Coach defies odds to survive cardiac arrest: Josh’s story

As a collegiate volleyball coach and former professional volleyball player, Josh Steinbach's life and career are rooted in athletics. At age 53, he led an active lifestyle and enjoyed good health. But the serendipitous timing of a cardiac emergency would make him grateful for fast-acting colleagues and expert cardiovascular care from Main Line Health.

Sudden cardiac arrest with no warning signs

Throughout his nearly 20-year tenure as head coach of the Villanova University women's volleyball team, Josh played pickup basketball regularly with colleagues in the athletics department. It was a day like any other, except that Josh was guarding one of the "young guys." Josh was up for the challenge and played well, but after a few games, he began feeling a bit off.

"I started feeling some tingling in my fingers. I remember thinking I should sit down, and then I don't really remember anything after that," recalls Josh.

Moments later after grabbing a rebound, Josh landed and took a knee. His colleagues thought he had sustained an ankle injury. However, they quickly realized he was slumped over and unresponsive.

What are the signs and symptoms of sudden cardiac arrest?

Josh was experiencing sudden cardiac arrest, a malfunction of the heart's electrical system. The heart stops beating properly and its pumping function is "arrested," or stopped.

Also known as sudden cardiac death, the signs of cardiac arrest are:

• Sudden loss of responsiveness
• No normal breathing

What are the survival rates of sudden cardiac arrest?

The statistics surrounding cardiac arrest are grim. Adults who experience cardiac arrest outside of the hospital have a less than 10 percent chance of survival. However, if someone receives cardiopulmonary resuscitation (CPR) immediately, their survival rate can double or even triple.

CPR-trained bystanders reverse sudden cardiac death

Everyone on the court divided up the actions that would save Josh's life: calling 911, beginning CPR and locating the automatic external defibrillator (AED). An AED is a lightweight, portable device that delivers an electric shock to the heart and changes the rhythm back to normal.

Villanova athletics department staff are required to be CPR- and AED-certified. In fact, Josh had just completed his own re-certification two weeks before. Within 90 seconds, Josh's colleagues resuscitated him with 200 chest compressions and one shock by the AED.

"The real lifesavers are the people who started CPR and placed the AED on Josh. If he had not been shocked with the defibrillator, he would have died. This is why AEDs are so important," says Howard B. Kramer, MD, cardiologist at Main Line Health who oversees Josh's cardiovascular care.

The serendipity of the circumstances surrounding Josh's near-death experience are not lost on him.

"I had been out a few days before on a four-mile hike that was pretty strenuous, and I was going up some pretty big hills. If I had experienced cardiac arrest when I was in the park, I would have been by myself, and there would have been no AED nearby. I would not have made it," says Josh.

Main Line Health cardiologists provide expert cardiac care

Josh regained consciousness, but he was not out of the woods yet. Emergency responders transported him to Bryn Mawr Hospital, part of Main Line Health. There cardiologist Tarun Mathur, MD, FACC ordered a cardiac catheterization to examine Josh's heart.

The catheterization revealed none of his arteries were blocked. Josh would require further testing to determine the underlying cause of his heart trouble. An echocardiogram and cardiac MRI revealed acute myocarditis.

What is myocarditis?

Myocarditis is a rare, but serious condition, where inflammation develops in the heart muscle, typically after a viral infection.

"The inflammation in Josh's heart made the tissue abnormal, which led to the heart's electrical impulses becoming abnormally conducted. In Josh's case, this resulted in cardiac arrest," explains Dr. Kramer.

Implantable cardiac defibrillators prevent future cardiac arrest

To monitor Josh's heart and safeguard against another cardiac arrest, he would need an implantable cardiac defibrillator (ICD). An ICD is a battery-powered device placed under the skin that monitors heart rate. If an abnormal heart rhythm is detected, it delivers an electric shock to restore a normal heartbeat.

"Whenever a patient survives sudden cardiac arrest and there is nothing mechanical to fix in their heart, they always get an ICD for secondary prevention. Josh's ICD gives him peace of mind that he can exercise and play sports without worrying that this could happen again. Especially coaching for a living, it's an insurance policy to help him feel safe," says Dr. Kramer.

After five days in the hospital, Main Line Health electrophysiologist, Sheetal Chandhok, MD, successfully installed the ICD in Josh's heart. He was discharged that same afternoon.

Thriving after surviving sudden cardiac arrest

"Everyone at Main Line Health was awesome. I had such a positive experience with the people there. Interestingly, I had to take one of my volleyball players to the Bryn Mawr Hospital ER after my ICD was implanted. While I was there one of the nurses recognized me and said, 'It's good to see you on your feet!'" says Josh.

Josh is more than back on his feet; he is making strides in his recovery. Just a few months following his cardiac arrest, his heart is getting stronger every day. He has even returned to his life-long passion of coaching.

"At our first volleyball match this year, I was super emotional because I really enjoy my job. Coaching is something I love, and I just felt fortunate to be doing the things I like doing again," says Josh.

Next steps

Schedule an appointment with Howard B. Kramer, MD

Learn more about heart and vascular care at Main Line Health

Find a CPR/AED class

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