A Second Chance at a Healthy Heart

By Hussam Suradi, MD

I was in medical school when my dad suffered from a heart attack that required an emergency procedure. It made me realize that sheer minutes can make a difference in treating cardiac patients. I wanted to make that difference for people like my father; I wanted to save lives in the minutes that mattered most.

One thing I love about my job is being able to tell patients that they have more options — that it’s not the end of the road. And frankly, this is the heart of our work as interventional cardiologists as we can provide minimally invasive treatments for structural heart diseases.

Every day, we see people who think nothing can be done for their heart problems, but most of the time, they’re willing to do whatever it takes to improve their quality of life. Perhaps they’re older, or maybe they’re dealing with illness or birth defects that limit their possible treatments. The good news is, there are always more options.

Alternatives to open-heart surgery

Structural heart intervention is a relatively new field in cardiology, treating patients with heart valve problems such as tight or leaky valves, or those born with birth defects. In the past 10 years especially, technology and devices for treating structural heart conditions have changed dramatically. Today, patients are treated for these conditions through minimally invasive procedures rather than open-heart surgeries, regardless of how old or sick they may be.

One of the biggest innovations we’ve seen is the treatment of valvular heart disease through minimally invasive catheter-based procedures. One of these procedures is called TAVR (transcatheter aortic valve replacement), which involves replacing the aortic valve without needing open-heart surgery.

With TAVR specifically, patients recover much faster. In fact, they can usually go home the very next day. Additionally, they typically don’t need cardiac rehab after the procedure and they surely don’t endure as much pain — whereas, open-heart surgery patients typically go through cardiac rehab and need several months of recovery before feeling “normal” again.

Aside from a faster recovery, data has now shown that TAVR is as effective and safe as open-heart surgery. Only recently, but fortunately, TAVR was expanded to low-risk patients after initially only being for high-risk patients who were not candidates for surgery.

Another similar treatment option is MitraClip, specifically for those with severe leakage in their mitral valve. Using a catheter, the interventional cardiologist attaches a small clip to the valve to enable it to close more completely without leaking. Given the minimally invasive nature, this is another ideal treatment option for those not eligible for traditional surgery.

A better solution and quality of life

At least 30% of the people we care for have had some sort of heart procedure before — whether it’s a stent procedure or bypass surgery. When they come to us, they not only gain a more hopeful outlook, but they experience the full “heart team” approach. They’re evaluated by an interventional cardiologist and a cardiac surgeon who, together, evaluate their data and tests to recommend the best treatment options available — including some of our latest clinical trials.

It’s so rewarding to be able to tell patients they have another shot at life, and it’s even more powerful to feel their gratitude. If you ever feel it’s the end of the road, know that there are always more options.

Hussam Suradi, MD, is a fellowship-trained structural/interventional cardiologist at Rush.

Rising to the Top in Lowering Blood Pressure

Dr Hanak gives blood pressure exam to consented patient.By Michael Hanak, MD

Last year more than 23,000 patients were seen for high blood pressure as part of a visit with a doctor in one of Rush’s outpatient practices. By the end of the year, 75 percent of this group brought their blood pressure into a healthy range.

This great news was among data about various clinical measures just released this week. The turnaround puts Rush University Medical Group, known as RUMG*, in the top 10 percent of physicians who treat hypertension nationwide, according to the National Committee for Quality Assurance, a non-profit organization that promotes health care quality. More importantly, it means that more than 17,000 of Rush’s patients significantly have reduced their risk of heart attack and stroke, and of dying from these preventable conditions.

High blood pressure, or hypertension, is known to be a silent killer, because people often don’t notice they have high blood pressure. Far too many are at risk: According to the  Centers for Disease Control and Prevention, about one in three people in the United States (75 million) have high blood pressure, and only about half (54 percent) have their blood pressure under control.

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Rush Nurse Helps Save Girl’s Life at Lakefront

Joselyne Nicolalde1Being called a “hero” by her colleagues seems a bit strange to Joselyne Nicolalde, BSN, RN, a nurse in Rush University Medical Center’s cardiac intensive care unit.

After all, Nicolalde says she did what any one of them would have done when a teenage girl was pulled from Lake Michigan unresponsive and not breathing after a near-drowning incident. She sprang into action.

She was enjoying an afternoon at Montrose Beach with her 10-year-old son and a friend on Aug. 14 when they heard people yelling for help.

“I looked up and saw a man holding what seemed to be a lifeless girl on the shore,” she recalled. “I couldn’t believe my eyes. I had to do something.”

‘She lacked a pulse’

Nicolalde and a lifeguard were the first to reach the girl. “She lacked a pulse and was unresponsive at the time, so we immediately administered CPR. There was a return of circulation shortly thereafter. It wasn’t long before the paramedics arrived and took over.”

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Diving in: a Cardiologist’s Transition to a Vegan Diet

jeffrey-sobleBy Jeffrey Soble, MD

Nearly two years ago, I decided to follow a vegan diet, or an almost vegan diet, anyway. As I tell my patients, the decision to embrace a plant-based diet is a very personal one. People choose it for a variety of reasons, and it’s just one of several ways to eat more healthfully. Just look at your priorities and do what’s right for you.

For me, a plant-based diet made sense. Here, I share how I made the transition and why.

Health, environment, animal welfare

Several factors in my life converged to convince me to go vegan.

Certainly, there were health reasons: I have a family history of heart disease, and my father died of a heart attack. Heart medications didn’t agree with me, so I took a more serious look at my diet. That thinking coincided with my evolving views of animal rights and a growing desire to do good things to help the planet. I had already started driving less and riding my bike more for health and environmental reasons. Helping to reduce our dependency on the meat industry seemed like another way to be a good world citizen: It can help conserve land, water and energy resources as well as prevent pollution.

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5 Things Dietitians Wish People Knew About Cholesterol

heart-healthy-foodsBy Justine Britten, Liz Page and Allison Wood

September is National Cholesterol Awareness Month, so it’s a great opportunity to educate yourself about the vital role cholesterol plays in your health.

Most people are aware that you want to have low LDL (“bad”) and high HDL (“good”) cholesterol. But there are a lot of misconceptions about what makes your LDL and HDL go up or down. Should you avoid egg yolks? Should you stick to low-fat foods, or is sugar the real culprit?

To help clear things up, we’ve compiled a list of tips that we, as dietitians, routinely share with our patients — especially those who are trying to improve their cholesterol numbers, or who have a family history of heart disease and want to reduce their own risk.

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Protectors of the Heart

heart-center-for-womenBy Marissa Bergman and Annabelle Santos Volgman, MD

Heart disease long was thought to be solely a men’s health concern, but it’s the No. 1 killer of women as well. In fact, 2013 was the first year since 1984 that fewer women died of heart disease than men. This decline was the result of the tireless work of a small group of women who have dedicated their lives to eradicating the misunderstanding and unequal treatment of women’s heart disease. Since March is Women’s History Month, it’s an apt time to look back on their lifesaving work.

Heart disease first came to medical prominence in 1948 with the start of the long-term, ongoing Framingham Heart Study — which now is in its third generation of subjects residing in the Massachusetts town for which the study is named. It was reported in 1955 that age and sex were clearly risk factors for heart attacks; men suffered from heart attacks as early as their 30s and 40s, while women seemingly were spared, because they had much less incidence and experienced heart attacks about ten years later than men.

By 1979, 30,000 more men were succumbing to heart disease than women, cementing the perception of heart disease as a men’s disease. As a result, medical attention was focused almost exclusively on men and their hearts — the Multiple Risk Factor Intervention Trial started in 1974 only examined one sex.

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Keeping Pace With Atrial Fibrillation

heart-rate-running
By Thurston Hatcher

On a cool, sunny morning last October, as tens of thousands of runners raced east toward downtown, I was watching the Chicago Marathon from eight floors up, in a hospital room at Rush University Medical Center.

Instead of attempting what would have been my 11th 26.2-miler, I was being treated for atrial fibrillation, a type of irregular heartbeat — or arrhythmia — that made it tough for me to run very fast, or very far.

I was diagnosed the previous spring, after weeks of struggling to run the 8:30-minute-per-mile pace that had become routine for me over the last 10 years. Even during relatively brief, three-mile outings, I had to stop every few minutes to catch my breath.

So I went to see my primary care doctor at Rush, who ordered the electrocardiogram that immediately revealed my arrhythmia. To be honest, I wasn’t all that surprised. I had suspected for several years, particularly after long marathon training runs, that my heartbeat was a little off. But even though I’m pretty health-conscious — maybe even borderline hypochondriac — I failed to appreciate that it could be something serious.

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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.