Hidden heart problem revealed by calcium test
Coronary scan uncovered serious issue for man from Howland
Editor’s note: This is the first of a weekly series focusing on cardiovascular health to be published in February, American Heart Month.
HOWLAND — It was just a twinge. That’s how Bernie Carpenter thought about it.
“I call them twinges. In medical terms, they call them chest pains,” Carpenter, 63, of Howland, said.
With his family history of heart-related issues, Carpenter already was seeing a cardiologist as a precaution. His numbers for blood pressure, cholesterol and other markers always were solid. The twinges were no big deal.
Then his cardiologist retired. Carpenter found himself undergoing a new patient interview with Dr. Fadi Naddour at Trumbull Regional Medical Center. “At the end, he said, ‘I’d like to get a calcium score.’ I’d never heard of it,” Carpenter said.
A relatively recent tool, a coronary calcium CT (computed tomography) scan shows calcified plaque on the walls of the coronary arteries. Calcium can hinder blood and oxygen flow to the heart muscle. The procedure takes about 15 minutes and requires no injection of contrast material.
The next week, Carpenter had an appointment with his personal care physician to review the results.
“He said 100 is good; 300, we need to talk about it,” Carpenter said. “I was at 660.”
At home, his significant other said that he needed to get to the hospital. Carpenter said sure, right after he ran some errands in Akron. She said, “Now.”
After a 10-minute drive to the hospital in Warren that day, Oct. 21,
Carpenter met with Dr. Naddour. “His team was on me like ants on a hot summer sidewalk with ice cream,” Carpenter said.
A heart catheterization — a tube was inserted into his right wrist and followed the artery to the heart — found a 99 percent blockage in a cardiac artery on the right side and a 78 percent blockage in another cardiac artery on the left.
Missie Herman, director of Cardiothoracic and Vascular Services at Trumbull Regional, noted that blockages of up to 50 percent can be treated with medications and diet. “Anything greater than 70 percent gets stents,” she said.
A coronary stent is a tube-shaped implant to keep the arteries open and blood flowing to the heart.
Carpenter awoke from the anesthesia with two stents to deal with his blockages.
“I never felt anything. Everything was smooth,” Carpenter said.
Naddour showed him before-and-after photos and video. “It’s pretty amazing to see your heart on a screen blocked and unblocked. I was really lucky,” Carpenter said.
“I went home the next day,” he said. After five days of resting, he went back to his job in sales and back to playing pickleball three days a week.
Last month, Carpenter was diagnosed with a-fib — atrial fibrillation — which is characterized by extremely fast or irregular beats in the atria, or upper chambers of the heart. On Jan. 6, he was anesthetized for an a-fib shock. Electrical cardioversion gives shocks through paddles to regulate the heartbeat. Carpenter’s heart returned to normal rhythm after one shock.
“The next morning, I played pickleball,” he said. “She (his girlfriend) wasn’t very happy with that. I said I’m going back to life.”
Now Carpenter wears a bracelet that tracks his heart rate and blood pressure.
“One of the things they stressed to me is to listen to your body,” he said. “Before that, I was, ‘It’s me, nothing is going to happen to me.’ But listen to your body. If it (twinges) happens enough that you start remembering it, it’s real.” Especially if you feel your heart racing when you’re at rest, he said.
“Pay attention to your body. It’s pretty smart,” Carpenter said.
He’s changed his diet to cut out things like fried foods, and even ice cream. He continues to play pickleball three times a week. The only restriction his doctors placed on him was to not shovel snow. No problem, he said.
She agreed that a person needs to listen to his or her body. For example, the rare bout of heartburn probably is nothing more than a spicy meal talking back, but continuous or frequent heartburn more likely is a warning sign that the cardiovascular system needs attention, she said. That person should get to his or her primary care physician.
Also, anyone with a family history of heart disease or with high blood pressure, diabetes or other factors that affect the heart’s ability to pump blood should already have a cardiologist, she said.
A-fib is the flutter or racing of the heart, Herman said. Think of it as the electrical and plumbing systems of the house of the heart. A-fib affects the
electrical impulse part of the heart process. Artery blockages clog the plumbing.
Carpenter said that when he chose a new cardiologist, he could have gone to a major facility in Pittsburgh or Cleveland. But knowing that time counts when the heart is in distress, he prefers staying local.
“We have good cardiologists here. Why risk an hour ride when I’m in trouble?” he said.
Heart attack signs
•Typical signs of a heart attack include discomfort in one or both arms, chest, back, neck, jaw or stomach described as pressure, squeezing, fullness or pain.
•It may be sudden and intense, or start slowly with mild discomfort. It may last more than a few minutes, or go away and come back.
A person may have persistent shortness of breath with or without chest discomfort.
• Atypical signs, which are more common in women, diabetics and the elderly, include weakness or fatigue, cold sweats, nausea, vomiting or a feeling of fullness, dizziness or lightheadedness, anxiety, or difficulty breathing.
• Anyone experiencing any of these signs and symptoms should call 911 immediately and get to a hospital right away.
• During a heart attack, 85 percent of the damage takes place in the first two hours.
SOURCE: Trumbull Regional