Patient Success Stories
'He was healthy and fit' 9-minute heart attack survivor finds reality defies statistics
Nine minutes. That was the time it took to open John Gallagher Jr.'s blocked coronary artery, spare his heart muscle and save his life.
But that may not have been the case if someone hadn't called 9-1-1. Or brought him to the right hospital.
Cardiologist Christine Zirafi, MD, says it's critical to recognize the symptoms of a heart attack and quickly go to the nearest hospital that can help you. In Gallagher's case, that was Parma Community General Hospital.
"You want to go to the closest facility that has interventional capabilities," says Dr. Zirafi. "If you're having symptoms, don't think because you don't have any risk factors, it can't be heart problems. Risk factors aren't everything. Always come to the hospital."
The absence of risk factors can fool a person. Gallagher was a classic example of this. His cholesterol was normal, he had no personal or family history of heart problems and he just returned to his Independence office building from a lunchtime workout.
Then he collapsed.
"I remember walking up on the floor," says Gallagher, now 65. Bystanders assisted him and called an ambulance, which brought him to Parma Hospital. Marymount Hospital, where he would typically go as a Cleveland Clinic patient, does not have a high-risk catheterization lab for interventions, and he would have to be taken by helicopter to another hospital, delaying his care by precious minutes.
Parma Hospital's Cardiac Catheterization Lab is recognized regionally for expediting heart attack patients. A "Code STEMI" is called when an EKG indicates they are having an ST-Elevated Myocardial Infarction, or heart attack. This call readies the Cath Lab team for a heart attack patient who is en route- another benefit to calling for an ambulance rather than getting a ride from a family member or neighbor.
Hospitals have been exceeding the national standard of 90 minutes for door-to-balloon time (D2B time), measured from the moment the patient comes through the Emergency Department doors to the minute the balloon opens the blocked artery (angioplasty) in the Cath Lab. Parma Hospital's average D2B time this year is 56 minutes, with routine D2B times of 14, 15 and 17 minutes.
Gallagher's door-to-balloon time was 9 minutes.
"If you do the simple math, it's pretty impressive," said Gallagher, who lives in Broadview Heights and spend just one night in the Heart Center after his catheterization. "It was a good experience. Everybody was extremely nice."
Recognizing the warning signs, no matter how otherwise healthy you have been, can save your life.
"He was healthy and fit", said Dr. Zirafi. "And yet he recognized what was going on and got help."
Informed Winter 2011
ER doctor experienced own emergency
John Lazo Jr.,MD, reasoned away the winded weariness he felt after even brief sessions of yard work, chalking up to the heat and added weight that had accumulated through the years.
When scheduled for an evening shift in Parma Hospital's Emergency Department, this physician of 33 years, who once had boundless energy, was now having to take a nap before work. Like most people, the 64-year old assumed he was "just getting older."
"I didn't have the energy, and I didn't have the stamina anymore," said Lazo. "I thought I was feeling OK for someone who was overweight and out of shop, and I thought 'Well, I'm not as young as I used to be.' I was denying the obvious.
A shopping trip sealed his fate. One day at a home improvement store, after pushing a cart loaded with lumber all the way to the checkout, he arrived beside the cashier looking ashen. Dizzy and lightheaded he called his wide, Donnalynn. His next call was to his cardiologist.
The aortic stenosis Gerald Burma, MD, had been monitoring had now suddenly gotten markedly worse. The frequent exhaustion Lazo had been feeling was the failure of his aortic valve to fully open when blood flows from the heart into the aorta, the main artery carrying blood to the rest of the body.
Lazo definitely had been feeling more tired but had never experienced any chest pain. Nevertheless, Dr. Burma performed a cardiac catherization that confirmed severe aortic valve disease and also discovered an 80% blockage of another artery. Dr. Lazo was now "patient Lazo." After consultation with Joseph Lahorra, MD- a Cleveland Clinic Cardiothoracic surgeon who has been a member of Parma Hospital's medical staff since the Heart Center opened- the surgery was set, and the type of valve replacement and bypass was determined. Leading up to his surgery date, Dr. Lahorra warned Lazo to stay within 30 minutes of a hospital at all times.
"Aortic stenosis is a progressive process," Dr. Lahorra said. "Once the narrowing is in the severe range and symptoms have developed, patients do not survive very long without surgery to replace the valve. John's aortic valve had reached a critical degree of blockage. He had arrived at the edge of a very dangerous precipice and needed aortic valve replacement not only to restore his quality of life but to preserve his life."
Lazo spent five days recovering in the Heart Center following a surgery that lasted over six hours. Specially trained nurses and doctors gave him the same personal, attentive care that all their patients receive. His wife, who had abundant confidence in Dr. Lahorra and the staff, said she felt somewhat guilty at times that she wasn't more worried about the outcome. They went in with a positive attitude, focusing on a future of growing old together and enjoying their grandson.
"I was amazed at how good I was feeling," Lazo recalled. "Even on the third or fourth day after surgery I was feeling better than I had before the surgery." Once he had returned home, he restricted salt intake and scrutinized calories in everything he ate. He began attending Cardiac Rehabilitation, a supervised exercise program for patients who have had surgery or a cardiac event. Now six months after his surgery, Lazo has dropped more than 38 pounds.
Annual CT scans will be done to check the diameter of Lazo's aorta and ensure that there is no leakage or disection. Lazo continues to take maintenance medications for high blood pressure and cholesterol.
And now he's looking forward to the warm weather instead of dreading it.
"I'm looking forward to running and playing with my grandson, now that I feel I've been given a new lease on life," Lazo said.
Symptoms of Aortic Stenosis include:
- Breathlessness with activity
- Chest pain, including pressure, tightness, squeezing or crushing
- Fainting, weakness or dizziness with activity
- Pain increases with exercise, relieved with rest
John Lazo Jr., MD, Informed Summer 2011
A heart attack at 40
On June 16, 2010, I had a massive heart attack and was rushed to Parma Hospital. Thank goodness for Parma Hospital. From the time I hit the door until I had two stents in my heart, it was 16 minutes. The doctor said had I gone another 10 minutes, I probably would not have made it. The Hospital was absolutely fantastic and I can't say enough about them and the care I was given.
Trish Rohman, Informed Summer 2011
Macedonia woman declares: "Take me to Parma"
Dolores Kever insisted on going to the hospital that would give her the best chance of recovering from a massive heart attack.
So the emergency team at Sagamore Hills medical center put her on a helicopter and sent her to Parma Hospital, known across the region for superior success with heart attack response.
"I didn't want to go where they'd tell me there was a problem, but they couldn't fix it," said the woman, who can't shake the memory of feeling like a truck had been parked on her chest.
"Before I knew it, I was at Parma Hospital. I'm glad they brought me here."
Kever's heart attack was compounded by multiple health problems, including congestive heart failure and pericarditis.
The heart attack was stopped in minutes by balloon angioplasty, performed by Jaikirshan Khatri, MD, a cardiologist at Parma Hospital. Kever was stabilized and admitted to the Heart Center. Within 48-hours, Jamie Cohen, MD, another cardiologist with the Cardiovascular Medicine Associates, performed a second angioplasty to open two other vessels that were almost completely blocked.
"The longer the heart muscle is not getting enough blood supply, the greater the injury," said Dr. Cohen. "The first angioplasty is key to the patient's survival. The second intervention was a key element in her improvement."
"She's really done well, all things considered. She was pretty sick. After the second intervention things seemed to stabilize pretty quickly."
The two cardiac interventions were effectively equivalent to coronary bypass surgery. The difference with this less invasive procedure, including a radial approach that involves putting the catheter through the wrist instead of the groin, is a stronger chance of solid recovery.
"With her age and her kidney disease, the risks of surgery are extremely high," Dr. Cohen said. "With angioplasty and stenting, we can safely, with very little morbidity and shorter recovery, achieve perhaps better results."
Kever had a pleasant week long recovery in the Heart Center, where she was already planning lifestyle adjustments,
"There's going to be some changes," said Kever. "I'll have no one to blame but myself. They brought me this far."
Dolores Kever, Informed Spring 2011
Cardiac team saves lives like clockwork
It’s no surprise to Jim Hatfield that Parma Hospital is among the 100 Top Hospitals in the nation for cardiovascular care.
Brought to Parma Hospital by ambulance on an August afternoon, the Brecksville resident was facing the most serious health crisis of his life. A longtime patient of another hospital, he had never set foot in Parma Hospital before. Now he won’t go anywhere else for his health care.
The 100 Top Hospitals listing is the result of a comprehensive study of nearly 1,000 hospitals nationwide using publicly available data over the past two years. The study reveals that the U.S. hospitals recognized for the best clinical outcomes also treat patients in less time and at a lower cost. If all cardiovascular hospitals achieved the same results as the 100 Top Hospitals award winners, more than 7,000 lives would be saved and nearly 750 medical complications would be avoided annually.
“The people (at Parma Hospital) put me at ease quickly with their interest in providing great care,” says Hatfield, 70. “This award was well-deserved, based on my experience.”
Hatfield arrived at Parma Hospital in the throes of a heart attack and cardiogenic shock. Though he had experienced intermittent chest pain for more than three years, the hospital he previously went to for his care had never performed a cardiac catheterization. Parma Hospital immediately did an emergency catheterization, modified to spare serious damage to his weakened kidneys, which cleared a 99-percent blockage. After the cath, he underwent triple bypass surgery and a heart valve repair.
Recovery took place in the Heart Center, which cares for cardiac surgical and interventional patients. During his stay, Hatfield benefited from the consistent care of experienced nurses until his discharge.
Cardiothoracic surgeon Joseph Lahorra, MD, was kind but direct in explaining to Hatfield the seriousness of his situation, especially after the patient’s heart raced so fast that it stopped beating – just one of the times staff jumped in to save his life.
“I spent all my life in research and development,” says Hatfield, a stocktrader. “I didn’t want any sugar coating, and Lahorra and the other doctors and nurses were really good at telling me how it really was. Everybody thought my chance of survival was slim. Dr. Lahorra came in one evening, took my hand and said, ‘You’re walking out of here.”
Lahorra gave Hatfield the boost he needed most – and the fortitude to fight.
“You have to motivate patients,” says Dr. Lahorra. “His survival is truly a testament to the team here.”
And he did. Hatfield’s lungs and kidneys slowly revived and Cardiologist James Ramicone, DO installed a defibrillator that would shock his heart back into rhythm if it stopped again.
Later in the year Hatfield returned to Parma Hospital’s Coronary Care Unit when his congestive heart failure acted up. Again, the care did not disappoint.
“I received world-class care at Parma Hospital,” says Hatfield. “The staff was not only attentive and professional but seemed to have a sincere personal commitment to going the extra mile in providing their patients with the best care and comfort possible.
“I am now using doctors affiliated with Parma for all my health needs.”
Jim Hatfield, Informed Spring 2008