A fervently active woman with nor- mal blood pressure and low cholesterol, Bertozzi had never experienced any shortness of breath, fatigue, weakness or chest pain—common symptoms of heart disease in women. Growing up in Jacksonville, Florida, with three older brothers, she was a “bit of a tomboy.” She swam and ran cross-country in high school, which is when she met her future husband, Gianfranco, at a Catholic youth retreat. They’ve been married for 23 years.

More than two decades ago, the young couple was living in New York City when Bertozzi, pregnant with the first of her three children, started doing yoga. It was transformative. “I’ve always loved moving my body, but with yoga there’s a spiritual and emotional part to it as well,” she says. “The deeper exploration spoke to me.”

Gianfranco’s job at the World Bank brought the family to Bethesda, where they’d been living for five years when Bertozzi walked into that gourmet grocery store. Luckily, when she collapsed she was only about a mile from Suburban, where doctors discovered that she had an ascending aortic aneurysm with a dissection. “The layers of my aorta were tearing apart, causing my blood flow to become erratic,” Bertozzi says. If the aneurysm had ruptured, they later told her, it likely would have killed her. She underwent a 12-hour open-heart surgery, which involved replacing a 5-inch portion of the aorta with a graft.

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Photo by Lisa Helfert

The Centers for Disease Control and Prevention’s Division for Heart Disease and Stroke Prevention defines an aortic aneurysm as “a balloon-like bulge in the aorta, the large artery that carries blood from the heart through the chest and torso. …The force of blood pumping can split the layers of the artery wall, allowing blood to leak in between them. This process is called a dissection.” Aortic aneurysms were the primary cause of 9,928 deaths in the United States in 2017, according to the CDC, and aortic aneurysm or dissection were listed as either the underlying or a contributing cause of 16,954 deaths. But just one-third of people with an aortic aneurysm are female, and it’s rare for a fit woman in her 40s to have one. This led Bertozzi’s doctors to suspect that her condition was hereditary.

“My paternal grandfather died of a cardiac event when he was 53,” Bertozzi says. “Because he was so young, there was an autopsy done that showed that he died in his sleep of an aortic aneurysm and dissection.”

Tests performed on Bertozzi following her surgery confirmed that an unnamed connective tissue disorder runs in her family. After her aneurysm was discovered, her three brothers all were found to have one as well. The oldest, Steve, and youngest, Bob, underwent procedures to repair the aneurysms. Tragically, Bob died last year from complications connected to his surgery. He was 54.

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“He had a fungal infection that caused a massive heart attack,” she says. “Bob did all the right things to proactively combat this disease, but in the end, his own anatomy let him down. It constantly reminds me how vulnerable we all are. I don’t take that lightly.”

Bertozzi’s middle brother, Tom, has chosen to take medication instead of undergoing surgery, but monitors his condition closely. Bertozzi’s son, Luca, 21, and daughters Gabi, 18, and Sophia, 16, now get echocardiograms annually, which they will have to do for the rest of their lives, but otherwise, the condition does not affect them. Bertozzi says she focuses on educating herself and her family about aneurysms and heart disease by attending conferences and webinars, and reading as much as she can.

Back in the fall of 2014, Bertozzi’s surgical team was focused on saving her life. After the operation she suffered an MRSA scare and blood clotting. She also had to have a pacemaker implanted. “Pain is not fun, that’s for sure, but I felt protected,” she says. “Maybe that was my faith, or the confidence I had in the care I was getting at Suburban. I had a lot of love surrounding me.”

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Bertozzi was in the hospital for 18 days, and she could sense the increasing concern among her family and doctors as complications developed. But she was rarely alone. Her husband, mother, children and other relatives and friends practically set up camp in her room, yet it was another visitor, an octogenarian she’d never met, who changed the course of her life.