What was supposed to be a fun outing with friends took two unexpected turns. Noelle Stoffel, 50, of West Bend, was roller skating when she fell and broke her ankle in three places.

“It was obviously broken,” Noelle said. “The skating rink employees got a pizza box and some rope, secured my ankle and took me in a wheelchair to the car.”

As her boyfriend drove her to Froedtert West Bend Hospital, part of the Froedtert & the Medical College of Wisconsin health network, Noelle started feeling as if she had a pill in her throat that would not go down. A drink of water didn’t make the feeling go away. Then, her left arm started to hurt. When they arrived at the Emergency Department and explained what had happened, Noelle mentioned she had been having left shoulder pain since the night before.

Heart Care Takes Priority

Emergency Department staff quickly determined an EKG was needed to check the functioning of her heart. The result indicated Noelle was having a heart attack. Her main artery was blocked.

“Doing the EKG was a great catch in the Emergency Department,” said David Marks, MD, MBA, interventional cardiologist and MCW faculty member. “Shoulder pain is an atypical symptom experienced with some heart attacks. Thinking broadly is one of many things physicians within the Froedtert & MCW health network do so well, and, in this case, the EKG provided lifesaving information.”

Noelle was transported to Froedtert & MCW Froedtert Hospital, where Dr. Marks met her in the ambulance bay and escorted her to the catheterization lab. Froedtert West Bend Hospital has a direct connection to the catheterization lab for complex care.

“The key to Noelle’s care was timing,” Dr. Marks said. “The short span from diagnosis to treatment was essential because seconds count. She had a blood clot in her artery, abruptly stopping the flow of blood to her heart.

After Noelle’s artery was opened with a balloon, a stent was placed, restoring blood flow. She felt immediate relief.

“It’s a minimally invasive surgery with a dramatic outcome,” Dr. Marks said. “All of her heart muscle was preserved after the procedure. It was a very successful result of a true medical emergency.”

Ankle Repair

With Noelle’s heart issue under control, attention turned to her broken ankle.

“Her severe and unstable break needed surgical repair,” said Brian Law, MD, orthopaedic surgeon and MCW faculty member. “However, with these types of breaks, we ideally like to wait for the swelling to go down, so we reset the fracture, put the ankle in a splint and made a plan.”

Because Noelle was considered high risk for surgery due to her heart attack, Dr. Law put together a team of experts to ensure her treatment was considered carefully from all angles.

“We met with cardiology, anesthesiology and internal medicine; ordered needed tests; and evaluated her medications,” Dr. Law said. “Weighing the risks and benefits for Noelle’s treatment was imperative. We had all our ducks in a row and made sure she could tolerate surgery in the best way possible.”

Two weeks following her heart surgery, Noelle’s ankle was successfully repaired at Froedtert Hospital.

Road to Recovery

About 10 weeks after ankle surgery, Noelle started physical therapy in West Bend, conveniently close to her home and work.

“With a lot of hard work, I progressed from using a wheelchair, to crutches, to a cane, to finally walking by myself,” she said.

“Our goals in physical therapy were to ease Noelle into her normal routine and to get her out in the community and back to work,” said Melissa Tauben, physical therapist. “She knew it would take time and she did a great job staying focused, doing her exercises and regaining her strength.”

Within a few months, Noelle was back to most of her regular activities.

“It’s been quite a year,” Noelle said. “My heart is healthy and my ankle is on its way to a full recovery. I’m really grateful to the fantastic medical team that helped me every step of the way.”