Jonae Santos, RN, a veteran cardiac nurse and manager of the Cardiac Catheterization Laboratory at Abrazo West Campus, has spent years guiding patients through some of the most urgent and complex heart procedures. But in late 2024, at age 47, it was her own clinical intuition that ultimately saved her life.

After returning from a trip to Florida in August, Santos began experiencing unusual fatigue followed by intermittent chest pain. “I knew something wasn’t right,” she recalled. “As a runner, I’m used to feeling strong. When I suddenly couldn’t keep up, that was a red flag.”

Despite undergoing an echocardiogram, heart monitoring, and a coronary CT angiogram (CCTA) — all of which appeared normal — Santos continued to sense something was off. Conservative treatments and medications were not doing the trick.

Drawing on her clinical experience, and mindful of a family history of premature coronary artery disease, she advocated for further evaluation.

That’s when Dr. Richard Pham, Interventional Cardiologist and Director of Cardiology & Cardiac Rehab at Abrazo West Campus, took a closer look at her CCTA results, which showed evidence of moderate non-calcified plaque in her Left Anterior Descending Artery (aka “the widow maker”).

“I noticed her calcium score was zero, which rules out hard plaque but doesn’t exclude soft plaque,” said Dr. Pham. “Research shows that 4–15% of people with a zero-calcium score still have non-calcified plaque — the kind most likely to rupture and cause sudden heart attacks.”

Dr. Pham recommended a left heart catheterization, which revealed a much more significant soft-plaque blockage than imaging had suggested. Acting quickly, he performed a percutaneous coronary intervention (PCI) and placed a drug-eluting stent to immediately restore proper blood flow.

“Jonae’s persistence and medical insight played a critical role,” Dr. Pham said. “Soft plaque is unpredictable and highly dangerous. Had she not pushed for the angiogram, she was at real risk of experiencing a cardiac event within months.”

Today, Santos has fully recovered, returned to her running routine, and resumed leading the cath lab team she has long supported.

Her message is simple — and urgent.

“Working in cardiology, I’ve seen how early detection and self-advocacy save lives,” she said. “Even when initial tests are normal, if something feels wrong, don’t ignore it. Trust your instincts and speak up.”