It was a normal day for Jeff Zampi, M.D., who had spent most of it performing procedures to treat babies, children, adolescents and adults with congenital heart disease.

And after wrapping up work at University of Michigan Health C.S. Mott Children's Hospital, the pediatric cardiologist laced up his skates to hit the ice for a hockey game nearby in Ann Arbor: his Mott team was facing the Ice Cats.

But by the third period of the match, Zampi found himself switching back to doctor mode.

After skating back to center ice for the next puck drop, there was a call for help from the opposing team's bench.  As he looked over the bench, he saw a player face down.

He recognized the man's jersey: No.32.

It was Greg Kowalewski, a family friend and father of three. Their 12-year-old sons play on the same hockey team and attend middle school together.

Initially Kowalewski seemed to have a pulse, but within 30 seconds it was gone.

"That's when I jumped over the bench and started doing chest compressions," Zampi said. "You kind of go into war mode when someone's life is in danger."

Another member of the team ran to get an automated external defibrillator, commonly known as anAED, stored at the rink. Zampi quickly opened the medical device that can analyze the heart's rhythm and deliver electrical shocks if necessary to help the heart re-establish an effective rhythm.

Sure enough, Kowalewski's heart needed to be shocked. After another few minutes of chest compressions, the 47-year-old's pulse returned. By the time the ambulance got there nearly 20 minutes later, he was responsive and able to move his hands and feet.

"It was scary. There were about 20 grown men standing there frozen and terrified. It was especially difficult to know who this person was, thinking of what I was going to tell his wife and kids," Zampi recalled.

"There was such a great sense of relief when his pulse came back. I feel fortunate to have played a small role in getting him the care he required. I'm also thankful that someone knew where the AED was so we could use it in time," he said.

"It absolutely saved his life."

"I got really lucky"

Kowalewski was excited to see Zampi at that winter game on Dec.1, 2021. The doctor wasn't always able to attend since he was often on-call or working.

"I remember during warmups skating into the center of the ice to say hi and saying 'I'm happy you're here. This is going to be fun tonight,'" Kowalewski said.

"I had no idea how happy I'd be that he ended up making it to that game."

Kowalewski says he felt a little off that day, feeling unstable on the ice, which was unusual having played hockey for nearly 37 years. And he couldn't catch his breath. But he blamed his asthma and sat down to rest.

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"That's when things went from bad to worse. It was a feeling I'd never had in my life, like someone was squeezing my chest and I couldn't get any air in," he said. "I started feeling lightheaded and then things started looking white around the edges."

Next thing he knew, he was starting to wake up to people telling him he'd be OK.

"It was like out of a movie. All the sound came back in a rush, really loud and startling," he said. "I remember seeing Jeff over me and hearing him and a teammate encouraging me. My brother-in-law told me my wife was on the way."

"I had no idea what had happened or how serious it was. Thank God Jeff was there. Of all the times and places this could happen, I got really lucky."

Not until being in the ambulance, did he realize he'd had a sudden cardiac arrest.

A condition that's usually fatal within minutes

Kowalewski was admitted to U-M Health, of Michigan Medicine, and diagnosed with critical narrowing in the main artery to front of his heart – the left anterior descending, or LAD – among the most dangerous locations for a blockage.

It was an unlikely scenario given Kowalewski's age, active, healthy lifestyle and having no history of heart issues.

But stories like his aren't uncommon. Sudden cardiac arrest, the abrupt and unexpected loss of heart function in someone with or without heart disease, is a major cause of death worldwide. It affects an estimated 300,000 to 450,000 people in the U.S. every year and can impact children and adults of any age. 

If the right steps aren't taken right away, it's often fatal within minutes. 

Cardiopulmonary resuscitation (CPR) and AEDs are critical tools to saving a life during such cardiac emergencies, which is why Michigan Medicine has partnered with organizations like Project ADAM. The organization, named after a 17-year-old who collapsed and died from sudden cardiac arrest while playing basketball in 1999, helps schools and communities prepare for such events through advocacy for emergency plans, CPR training and AED accessibility.

Brett Wanamaker, M.D., an interventional cardiologist at U-M Health Frankel Cardiovascular Center who treated Kowalewski, recalls his own hockey coach suffering a cardiac arrest on the ice during a pickup game when Wanamaker was a teen.

"Unfortunately, there was no AED in the arena, and he couldn't be resuscitated," Wanamaker said. "The more widespread availability of AEDs makes a big difference for people who experience sudden cardiac arrest. Seeing how this impacted Greg and playing a role in his incredible story have been really meaningful for me."

And Kowalewski wants his story to aid efforts that may help save other lives.

"This has been really eye-opening. Until it happens to you, you may not think about things like CPR and AEDs. They can save someone's life. In a different circumstance I may not have had a fighting chance."   

Looking back, there were also signs something wasn't right, he says. He'd had shortness of breath during the last three hockey games but just thought it was his asthma, encouraging others to not ignore symptoms and "always listen to your body."

A perspective changed forever

Kowalewski spent just two days in the hospital after undergoing a minimally invasive stent procedure to open his artery led by Wanamaker.  

He was sent home under orders to rest, stay on a heart healthy diet and continue heart medications.

But he knows it could have been much worse.

"I didn't check any of the boxes for a likely candidate of a heart problem like this. And everyone told me that most people who came in for a cardiac arrest for an LAD blockage were in way worse shape," he said. "I've looked at the stats. It's rare to survive this outside a hospital setting."

He credits the fast action from those around him, noting that him and his wife, Tara, continue to joke with Zampi that "we're not going anywhere without you now."

Kowalewski, who does marketing for a Detroit software company, also isn't taking anything for granted these days, soaking up family time with Tara and children Erin, 16, Rowan, 14 and Declan, 12.

"It's such a scary thought to imagine what my family could've been going through heading into the holidays," he said.

"I cannot tell you how fortunate we feel to live where we live and to be this close to a facility with such amazing caregivers – every doctor, every (physician's assistant), every nurse, every technician – they all treated me so well. I always knew I was in good hands.

"Something like this changes your perspective forever. I'm just eternally grateful."  

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