Bob Miller’s no stranger to the doctor’s office. He’s diabetic.
He’s cancer-free after fighting Stage 3 colon cancer four years ago.
And he’s suffered a widowmaker heart attack at work.
Bob works in distribution at CHI Health St. Elizabeth, making sure hospitals and clinics have supplies when they need them. That day in March, he was at CHI Health Nebraska Heart helping out.
He couldn’t have picked a better place to have a heart attack.
“I woke up that morning with a sore shoulder and stuffiness in my chest,” he says. “I was achy. I thought I had a bug.” At work, he remembers leaning against some shelving because he felt so weak. He collapsed; a co-worker in the room called for help when she couldn’t feel a pulse.
The so-called widowmaker heart attack cut off the flow of blood to the entire left side of Bob’s heart. Without oxygen-rich blood, the side can shut down, causing irreparable damage or sudden death.
“He had s 95% blockage in the early portion of the front artery which feeds the majority of the heart muscle,” says Denes Korpas, MD, the interventional cardiologist who saved Bob. “Some refer to it as the widowmaker because if you are not close to a hospital, there’s a possibility of sudden death.”
It was critical that doctors move quickly to remove the blockage that caused Bob’s widowmaker. They worked so fast, they even beat their own record.
The American College of Cardiology and the American Heart Association have set 90 minutes as the so-called “door-to-balloon” time. That’s the longest it should take from when a patient comes through the emergency room door to when a catheter is threaded through his artery and restores blood flow.
Bob’s door-to-balloon time was a fraction of the recommended 90 minutes. It was just seven minutes.
“Even inside hospitals, seven minutes is exceptional, especially before and after hours. This happened at 6:30 a.m.,” says Dr. Korpas. “Nebraska Heart is a well-oiled machine with superior speed and efficiency of the staff. It’s truly an example of excellent teamwork.”
Nebraska Heart’s average is 20 minutes, again far below the national recommendation.
“He was very lucky he was here,” says Dr. Korpas. “This happening anyplace else would have significantly decreased his chances of survival.”
The prognosis? “Typically, if you open a blocked coronary artery within three hours, people have no or minimal heart damage,” says Dr. Korpas. “Damage is extremely rare if the balloon or stent is placed in the first hour, the ‘golden hour.’”
Bob later found out he’d also been shocked twice before the procedure and was amazed at the teamwork and preparedness: “They worked super fast,” he says. “It amazes me how hardworking they are. Later that evening, I was walking up and down the hallway.”
Bob says family history – on both sides of the family – was a big factor in his heart attack. He’s never smoked, is now changing his diet and intends to use what he’s learned in cardiac rehab to stay healthy.
And he sees Nebraska Heart in a whole new way. “I’d been here maybe 20 different times to work,” he says. “It never even crossed my mind – I never ever thought I’d be a patient here!”
He also marvels that he went to work early that day. If he’d waited five minutes or so, he would have had his heart attack while driving. “And I wouldn’t be around today,” he says. “God definitely put me in the right spot.”
Too Young to Die: Patient Survives Congestive Heart Failure, Stroke and More
He was 35 years old when he was diagnosed with congestive heart failure. But it wasn’t until doctors suggested Josh Van Pelt might need a heart transplant that it hit him how sick he really was.
Josh hadn’t been feeling well for months. He worked overnight, ate fast food a lot and helped himself to the fountain soda machine more than he knew he should.
“I’d been feeling kind of ‘off,’” he remembers. “I was tired all the time.” He thought his health would improve when he changed jobs and started working days. “It didn’t. It was the oddest thing. The symptoms were very similar to the flu.” More months passed and by mid-July, he was hospitalized. His doctor thought he had pneumonia.
Bad got worse. “We found out I was severely allergic to heparin (a blood thinner that prevents blood clots from forming),” he says.
“I ended up with a gigantic clot in my heart.” He was too sick to work and by late October, he turned to a new doctor, a CHI Health St. Elizabeth physician.
“I was having trouble seeing and one day physically couldn’t get off the floor,” he says. “But I was still in a state of denial.” When his wife Stacey couldn’t help him up, she called 9-1-1 and he was rushed to St. Elizabeth’s emergency department. He was hoping he’d be in and out. The emergency medicine doctor quickly set him straight: “You’re going to be here for a while.”
“A while” turned into three weeks. But finally he had a diagnosis. “Heart failure can be difficult to recognize, especially in young people,” says CHI Health Cardiologist Gina Mentzer, MD. “For example, shortness of breath is more commonly caused by respiratory infection than heart failure.” Josh was experiencing multiorgan failure, along with other life-threatening issues. The highly-skilled multidisciplinary care team at St. Elizabeth went to work.
“There were a lot of scared people in my family,” Josh remembers. “Doctors were preparing my wife, parents and brother for my possible death.” There was also talk of a heart transplant.
Then the clot in his heart started breaking up. “One piece broke off and went into my leg. I felt my leg go dead. As they rolled me into surgery, they were concerned they might have to amputate.”
A second clot traveled to his brain and he suffered a stroke. Fortunately, he recovered quickly and a leg amputation wasn’t necessary.
“Even after all that, I was still naïve,” he says. “I thought I’d get out of there and in a couple of weeks I’d be fine and back to normal.”
A diagnosis of congestive heart failure shattered that expectation. But Josh improved enough to begin cardiac rehabilitation at St. Elizabeth. “I was weak but super-happy to be alive!” he says. “I went to rehab three times a week for three months. I was the youngest person there. Many of the patients were elderly. Getting to know them gave me a lot of perspective.”
Josh lost 230 pounds. He’s working out four times a week. With diet and exercise changes, as well as heart failure education at rehab, adjustments to his medications and close followups by Dr. Mentzer, Josh is healthier than he’s been in a long time. When he first came to St. Elizabeth, his ejection fraction (EF, a measurement that determines how well one’s heart is pumping blood) was 25%.
“He’s doing excellent and is a role model patient who is a joy to take care of at Nebraska Heart and St. Elizabeth,” says Dr. Mentzer. “His biggest challenge now is weight loss. I relate this to a vehicle – a small engine struggles to get a big car with a big load around. The smaller the car, the easier the small engine can work. By losing weight, he places less demand on his heart, which will help with further recovery.”
Josh still can’t believe he came close to dying. “It really shakes you up to go through that. To go to my grave at 35 – I don’t want to be remembered that way.” He wants to be remembered as someone who helped people. So he’s back at school, preparing to teach high school and coach sports.
“I can now handle long days!” he says. “Thank God for fantastic doctors and nurses at St. Elizabeth. I feel great. And it’s because of them.”
The most common signs of heart failure are fatigue, shortness of breath, leg swelling and any change in typical physical capacity – for example, not being able to walk around the grocery store like you were able to do recently.
Both St. Elizabeth and Nebraska Heart have comprehensive care programs that provide care at different levels: heart failure coordinators who coach, dedicated heart failure specialists and a program that reaches across multiple hospitals and clinics and works closely with cardiac rehab.
We also have prevention and screening clinics; we emphasize early detection and intervention to avoid worsening of symptoms and hospitalization.
Our program can help modify the effects of heart failure and its symptoms as we work with patients to manage their disease.