For Emma Topp, what began as chest pain during gym class turned out to be something else.

December 2021 was a big month for Emma Topp. It was just a week before Christmas, and the Leonardo resident was getting ready to celebrate her birthday, as well as her friend’s birthday, which was just two days before hers. The two were planning how to celebrate in Atlantic City.

But before that, she had to get through gym class, which was more challenging than normal. While playing pickleball, she started to feel pain in her chest and arm and was having a hard time catching her breath.

Despite that, she finished gym and went to lunch. “I thought it was going to go away,” she said. “You say to yourself what everybody says to themselves: ‘It’s no big deal. I’m freaking out for nothing.’ ”

After a friend told her that she didn’t look well, and the pain in her chest continued, she went to the school nurse. Her heart rate and blood pressure were high, and her mother, Monique, was called to bring her to the hospital.

Emma and her mother, Monique, meet with Dr. Mark Kayton.

Discovering the Problem

The medical team at Riverview Medical Center evaluated her but couldn’t find an obvious cause for the high heart rate and high blood pressure. She was soon taken to the intensive care unit at K. Hovnanian Children’s Hospital at Jersey Shore University Medical Center where specialists began assessing the situation.

Due to the high blood pressure, the immediate concern was that something was going on with her heart, so a chest ultrasound was performed, said Mark Kayton, M.D., division chief of Pediatric Surgery.

Guillermo Hidalgo, M.D., division chief of Pediatric Nephrology, suggested expanding the imaging to include Emma’s abdomen to examine her kidneys. That’s when the team realized they were dealing with something — a large mass in her belly.

Emma takes a tour of the stage at the Count Basie Theater for the Arts.

“The beauty of a children’s hospital is that if your child’s case takes an unexpected turn, we pivot and bring the appropriate resources to bear,” Dr. Kayton said. “We were able to recognize in the first 24 hours that this wasn’t a heart problem at all. In fact, this was coming from her reproductive tract, and when that specialist was needed, they were at her bedside almost immediately.”

Everyone was relieved once the mass was removed and determined to be a benign ovarian cyst the size of a football. The cyst had been compressing structures within Emma’s abdomen, causing high hypertension, according to Heather Appelbaum, M.D., division chief of Pediatric & Adolescent Gynecology, who removed the 7-pound cyst and an additional cyst the size of a softball that was tucked in behind the larger one.

Ovarian cysts are not uncommon in adolescent patients, however, Emma didn’t experience the symptoms usually associated with them, such as abdominal pain. Additionally, most ovarian cysts resolve on their own before growing to the size of Emma’s.

Emma and her family were relieved once the mass was removed and determined to be a benign ovarian cyst the size of a football.

Moving On

To lower the risk of stroke or heart dysfunction Dr. Hidalgo fine-tuned and lowered her blood pressure using three medications, and surgery was performed successfully.

Because the cysts were fully removed, Emma likely will not experience regrowth, but she will get annual pelvic ultrasounds.

Once she fully recovered, she remained with normal blood pressure, and her doctors cleared her to resume her normal activities, her mom took her and four friends to a water park to celebrate.

Today, Emma is back to doing what she loves: singing, acting and performing in community theater productions.

“It was super fun,” Emma said. “I was going on the water slides and all that and having a good time with my friends. I wasn’t really thinking of what just happened. I was actually living in the moment.”

Today, Emma is back to doing what she loves: singing, acting and performing in community theater productions.

Next Steps & Resources

As the No. 1 children’s hospital in New Jersey, we are ready to get kids, like Emma, back to being kids. To learn more about our world-class pediatricians, 200-plus pediatric specialists, and extensive pediatric programs, visit hackensackmeridianhealth.org/kids. 

• Meet our sources: Mark Kayton, M.D., Guillermo Hidalgo, M.D., and Heather Appelbaum, M.D.
• To make an appointment with Dr. Appelbaum, Dr. Kayton or Dr. Hidalgo or a physician near you, call 800-822-8905 or visit our website.

The material provided through HealthU is intended to be used as general information only and should not replace the advice of your physician. Always consult your physician for individual care.