Posts Tagged ‘heart conditions’

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 Should I Know About Coronary Heart Disease

March 10th, 2011 By John Douglas, MD

John Douglas, MD

Heart month 2011 has passed, but it’s always important to keep heart health on the top of your priority list throughout the year. In March, we will focus on coronary heart disease and a unique treatment option Emory physicians are performing for this disease. Let’s start with some background information about coronary artery disease, also referred to here as CAD.

CAD is the most common type of coronary disease. Some of the risk factors for the disease are smoking, hypertension, obesity and diabetes. If you are at risk for coronary heart disease, we recommend lifestyle changes such as:

  • Maintain a healthy weight
  • Quit smoking, or avoid smoky areas
  • Exercise regularly
  • Maintain a healthy diet
    • Reduce intake of animal-based foods and increase plant-based foods
    • Increase fish consumption to increase omega-3 fatty acid intake

Some traditional methods of treatment include:

  • Medical management such as:
    • Cholesterol lowering medications
    • Hypertension reduction medications
    • Aspirin
  • Angioplasty
  • Stents (bare-metal or drug-eluting)
  • Coronary artery bypass
  • Heart transplant (last option)

In the next blog post by Dr. Michael Halkos, we will discuss more fully a newer treatment option that’s an alternative to traditional bypass surgery called coronary hybrid revascularization. The procedure is a less invasive procedure that combines heart surgery with heart stenting. Emory is one of a few centers in the nation studying this procedure.

Do you have questions about coronary artery disease? If so, visit the Emory Healthcare cardiology website at http://www.emoryhealthcare.org/interventional-cardiology or feel free to ask away in the comments section below.

About John Douglas, MD
Dr. John Douglas is an interventional cardiologist at the Emory Heart & Vascular Center. He is also a Professor of Medicine at Emory University School of Medicine and Director of the Interventional Cardiology and Cardiac Cath Lab at Emory University Hospital. He is one of the most tenured Emory cardiologists, beginning his career in 1974. He has been recognized in America’s Top Doctors, Atlanta’s Top Doctors and The Best Doctors in America.

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Increase Awareness of Heart Disease in Women – Wear Red February 4th

February 2nd, 2011 By Kathy Lee Bishop MS, PT, CCS; Manager, Emory HeartWise Risk Reduction Program

Heart Disease AwarenessFebruary is American Heart Month. Almost everyone knows someone who has been affected by heart disease, as heart disease is the number one killer in America. Help increase awareness of heart disease by wearing red on Friday, February 4! Women from all over the country are banding together and pledging to wear red on this special day. Be one of them!

Symptoms of heart disease in women are very different than in men. Women are not as likely to recognize the symptoms and seek immediate treatment. Women can learn to recognize symptoms of heart attacks so they are empowered and can potentially save their own life or save the life of someone else. Some of the most common symptoms of heart attacks in women are:

• Burning sensation in the chest or upper abdomen
• Cold sweat
• Dizziness
• Discomfort such as pressure, aches and/or tightness that can come and go
• Irregular heartbeat
• Nausea
• Pain or pressure in the back or high chest
• Pain or discomfort in one or both arms
• Shortness of breath
• Weakness
• Extreme fatigue

Experts agree that women should become more assertive in their heart care. Attend one of Emory’s seminars during heart month to learn how to live heart smart.

Please feel free to leave a comment if you have any questions or thoughts regarding any of the content listed above or the seminar series!

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Are You at Risk for an Aortic Aneurysm?

January 18th, 2011 By Karthik Kasirajan, MD

Emory Heart & Vascular

An Aortic aneurysm is a serious vascular condition and a leading cause of sudden death in men over 60. Therefore, it is important that we discuss what aortic aneurysms are, possible symptoms and how to treat them.

What are aortic aneurysms?

Aneurysms are abnormal bulges (ballooning) in the wall of an artery. Many aneurysms occur in the aorta (the main artery that carries blood from the heart to the rest of the body). Since the section with the aneurysm is overstretched, it can burst. If the aorta bursts, it usually causes serious bleeding. If not treated very quickly a burst aorta can quickly lead to death.

There are two main types of aortic aneurysms:

  1. Thoracic aortic aneurysms – these aneurysms occur in the part of the aorta that runs through the chest.
  2. Abdominal aortic aneurysms – these aneurysms occur in the part of the aorta that runs through the abdomen.

What are causes/symptoms of aortic aneurysm?

Some medical problems like high blood pressure or hardening of the arteries weaken the artery walls and can result in a weak aortic wall that will bulge.
Unfortunately aortic aneurysms do not usually cause symptoms so we recommend screening tests for aneurysms for men who are in the following categories:

  • 65 to 75 and have smoked in his lifetime or
  • 60 years old and have a first-degree relative (father or brother) who has had an aneurysm.

Some people say they have belly, chest, or back discomfort that may come and go or stay constant. If not diagnosed and treated the aortic aneurysm can lead to other problems such as blood clots that lead to stroke or blood clots that form an aortic aneurysm in the belly or legs.

If you are an older male with high blood pressure, a family history of abdominal aortic aneurysms in first degree relatives that you are at risk for an aortic aneurysm and have been a smoker or alcohol drinker you could be at risk.

If you think you have an aneurysm, we recommend you call your physician and schedule a screening test. Your physician will likely perform an ultrasound, a CT scan, or an MRI to find out where it is and how big it is.

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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A Look at Causes & Diagnosis of Atrial Fibrillation (A-fib)

August 4th, 2010 By Dr. Lloyd


In our last post, Dr. Langberg defined Atrial Fibrillation, or A-fib, as the quivering of the two upper chambers of the heart resulting from disorganized electrical activity, and the most common heart rhythm conditions requiring treatment. Together, Emory University Hospital and Emory University Hospital Midtown perform more than 3,600 electrophysiology procedures per year, including diagnosis and treatment procedures for A-fib. In this post, I’ll examine causes of A-fib and discuss how we diagnose it.

It’s crucial that we identify potential causes of A-fib in order to determine the best approach to treatment. Although we can’t always find the specific trigger, certain pre-existing heart and lung conditions are the most common causes. These conditions include:

-      Thyroid conditions

-      Obesity

-      Obstructive sleep apnea

-      Hypertension (high blood pressure)

-      Coronary artery disease

-      Heart valve disease

-      Heart surgery

-      Chronic lung disease

-      Heart failure

-      Cardiomyopathy (disease in which the heart muscle is weakened)

-      Congenital heart disease

-      Pulmonary embolism (blood clot to the lungs)

Less common causes of A-Fib include hyperthyroidism, pericarditis and viral infections.

In at least 10% of cases, we’re unable to find underlying heart disease or lung conditions. In these instances, A-fib may be related to alcohol, excessive caffeine use, stress, certain drugs, electrolyte or metabolic imbalances, or severe infections. It’s important to note that the risk of A-fib increases with age, particularly after age 60.

Next—how do we diagnose Atrial Fibrillation? There are a variety of methods, but our initial diagnosis begins with a conversation. We ask you about your medical history, including your health habits and symptoms, which may include fatigue, palpitations, chest discomfort, shortness of breath, or dizziness. We also ask about your family history, and then perform physical exams and conduct appropriate tests and procedures. One of the most useful tests is an electrocardiogram (EKG), a painless procedure that records the heart’s electrical activity. With an EKG, we can determine how fast your heart is beating, whether its rhythm is steady or irregular, how strong the electrical signals are when they pass through your heart, as well as how long it takes these signals to reach each section of your heart.

In our next Heart & Vascular post, we’ll explore treatment options for A-Fib at Emory, including innovative therapies and clinical trials.

For more information about the Emory Atrial Fibrillation Program, or to schedule an appointment, please call Emory HealthConnectionSM at 404-778-7777 or 1-800-75-EMORY.

Are you concerned that you may have A-fib? If you have questions or comments about A-fib diagnosis, please let me know in the comments section below.

About Michael Lloyd, MD:

Dr. Lloyd began practicing medicine at Emory in 2007—he specializes in Internal Medicine, Cardiology, and Cardiac Electrophysiology. His areas of clinical interest and research include arrhythmias, electrophysiology lab, and pacemaker. Dr. Lloyd’s organizational leadership memberships include the American College of Cardiology, the American Heart Association, and the Heart Rhythm Society.

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Take a Tour of the Cardiac Rehabilitation Center at Emory

July 14th, 2010 By Kathy Lee Bishop MS, PT, CCS; Manager, Emory HeartWise Risk Reduction Program

In this post, I’d like to introduce you to the Cardiac Rehabilitation Center at Emory Healthcare. The facility offers state-of-the-art amenities, panoramic views, and experienced staff to care for patients following heart attacks, open heart surgery, angioplasty, and stent placement.

Our mission is to help reduce risk factors for heart disease through exercise, education, and support. If you’d like to visit us in person, please call 404-778-2850 to arrange a site visit. We’re available Monday through Friday (except on major holidays) and are located within the Earle B. and Stephanie Blomeyer Fitness Center at 1525 Clifton Road NE in Atlanta. We’ll help you to identify your risk factors and generate a plan to make you healthier.

Here, you can join me on a virtual tour to learn more about what we can offer patients as they recover from heart procedures:

If you have any questions or comments about our facility, please feel free to let me know in the comments section.

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What is Aortic Stenosis?

June 23rd, 2010 By Dr. Block

The word Aortic is derived from aorta, the main artery that pumps blood to the body from the heart. Additionally, the Greek translation of narrow is stenos.  In aortic stenosis, the aortic valve narrows, restricting blood flow from the heart to the body.

Most people are born with three leaflets of tissue over each artery that open and close as the heart beats. If someone is born with two leaflets, they may have premature narrowing of the valve. People with three valves often do not develop aortic stenosis until their 70s or 80s. Unfortunately, we can expect an increase in patients with aortic stenosis as baby boomers approach this age.

Common symptoms of aortic stenosis include:

-        Shortness of breath

-        Chest pain (often increasing with activity)

-        Fainting

-        Weakness

So, what is the science behind these symptoms? Simply put, as the aortic valve narrows, pressure increases inside the left heart ventricle. The left heart ventricle then becomes thicker, decreasing blood flow and causing chest pain. As the pressure continues to rise, blood may back up into the lungs, leading to shortness of breath. If you have a severe form of aortic stenosis, blood may not be able to reach your brain or other parts of your body as easily, causing fainting and weakness.

Typically, diagnosis starts with history-taking and a physical examination. We listen to the heart for a characteristic murmur that signifies a turbulent flow of blood across the narrow valve, and then perform an ultrasound to confirm the diagnosis.

For over 30 years, open heart surgery was the only way to treat aortic stenosis. Emory is the first hospital in the Southeast to study a non-surgical treatment called transcatheter aortic valve implantation.  It involves replacement of the narrow valve with a better-functioning synthetic valve from outside the body. We create a small incision in the groin or chest wall and then feed a wire mesh valve through a catheter, or tube, placing it where the new valve is needed. This technique may extend the lives of many people who are too ill or too frail to endure open-heart surgery.

In our next Heart and Vascular blog post, we’ll delve into more detail about procedures and technology surrounding aortic stenosis.

If you’re concerned that you may have aortic stenosis, we strongly encourage you to contact your physician for a physical. If you have further questions or comments regarding aortic stenosis or any other related condition, be sure to let me know in the comments section below.

Peter Block, MD has been practicing at Emory since 2000, where he specializes in internal medicine and cardiology. His areas of interests include angioplasty, cardiovascular disease, arteriosclerosis, and valve disease. Dr. Block’s major and/or recent publications focus on topics such as Equivalence Trials, Images in Clinical Medicine, and Short-Term Folic Acid Supplementation.

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Ventricular Assist Devices: Hope for the Broken-Hearted

May 16th, 2010 By Dr. Laskar

HeartMate II® LVAD; reprinted with permission from Thoratec Corporation

Many of you are aware of the benefits of heart transplant in patients with advanced heart failure; however, another form of therapy has been quietly emerging as a viable option for patients suffering from this condition.

A ventricular assist device (VAD) is a battery-operated mechanical pump that helps a weakened heart pump blood into the body. Essentially, it takes over the pumping action of the heart and drives blood into the aorta (the large artery that extends from the left ventricle of the heart and into the abdomen) and throughout the body. The device resides both inside and outside of the body, and is operated by an electric motor powered by a battery pack. The controller and batteries are typically worn over the shoulder or around the waist.

In most cases, VADs offer a short-term solution for patients awaiting a suitable donor for a heart transplant, particularly if their medical therapy has failed or if they’ve been hospitalized with end-stage heart failure. According to the United Network for Organ Sharing, over 2,900 Americans are currently awaiting a heart transplant (43 of which are in Georgia).

However, in some cases patients turn to VADs as an alternative to a heart transplant. We refer to this as ‘destination therapy’, meaning that the LVAD serves as a permanent solution for patients with advanced heart failure. Patients who are not heart transplant candidates but who have severe heart failure often pursue this course of treatment.

Ventricular Assist Devices support the left ventricle (LVAD), the right ventricle (RVAD) or both simultaneously (biventricular, or BiVAD). LVADs are used most commonly, and have been in existence for over twenty-five years.

A recent study comparing a new generation LVAD to an older model showed a marked improvement in survival at 2 years (58% vs 25%). In addition, patients reported an improved quality of life. As a result the FDA approved the Heartmate II as destination therapy for patients with end-stage heart failure.

Despite the severity of their illnesses, 70-80% of LVAD patients survive to transplantation.

There are several different types of LVADs, and I’ll go into more detail about specific devices and technology that the Emory Heart and Vascular Center utilizes in a later post. You’ll also hear from two very special patients who have been kind enough to share their stories with us.

Do you have any questions or thoughts about VAD technology or heart conditions in general? If so, please share them with me in the comments.

About Sonjoy Laskar, MD:

Dr. Laskar joined Emory Healthcare in 2005 and has devoted his career to providing direct care to patients with heart failure, heart transplantation and ventricular assist devices, as well as to teaching residents and fellows. He is an active researcher in the areas of echocardiography and ventricular assist devices as destination therapy, and is a member of the American College of Cardiology, Heart Failure Society of America and the International Society of Heart and Lung Transplantation.

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