Advances in Cardiac Care Offer New Hope for those Suffering from Heart-Related Diseases
Few health conditions are as frightening as heart disease, which can seemingly strike at any time, often with fatal consequences. According to the U.S. Centers for Disease Control and Prevention, “Heart disease is the leading cause of death for both men and women. About 630,000 Americans die from heart disease each year,” which accounts for one in every four deaths.
Cardiovascular disease, which affects the heart and blood vessels, can take many forms, including stroke, which is the fifth leading cause of death in the U.S. Common heart conditions include heart attack, irregular heart rhythms, heart failure, congenital heart defects, blocked arteries and blood clots, and structural heart defects such as leaky heart valves.
Although cardiovascular disease can be potentially catastrophic, area physicians point to improvements in screening, diagnosis, and treatment that can help people prevent heart disease and lead healthier lives, even after a heart attack.
Know Your Risk Factors
When it comes to heart disease, we may be our own worst enemies. Although some risk factors are beyond our control, such as age, gender and a family history of heart disease, it turns out that poor lifestyle choices are among the leading causes of heart disease. Cardiologists point to such major risk factors as smoking, obesity, lack of exercise, diabetes, high cholesterol, and high blood pressure, otherwise known as hypertension.
The American Heart Association recently changed its guidelines for high blood pressure, reducing the definition of a high reading from 140/90 to 130/80, while normal is now 120/80. Patients with high blood pressure often are prescribed medications to lower their blood pressure and are encouraged to make lifestyle changes to decrease their risk of developing heart disease.
“Most people require more than one blood pressure medication,” says Andrew Rauh, M.D., a member of the Chicago Metropolitan Board of the American Heart Association and a cardiologist with the DuPage Medical Group, Edward-Elmhurst Health and Advocate Health. “The real push with the new guidelines is not medications, but making the population healthier.” He recommends following a plan developed by the American Heart Association called Life’s Simple Seven that guides people to address the risk factors related to lifestyle. “All of us are born with good cardiac health,” he states. “By age 50, only one percent of us have it.” He encourages people to adopt a healthy lifestyle for their own benefit, as well as for their children and grandchildren.
At Advocate Good Samaritan Hospital in Downers Grove, cardiologist Gaile Sabaliauskas, M.D., started a program that is now used in all Advocate hospitals. It tracks cancer patients receiving certain types of chemotherapy and radiation treatment that may put them at higher risk for uncontrolled hypertension or heart damage.
“We developed a screening protocol similar to what is used at the Cleveland Clinic, which screens whether the patient is at high risk or not, depending on the type of chemotherapy and their risk factors.” Cancer patients at higher risk are urged to see a cardiologist who is familiar with the possible effects of chemotherapy and to continue to be screened after treatment. “What we’re discovering from research is that heart failure can develop ten years down the line,” she cautions.
Focus on Prevention
Ben Franklin might have been talking about cardiac disease when he coined the adage, “An ounce of prevention is worth a pound of cure.”
“Ninety to ninety-five percent of cardiovascular care is on the front end, in prevention,” explains Bharat Samy, M.D., an interventional cardiologist with AMITA Health in Elk Grove Village. He takes a long view of prevention, wishing he “could see all the patients we see in the emergency room ten years before.” He encourages patients to make incremental changes in their eating and exercise habits in order to lead longer, healthier lives. “It’s all about setting the stage,” he says. “What you do now affects the rest of your life.”
Although new high-tech screening methods to detect heart problems are enabling earlier diagnosis, he says, “With prevention, a lot of it can be done with low-tech means,” such as regular blood pressure tests, cholesterol tests, and blood sugar monitoring. He recommends that people see a primary care physician at least once a year after age 35 to 40 to get screened. For patients with specific risk factors, he and other cardiologists recommend getting a coronary calcium scan, which can indicate early plaque build-up in the arteries.
Loyola Medicine has opened a new Cardiac Prevention and Lipid Clinic at the Loyola Center for Health in Burr Ridge, aimed at people at high risk for heart disease, those with heart problems, and those with uncontrolled high cholesterol. “Everything we do is focused on reducing risk,” says Verghese Mathew, M.D., director of cardiology for Loyola Medicine. The Loyola system offers high-tech screening and imaging tests, including a new fractional flow reserve-computed tomography (FFRCT) scan that reveals blood flow through the arteries to indicate if plaque is restricting the flow. The test can help cardiologists determine whether bypass surgery or a stent would work best to open up blockages. Mathew says he has seen tremendous progress in the development of medical devices that can lower the risk to the patient and add years to their lives.
Another boost to prevention is that high-tech imaging is now detecting potential heart problems even before symptoms appear. At Northwestern Medicine’s suburban locations at Central DuPage Hospital and Delnor Hospital, Waleed Ahmed, M.D., director of advanced cardiac imaging, sees promise in a number of new technologies that can reveal hidden problems, including cardiac MRI with four-dimensional blood flow and three-dimensional echocardiography. In the hope of expanding the availability of heart screening, he shares that Northwestern is participating in a study of an artificial intelligence system developed by Bay Labs in San Francisco that would enable staff in primary care offices to conduct basic cardiovascular ultrasound scans.
Find Advanced Care Close to Home
Not that long ago, people with complicated heart conditions felt the need to travel downtown or even out of the Chicago area to access the latest technology and treatments. Now, hospitals throughout the western suburbs are offering the most advanced procedures. According to Paul Silverman, M.D., cardiologist with the Advocate Heart Institute, “Tertiary community-based hospitals are able to provide services that formerly could only be performed in an academic medical center.”
He explains that new minimally invasive treatments allow cardiologists to treat patients without resorting to open heart surgery and its risks, often by using a catheter to reach diseased areas through a blood vessel. “One of the biggest things that has happened in the last few years is with structural heart disease,” he says. He gives the TAVR procedure (transcatheter aortic valve replacement) as one example, where a cardiologist and surgeon work together to insert a catheter through the groin and replace the heart valve. “It’s amazing, almost miraculous.”
Edward-Elmhurst Health is developing a new Cardiac Innovations and Structural Heart Center at the Edward Heart Hospital in Naperville. According to Mark Goodwin, M.D., interventional cardiologist with Advocate Medical Group and system medical director of the new Edward center, the goal is to make it easier on the patient by coordinating care, bringing together a “high end group of doctors and nurses and the latest innovations.” He reports that the center is the only place in Illinois to use the Shockwave Medical Lithoplasty System, a new device that treats blocked arteries.
Other new technologies that Goodwin and other cardiologists say offer effective treatment include WATCHMAN, an implanted device used for atrial fibrillation, which can eliminate the need for blood-thinning medications, the Micra leadless pacemaker that is “smaller than a small jelly bean,” which can be implanted in the heart, and the MitraClip used to treat heart valve leakages.
For the most severe cases, patients still may need to travel a bit further from home. Those suffering from heart failure, who need a heart transplant, can find those specialized services at Northwestern Memorial Hospital, the University of Chicago, and Rush University Medical Center in the city, and in the suburbs at Loyola University Medical Center in Maywood and the Advocate Heart Institute in Oak Lawn. Those waiting for a transplant also may be implanted with ventricular assist devices to keep the blood circulating at those locations as well as at Edward Heart Hospital.
Living with Heart Disease
Following a heart attack, surgery or the diagnosis of other major heart problems such as heart failure, patients find that living with heart disease can present immense challenges. At Northwestern in the western suburbs, cardiologist Michelle Montpetit, M.D., notes the importance of follow-up care. “We focus on treating from the hospital to months out and the transition of care,” she explains. At Central DuPage Hospital and Delnor Hospital, a nurse coordinator keeps in touch with heart failure patients to ensure that they are taking the appropriate medications and to monitor their condition. Montpetit, who specializes in heart failure treatment, notes that new medications, such as Sacubitril/valsartan, are helping patients live longer, while a CardioMEMS monitoring device can be implanted to monitor fluid build-up and prevent repeat hospitalizations.
For some heart patients, outside help for recovery comes right to the bedside, in the form of a visitor from Mended Hearts, a national non-profit organization that provides peer-to-peer support for people living with heart disease. At Advocate Sherman Hospital in Elgin, one of the first community hospitals to perform open heart surgery starting in 1972, volunteer and former bypass patient Bill Gronow has been visiting heart patients for about 20 years. In that time, he has seen the number of open heart surgeries decline dramatically, as minimally invasive techniques have been introduced. What hasn’t changed is the impact that heart disease can have on a person’s outlook, often leading to depression. “We’re not medical people and we don’t give medical advice,” Gronow says. “We encourage them and give them hope and support. With the right recovery, they can live a normal, productive life.”Edit Module