a regular doctor; whenever she got sick, House says, she would just visit the college clinic. She got involved with a trial at a local teaching hospital, and the doctors there ended up becoming her primary health providers.
After the clinical trial ended, a year later, House had remarkable results.
“I had restoration of my energy, I started a new career, I got married … everything was going really well,” she says.
House, now 47, says looking back on her heart health journey, she now knows the importance of clinical trials and encourages other women to get involved in them. For decades, women — especially minority women — have been underrepresented in medical trials.
A review of seven cardiovascular trials published in January 2017 in the Lancet Diabetes & Endocrinology found that less than 5 percent of participants in these trials were black or African American, despite that population having double the rate of type 2 diabetes compared with non-Hispanic white people.
“When I was in the clinical trial, I didn’t see anybody who looked like me. I didn’t see any women, I didn’t see any black women,” House says. “And this particular medication improved my health in a way that no other medication could have.”
But House’s rigorous medication routine was hard to keep track of, especially with her hectic schedule and frequent business trips. She began to lose track of what meds she was taking when, and within less than a year, House says she became symptomatic again.
“My heart function decreased back to between 30 and 35 percent,” she says. “Because of my weakened heart, it was definitely a challenge to find a physician who wanted to treat me as a patient.”
Around this time, House says she was also thinking about having a baby. While she was able to mostly recover from not taking her medications, she never got back to the level she achieved during the clinical trial, which deemed her a high-risk patient — especially if she was trying to have a baby.
Working with her cardiologist, House was able to find a perinatologist, a type of ob-gyn who specializes in high-risk pregnancies. She successfully conceived her son, Asa, at age 30, but just two years later, needed to have an implantable cardioverter defibrillator (ICD) placed in her chest to monitor and treat potential life-threatening abnormal heart rhythms. Despite her health challenges, House was feeling pretty good. She was eating healthy, practicing yoga, and exercising five to six times a week. But suddenly her world started to unravel.
House’s mother passed away in 2013, a mere year after she lost her best friend to breast cancer. Her marriage also started to falter.
“I separated from my husband and consequently had a divorce, so it was a very stressful time,” she says. “I hadn’t been maintaining a good level of self-care, and started to notice a decline in my health.”
Hospital visits became more and more frequent, and she was so fatigued she could hardly change her bedsheets. House would cry at the thought of grocery shopping, and whenever she successfully completed the task, she would be too tired to unload the car.
In 2016, doctors told her it was time to think about a heart transplant, which she received in 2017. Complications with the procedure kept her in the hospital for 70 days, but House recovered, and says she is stronger now than she’s ever been.
She works out regularly, maintains a full-time job (something she wasn't able to do for years, she says), and is back to a plant-based diet. And perhaps most importantly, she puts her health first.
“I love my heart,” House says. “She’s my best friend, and I'm going to treat her well. Some days, I don’t feel like exercising, but I get on that treadmill for her, for my son, and for me.”