Why I Specialize in Adult Congenital Heart Disease

Julie Kovach, MDBy Julie Kovach, MD

“I’m a cardiologist who takes care of adults who were born with heart defects.”

This is what I tell anyone (patients, other physicians, friends or family members) who asks me “what kind of cardiology” I practice. My answer is almost always met with a quizzical look and a polite, “What?”

Everyone knows cardiologists who care for adults who have had heart attacks, or have high blood pressure, heart failure or heart rhythm problems (arrhythmias). These are common heart problems people face as they age.

But adults with congenital (present at birth) heart defects? What does that mean? How many of these patients could there possibly be out there? Don’t these folks just keep seeing the same cardiologist that they saw as a child?

So I tell them about Carrie*. When I first met Carrie, her husband brought her into my office in a wheelchair. A diminutive, 42-year-old woman dressed in a stylish suit, with tubing in her nose attached to an oxygen tank on her wheelchair, she smiled shyly and told me her story. Her husband stood behind her with tears in his eyes as she talked.

Carrie’s parents were told she had a heart murmur when she was nearly two years old and couldn’t keep up with the other kids while playing.

Fatigue, shortness of breath

As a young adult, Carrie remembers her mother telling her that doctors had suggested Carrie have heart surgery. Her parents were reluctant, however, because every child they’d heard of who had heart surgery died. Keep in mind, this was 40 years ago, a time when open heart surgery was a new specialty in its infancy.

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Stroke Heroes

Lynne Braun, PhD, CNP

Lynne Braun, PhD, CNP

By Lynne Braun, PhD, CNP

May is American Stroke Month, and volunteers from the American Heart/American Stroke Association gathered at the state capital to recognize Sen. Heather Steans, Rep. Robyn Gabel, and former Rep. Bob Biggins for their work to improve outcomes for stroke patients over the last five years. Stroke is the nation’s No. 4 killer and the No. 1 cause of severe disability.

Five years ago, Sen. Steans and Rep. Biggins, a stroke survivor, championed the groundbreaking Illinois Primary Stroke Center law of 2009. Since that time, 39 hospitals have been designated as Primary Stroke Centers, and five hospitals have been designated as Emergent Stroke Ready Hospitals, with many more waiting approval. These specifically designated stroke hospitals offer higher levels of stroke care, with strict national and/or state certification processes. EMS providers are directed to take stroke patients directly to these designated stroke centers, bypassing hospitals less able to provide high quality stroke care.

Sen. Steans and Rep. Gabel took the next step by introducing House Bill 5742, legislation that will keep stroke care moving in Illinois. This crucial legislation will allow Illinois to take full advantage of advances in technology, techniques, and standards of stroke care which have been developed since 2009, including:

  • Allowing the Illinois Department of Public Health to designate Comprehensive Stroke Centers, the highest level of stroke care available;
  • Align Emergent Stroke Ready Hospitals with National Acute Stroke Ready standards;
  • Facilitate the creation of an Illinois stroke data registry, a critical tool for continuing quality improvement.

In a press conference on May 22, as chair of the Illinois Advocacy Committee, I had the privilege of presenting Sen. Steans, Rep. Biggins and Rep. Gabel with Stroke Hero Awards. Shortly thereafter, I witnessed the almost unanimous approval of HB 5742 in the Senate. The bill now awaits the governor’s signature.

The Stroke Program at Rush has met the highest level certification standards by the American Stroke Association and the Joint Commission as a Comprehensive Stroke Center. Recently, Rush was awarded the Gold Plus Performance Achievement by the American Stroke Association.

Ciara’s Story: “I Know That I’m Safe Now”

Ciara McGrath was lying on the bed reading a book when the room went — as she puts it — “spinny crazy like you can’t even imagine.”

“I could barely walk. I was falling over,” she recalls.

After passing out and being resuscitated in an ER, she was referred to Rush University Medical Center, where she was diagnosed with a heart condition called Wolff-Parkinson-White syndrome. First she underwent an ablation procedure, then electrophysiologist Richard Trohman, MD, implanted a cardiac device “to make sure I don’t have any episodes like that again.”

“I know that I’m safe now, and I’m more active than I’ve ever been in my entire life,” she says. “Dr. Trohman, the nurses, the entire staff here in the EP department, they’re like family. They took such good care of me, I can’t imagine not coming to see them at least once a year to have things checked out.”

Ten Years of Caring For Women’s Hearts

Volgman_AnnabelleBy Annabelle Volgman, MD

In 1984, there were more women who died of cardiovascular disease than men. Cardiovascular disease has been the number one killer of American women, more than all cancers put together. Women were being treated differently than men, including hormone replacement therapy for high cholesterol instead of the more effective cholesterol-lowering medications called statins. This resulted in thousands more women dying from cardiovascular disease.

In 2001, the American Heart Association started a campaign to increase awareness about heart disease in women. This campaign was named the Go Red for Women campaign in 2003. Lynne Braun PhD, ANP, and I were involved with the inception of the awareness campaign, and we both continue to be involved with Go Red for Women.

In 2003, the Rush Heart Center for Women opened its doors to prevent and treat heart disease in women. In addition to our services, we also offered complimentary nutrition counseling, which we were able to offer through funding from grateful donors. We wanted to give comprehensive evaluation and compassionate care to prevent devastating cardiac events.

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Does Pet Ownership Promote Heart Health?

DogHealthBy Lynne T. Braun, PhD, CNP

Many people who own pets treat them like family members. Pets are thought to provide joy, comfort and stress relief, alleviate sadness, and give their owners unconditional love. Some hospitals, including Rush University Medical Centerallow family pets to visit their hospitalized owners if certain requirements are met.

Teams of specially trained “comfort dogs” visited and provided comfort to the survivors of the Oklahoma tornadoes, Boston marathon bombings and Sandy Hill school shootings. But what do we know about pets and the health of their owners? In particular, does pet ownership promote heart health?

The answer is probably yes. The American Heart Association recently published a scientific statement on pet ownership and risk for cardiovascular disease. This statement reviewed the results of research on pet ownership and high blood pressure, cholesterol, physical activity, obesity and even survival. Although some studies are conflicting, most show the following:

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Like a River: Heart Murmurs in Children

Damien Kenny, MD, pediatric cardiologist at Rush University Medical Center in Chicago, Illinois.By Damien Kenny, MD

Some of the simplest things we are asked to do often prove to be the hardest. Finding a good analogy for an “innocent” murmur to contextualize for parents is a challenge. A heart murmur is simply an extra heart sound, and at least 30 percent of children will have a murmur at some stage during their childhood. Less than 1 percent of children will actually have something wrong with their heart. However, the word still strikes fear in parent’s minds.

Often good clinical examination is enough to root out the worrisome murmurs from the “innocent” ones, but further testing with an ultrasound of the heart, termed an echocardiogram, can offer further reassurance to patients and their family.

So when I see children and their families and break the good news that thankfully their heart is normal, as it is in the majority of cases, sometimes I am posed with the very natural question of, “Well, what is causing the murmur then?” Most often it is due to rapid blood flow through a growing heart making a “whoosh-like” sound as the blood is pumped across heart valves into the lungs or out into the body.

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Stress Poses Heart Health Dangers For Women

Melissa Tracy, MD, cardiologist at Rush University Medical Center in ChicagoBy Melissa Tracy, MD

Women tend to not only take on their own stress, but also that of their families. This compounds the potential health hazards that include both psychological and physical issues.

Women tend to use food to suppress the impact of stress, resulting in increased weight and decreased exercise. When our weight increases and we have decreased exercise tolerance, the health-related heart risk factors can develop or worsen: Our blood pressure increases, cholesterol increases and the risk of developing diabetes increases.

Obesity, high blood pressure, high cholesterol and diabetes are the leading risk factors for developing heart and cerebral vascular disease, such as a heart attack and stroke. Women of all ages are at risk, even those who still have not undergone menopause. If a woman is postmenopausal, then her risk is greater.

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