heart conditions

Understanding Cardiac Arrest in Athletes Such as Fabrice Muamba

March 27th, 2012 By Emory Heart & Vascular Center

Fabrice Muamba

Source: CNN

Emory Heart & Vascular Center cardiologist Chandan Devireddy, MD recently sat down with the team at CNN to discuss what likely happened to English soccer player, Fabrice Muamba, when he collapsed from sudden cardiac arrest during a game earlier this month.

In the CNN interview, Dr. Devireddy also the cautions and guidelines athletes need to take to diagnose and prevent sudden cardiac death. To get Dr. Devireddy’s full take on cardiac arrest and athletes, check out his interview with CNN here.

Emory’s Heart & Vascular Center is consistently recognized by U.S. News & World Report as one of the top heart health centers in the nation. The Emory Heart & Vascular Center offers services that cover the entire continuum of care, from prevention and early detection to the latest in cardiovascular treatment. In fact, Emory has one of the few dedicated hypertrophic cardiomyopathy clinics (HCM) in the US. Emory’s specialized HCM center offers comprehensive care (surgery, interventional cardiology, genetic testing, etc.), as well as greater experience and expertise.

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Patient Story: Cardiac Robotics as an Alternative to Open Heart Surgery

March 9th, 2012 By Emory Heart & Vascular Center

Barry Chaney is an Emory Heart & Vascular Center patient and Emory Healthcare employee who after having chest pains while working out was told he had to have cardiac bypass surgery to relieve blockages in his heart.

Barry chose the robotic approach to surgery as opposed to traditional cardiac open heart surgery because of the less invasive nature and faster recovery time associated with robotic surgery.  Barry returned to work after 3 weeks and is now back to living an active life! Learn more about cardiac robotic surgery and Barry’s experience with the procedure by watching his amazing story video story below:

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Lone Atrial Fibrillation (A-Fib) – Takeaways from our Heart to Heart

September 7th, 2011 By Dr. El-Chami

Lone Atrial FibrillationThank you for those who were able to participate in the Emory Heart & Vascular Center Live Chat on Arrhythmias last week! You all had great questions and highly engaged. If you could not join me, you can view the Arrhythmia chat transcript here. We covered a lot of different topics. Please feel free to use the comments below to let us know if you have other heart and vascular topics you would like to cover in future live chats, and we will see if we can organize!

During the chat, there were questions I did not have time to answer. Specifically, I told attendees that I’d be posting a follow up blog on Lone Atrial Fibrillation, a less discussed type of arrhythmia that I got some good questions around.

What is Lone Atrial Fibrillation (A-Fib)?

Lone Atrial Fibrillation (A-Fib) is atrial fibrillation seen in patients younger than 60 years with no underlying structural heart disease.  It may be caused by a specific trigger or could occur without any trigger.

What are the possible triggers for Lone Atrial Fibrillation?

Lone A-Fib can be triggered by:

  • Emotional or work related stress
  • Physical Overexertion
  • Alcohol use or overuse
  • Caffeine consumption
  • Infection
  • Dehydration
  • Electrolyte imbalances
  • Drugs (cocaine, amphetamines, etc)
  • Hypoglycemia

Unfortunately, in the majority of cases of Lone Atrial Fibrillation occur without any triggers. It is probably difficult to avoid all the potential triggers for Lone A-Fib.  But when a trigger exists, it is  typically specific to each individual.  There is no consistent way to safely and effectively manage Lone A-Fib episodes, so I recommend you consult your cardiologist to ensure you are taking the most appropriate steps for your particular case.

You can visit our website to learn more about Emory’s Arrhythmia Program.

Dr. Mikhael El-ChamiAbout Mikhael El-Chami, MD
Dr. El-Chami completed his residency at Emory in 2003 and he was nominated for a chief residency year at Emory in 2004. His training in cardiology and electrophysiology also was completed at Emory. His areas of clinical interest include: cardiac arrhythmia ablation, cardiac resynchronization therapy and prevention of sudden cardiac death. Dr. El-Chami holds organizational leadership memberships with the American College of Cardiology and the Heart Rhythm Society. He speaks Arabic and French fluently.

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Surviving an Aortic Dissection: A Patient Survivor’s Story

June 16th, 2011 By Karthik Kasirajan, MD

Karthik Kasirajan, MD

Karthik Kasirajan, MD

In his last blog post, Dr. Veeraswamy outlined what aortic dissection is, what the symptoms are and what you can do to prevent it. Although it is best to detect aortic dissections early, it is possible to survive one. Emory Healthcare patient, Gene Winfrey is a living example. At another local hospital Gene was told he wouldn’t survive surgery to repair the aortic dissection. But Gene is tenacious and decided to schedule an appointment at Emory and he is glad he did. Gene not only survived surgery he is thriving and traveling all over the country as an evangelist. Gene says, “I tell people everywhere I go about Emory and about what happened to me. I am living proof about what happened.”

As mentioned in the last aortic dissection blog, men ages 60 – 70 are most likely to have an aortic dissection and it is relatively uncommon but it is the most common aortic emergency we see at the Emory Heart & Vascular Center. Most patients come in urgently with severe chest or abdominal pain. If not recognized and treated immediately, the tear will go through blood vessel and it is unlikely the patient will survive.

Gene knew he needed help and needed it quickly. We explained to him that if the outer layer of the aorta burst, he would have little chance of living through the dissection. We were adamant that the stent needed to be put in right away.

Luckily for Gene, treatments have changed from the past so he was a candidate for a more minimally invasive method to treat the dissection called endostents. In the past the only way to treat an aortic dissection was through open surgery. The patient benefits from the less invasive ways of performing surgery and is typically able to get home more quickly and return to work sooner with limited complications. Emory is unique in that we have access to devices that are not yet on the market.

Gene had run the Peachtree Road Race 27 straight times before this and wanted to make sure he could maintain his active lifestyle that included riding horses, playing golf and playing tennis.  I advised Gene that he could do whatever he feels like doing, and he is doing just that. He is one of the most active 88-year-old persons  I have ever met!!

Gene summarizes his experience at Emory as follows “They (the other hospital) said we can’t do it. You can’t live through it. I came here and Dr. K said you can. I am 88 years old and still living. I advise anyone to come to Emory, I think it is the greatest in the world.”

Check out our video about Gene and his story below, or visit our website to learn more about Aortic Dissection & Gene’s story:

About Karthik Kasirajan, MD:
Dr. Kasirajan specializes in surgery and vascular surgery, and has been practicing at Emory since 2003. Several of his areas of interest include peripheral arterial disease, endovascular surgery, abdominal and aortic aneurysm, vascular surgery, thrombotic disease, and stroke. Dr. Kasirajan holds many organizational leadership memberships, including the European Society for Vascular Surgery, International College of Surgeons, and the Peripheral Vascular Surgical Society, and is widely published in publications such as the Journal of Endovascular Therapy and the Journal of Vascular Surgery.

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What is Aortic Dissection?

June 1st, 2011 By Ravi Veeraswamy, MD

Aortic Dissection

An aortic dissection is a severe heart and vascular condition where there is a tear in the inner layer of the aorta, a large blood vessel that branches off the heart. Although aortic dissections are rather uncommon, this is a condition that anyone can develop. It is important to learn how to prevent them and when it is necessary to see a physician. Aortic dissections most commonly occur in men between 60 and 70 years old. Sometimes aortic dissection symptoms, outlined below, can be mistaken for other cardiovascular disease.

Aortic Dissection Symptoms

Symptoms of aortic dissection include:

  • Sudden chest of upper back pain that radiates down the neck or back
  • Fainting
  • Stroke
  • Sweating
  • Shortness of breath
  • High blood pressure
  • Weakness or paralysis

Aortic Dissection Risk Factors

Some of the risk factors associated with aortic dissection include:

  • An aortic valve defect
  • Uncontrolled high blood pressure
  • Hardening of the arteries
  • Weakened and bulging arteries
  • Constriction of the aorta

Aortic Dissection Prevention

The best way to prevent an aortic dissection is to follow your physician’s advice and:

  • Maintain a healthy blood pressure
  • Do not smoke, or try to quit smoking
  • Maintain a healthy cholesterol level
  • Maintain a healthy body weight

When Should I See My Physician?

If you have any of the symptoms listed above contact your physician or emergency medical assistance. You may not have an aortic dissection, but it would best to get it checked out as you may have other heart or vascular disorders.

Aortic Dissection at Emory Heart & Vascular

Emory Heart & Vascular Center cardiologists, cardiothoracic surgeons and vascular surgeons work together to treat patients with aortic dissections. If detected early, a patient’s chance of survival is improved. We believe that if you can maintain a healthy heart if you pay attention to the keys to prevention, understand symptoms and work closely with your physician.

About Ravi Veeraswamy, MD

Dr. Veeraswamy specializes in surgery and vascular surgery, and has been practicing with Emory since 2006. Some of his areas of clinical interest include aortic aneurysm, carotid endarterectomy, peripheral arterial and vascular disease, and vascular surgery. Recently, Dr. Veeraswamy has published articles in the Washington University Manual of Surgery, Vascular and Endovascular Challenges, and the Annals of Vascular Surgery.

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Learn About Atrial Fibrillation (A–Fib) in new Physician “Ask the Expert” Video Series

April 7th, 2011 By Dr. Leon

Atrial Fibrillation Ask the ExpertsAs we have discussed in previous blogs on the topic of arrhythmias, atrial fibrillation, also referred to as A – Fib, is the most common irregular heart rhythm in the United States.  It is so prevalent that over 2 million Americans suffer from it. Even though it is not directly life threatening, it can lead to other heart problems such as congestive heart failure and stroke, as well as shortness of breath, dizziness, chest discomfort and palpitations.

The physicians in Emory’s Arrhythmia Program talk about various arrhythmia topics and how to best manage your condition in our new “Ask the Expert” video series.

You can also view past blogs about arrhythmia including:

If you have further questions or think you may have A- Fib after viewing our atrial fibrillation videos, please call Emory HealthConnection℠ 404-778-7777 to speak with a nurse.

Do you have questions about this procedure or about A-Fib in general? If so, please let me know in the comments section.

About Angel Leon, MD:

Dr. Leon is a Professor of Medicine and the Chief of Cardiology at Emory University Midtown. His specialties include electrophysiology, cardiology, and internal medicine, and his areas of clinical interest include arrhythmia ablation, electrophysiology lab, and pacemaker. Dr. Leon holds organizational leadership memberships with the American College of Cardiology and the American Heart Association. He has been practicing with Emory since 1991.

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Coronary Artery Disease Treatment – A Patient Story

April 5th, 2011 By Dr. Halkos

Michael Halkos, MDMichael Armstrong joined the gym to get some aerobic exercise and lose some weight. One day, he was walking on a treadmill when he noticed pain in his chest as well as pain that went up into his throat. The pain then began radiating down his left arm.

Michael has worked in the health care industry for many years, so he quickly realized what he was experiencing could be signs of a heart attack, and he consulted his primary care physician. Michael told his physician about the symptoms and the physician quickly referred him to me at Emory University Hospital Midtown for an innovative procedure called hybrid coronary revascularization.

As I mentioned in my previous blog post about hybrid coronary revascularization, this procedure is typically performed on a patient who has blockage in the artery in the front of the heart and one other blood vessel with disease in it. This unique approach is a best of both world’s strategy where we combine durability of surgery with the minimally invasive nature of a procedure called stenting. Optimal therapy with this minimally invasive approach translates into shorter recovery time, potentially fewer complications and a quicker return to work. Emory is one of only a few centers in the nation offering this procedure.

Michael Armstrong sums up his experience:

“I didn’t know what to expect, this was my first hospitalization in my life but I was comfortable getting my heart care at Emory University Hospital Midtown. Dr. Halkos had done more than 100 robotic surgeries so I was very impressed with that. Dr. Halkos knows the road you are about to take together is treacherous and comes across as very knowledgeable while still friendly and empathetic.  Now shortly after the surgery, I am back to full exercise, I walk around the neighborhood with my wife, and even last weekend I walked to the top of Stone Mountain with a friend. That made me feel good. I know Emory talks about quality patient and family centered care, but actually experiencing it was pretty wonderful.”

Watch Michael’s story in this video.

Do you have questions or feedback? If so, please leave them in the comments section below.

About Michael Halkos, MD
Dr. Halkos is a cardiothoracic surgeon at the Emory Heart & Vascular Center. He specializes in minimally invasive adult cardiac surgery. He is leading the innovative Emory work with the hybrid coronary revascularization procedure being performed at Emory University Hospital Midtown. He finished his Medical School, Residency and Fellowship at Emory University School of Medicine and is a member of the American Medical Association.

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New Treatment for CAD – Hybrid Coronary Revascularization

March 15th, 2011 By Dr. Halkos

hybrid revascularization treatment for CADIn our last blog, Dr. John Douglas discussed Coronary Artery Disease (CAD). Now, we will cover a new procedure to treat CAD, called Hybrid Revascularization, that we are performing at the Emory Heart & Vascular Center.

Currently, Emory is one of the few centers in the country offering this procedure. Standard guidelines call for patients with blockages in the left main artery (the artery that provides most of the blood to the heart) to undergo bypass surgery.

Hybrid revascularization’s advantage is a combination of coronary artery bypass surgery (CABG) and percutaneous coronary intervention (PCI). Emory physicians are leaders in performing these procedures “off-pump” in a minimally invasive fashion, without breaking open the chest.

The minimally invasive CABG procedure uses robotic-assisted techniques that allow surgery to be performed using small incisions between the ribs rather than through a midline incision dividing the sternum.

The recovery from robotic assisted CABG is shorter and expected to have fewer complications. Impressively, most patients are able to leave the hospital within three to four days and return to full activity, including work, in two to three weeks rather than the two-month recovery generally required following traditional CABG.

This approach is a “best of both worlds strategy”- minimally invasive off-pump left internal mammary artery (LIMA) graft plus a stent placed via ultrasound from the left main to the left circumflex artery.

For more a case study about this procedure view the March issue of The Chamber, our heart and vascular e-newsletter.

About Dr. Halkos
Dr. Halkos is a cardiothoracic surgeon at the Emory Heart & Vascular Center. He specializes in cardiovascular disease, coronary artery bypass surgery and valve repair/replacement. He finished his Medical School, Residency and Fellowship at Emory University School of Medicine. He is a member of the American Medical Association.

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The Emerging Role of Fenestrated & Branched Aortic Endografts in the Treatment of Complex Aortic Aneurysms

January 25th, 2011 By Dr. Ricotta

Dr. RicottaAs Dr. Kasirajan mentioned in the last blog about aortic aneurysms, this condition can cause serious medical issues or even death. For patients with large complex aneurysms, there is a new procedure that we are performing at the Emory Heart & Vascular Center called a fenestrated and branched stent graft. This procedure is a viable option for patients who may have once been considered inoperable. These grafts are now used in select high-risk patients with complex aneurysms that are located throughout the entire length of the aorta.

In addition to being a safe and effective option for high-risk patients, fenestrated and branched endograft implantation provides patients with a number of benefits including:

• No incisions
• Shorter hospital stays (one or two days vs. 10 to 14 days for open surgical repair)
• Quicker recovery

Unfortunately, these devices are not yet commercially available in the United States. In countries where they are available, the grafts must be customized for each patient, a process that can take up to 12 weeks. During this time patients are at risk for a rupture in their aneurysm. As an alternative since 2007, several vascular surgeons in the United States have been custom-making fenestrated and branched stent grafts using available components.

Emory currently is one of only a few institutions in this country and the only one in the Southeast that offers these investigational procedures.

Fenestrated and branched endografts appear destined to play a key role in the management of complex aortic aneurysms. Research results have shown that these devices are both safe and effective in treating carefully selected patients, with low incidence of complications. Although additional research is needed to substantiate these results, Emory is poised to participate as a primary site in proposed clinical trials of these innovative devices.

You can learn more about Emory’s fenestrated and branched aortic stent graft program at www.emoryhealthcare.org/vascular

Do you have questions about fenestrated and branched aortic endografts? If so, feel free to ask away in the comments section.

About  Joseph J. Ricotta, MD:

Dr. Ricotta specializes in vascular and endovascular surgery, and came to Emory from the Mayo Clinic in August 2010.  His areas of clinical interest include fenestrated and branched endografts to treat aortic aneurysms, thoracoabdominal aortic aneurysms, peripheral aneurysms, PAD, carotid endarterectomy and carotid stenting, mesenteric and renal artery disease, and venous diseases.  He has authored several journal articles and book chapters on the topic of fenestrated and branched endografts, and holds organizational leadership memberships at the American Medical Association, the American College of Surgeons, the Society for Clinical Vascular Surgery and the Society for Vascular Surgery.
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Coronary Artery Calcium Scoring: What Does it Involve?

December 17th, 2010 By Dr. Raggi

As we’ve mentioned in previous blog posts, atherosclerotic plaque is made up of a combination of fat, cholesterol, and calcium beneath the inner layer of the arteries. The coronary arteries supply oxygen-rich blood to the heart, and the presence and severity of calcified plaque in these vessels is an indirect way to assess the presence of atherosclerosis. The sudden rupture of one of these plaques can cause a heart attack, which is why it’s crucial to know if an individual has accumulated large amounts of atherosclerosis.

An easy way of accomplishing this is through a cardiac CT scan—with this non-invasive method we obtain information on the level of calcified plaque build-up. If calcified plaque is detected, atherosclerosis of the coronary arteries (coronary artery disease: CAD) is present. Two-thirds of heart attacks aren’t caused by the narrowing of the coronary artery, but as I mentioned—by plaque rupturing within the artery wall.

With CT scanning we calculate a calcium score, which measures the extent of plaque burden on your arteries. We report 3 pieces of information with the calcium score: 1) your own absolute score 2) your percentile of calcium score, which tells you how you rank in comparison with people of the your age, sex and race, and 3) your estimated “vascular age”; this is an estimation of how healthy (i.e. young) or diseased (i.e. older) your coronary arteries are compared to people with similar backgrounds, and therefore gives you an indication of your relative risk.

Other components of our Heart CT scan screenings include:

Blood Pressure

If your blood pressure measures over 140/90 mm Hg, it is considered to be at a high level. Some people refer to high blood pressure as “the silent killer” because it can cause severe damage on the body with little to no symptoms.  In fact, it can cause strokes, heart disease and damage to your kidneys or eyesight if left untreated.

Fasting Glucose

The fasting glucose test measures your blood sugar level for the presence of early diabetes. While diabetes is a treatable condition, it may not manifest for years, and can cause damage to your heart and vessels without you realizing it.

Framingham Risk Score

The Framingham Risk Score indicates your risk of experiencing a heart attack within ten years, and is based on a combination of factors such as your age, sex, your blood pressure and cholesterol level.

Overall Cardiovascular Risk

This measurement results from the combination of your Framingham Risk Score and calcium score.

Emory’s comprehensive cardiovascular screening is very reasonably priced at $150, and includes all of the components listed above.

If you have any questions about our Heart CT scans, please let me know in the comments.

About Paolo Raggi, MD:

Dr. Raggi specializes in Internal Medicine and Cardiology, and has been with Emory since 2006. His areas of clinical interest include cardiac CT and MRI, echocardiography, nuclear cardiology, arteriosclerosis and lipids, cardiovascular disease, hypertension, and valvular disease. Dr. Raggi is fluent in Italian, Spanish, and French, and holds Organizational Leadership Memberships at the American College of Cardiology and the American College of Physicians.

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