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TAKING THEIR HEALTH TO HEART
Three southeastern Wisconsin women with three unique cardiac challenges, plus how local medical professionals diagnose and treat these conditions


By MARK CONCANNON

February 2017

A Life-Extending Monitor

For Miranda*, CardioMEMS allowed her to see her 24th grandchild. Last April, Miranda, who underwent bypass surgery almost five years ago, found herself unable to breathe. Doctors found she was retaining large amounts of fluid related to heart failure. Her medical team was able to relieve the retention problem and suggested she try CardioMEMS, the first and only FDA-approved heart failure monitoring system proven to reduce hospital admissions among heart failure patients classified as Class 3 or worse.

CardioMEMS is a small monitor that measures the pressure inside the pulmonary system. “It’s a gold standard way to measure the body fluid,” says Dr. Matthew Weinberg, a cardiologist and director of the Congestive Heart Failure Clinic at ProHealth Care.

The device comes with a pillow on which the recipient lies each day. The pillow downloads pulmonary pressure information daily and sends it to clinic staff. If irregularities or worrisome trends are detected, the device recipient is contacted and changes in medicines or food intake are made.

The implantation of CardioMEMS is a simple procedure. A small incision is made in the leg, a catheter is run to the heart, and the device is inserted. It’s the size of a small coin and contains loops, which eventually embed into the side of the vein. It remains charged by blood flow and never runs out of energy.

The beauty of CardioMEMS is that it detects potential problems patients may not even know they’re experiencing. It reduces hospital visits and cuts down on the number of crisis events, all of which eventually weaken an already-compromised heart.

Weinberg says there are currently 20 patients under monitor at the heart clinic. No one has returned to the hospital since receiving CardioMEMS.

As for Miranda, the Waukesha County resident and former nurse is ecstatic. “It really has changed my life,” she says. “It’s extended it for sure.”
 

The Cardio-Oncology Link

For Gerren*, her breast cancer diagnosis was a complete shock. The young mother of two is an athlete and participates in marathons and triathlons.

But another shock came when it was discovered that the very drugs combating her cancer were responsible for decreasing the efficiency of her heart.

Enter the team at the Karen Yontz Center for Cardio-Oncology at Aurora Health Care. A little more than one year old, the center includes a group of health care individuals from a wide spectrum of medical specialties. The team works together for patients fighting cancer who may be at risk of developing heart issues because of the cancer treatment.

Dr. Vinay Thohan is part of the team. He explains that it’s more than a coincidence that cardiovascular problems are the leading cause of death for cancer survivors. In general, cancer survivors have a higher incidence of cardiovascular disease than the rest of the population, he adds.

The cardio-oncology program seeks to identify people undergoing chemotherapy who may be prone to heart problems and then intervene early, before more damage is done. “Prevention is a lot better than treating,” Thohan says.

Also part of the team’s mission is education, early screening,

and a plan to use Aurora’s vast patient record database to find past chemo patients who may have developed heart problems that went undiagnosed.

In Gerren’s case, her decrease in heart activity was identified during chemotherapy treatment, and doctors suspended the treatments to deal with her heart issues. Chemotherapy was then successfully resumed, and today she is cancer-free and training for her next race.
 

The Team Approach

For Carol*, it started with shortness of breath just over one year ago. She visited her doctor.

And then she was told she had three months to live.

When the 68-year-old Muskego resident was undergoing chemotherapy for a condition similar to multiple myeloma, the therapeutic agents used to fight the cancer began to cause cardio toxicities. It resulted in a condition called amyloidosis, a disease that occurs when the substance amyloid builds up in tissues or an organ. In Carol’s case, it was the heart. Along the way, she also had to deal with Factor 8, a blood-clotting disorder that produced black and blue marks all over her body. 

It’s a condition that usually occurs in men. In fact, one of Carol’s doctors told her he had not seen a diagnosis in a female in nine years.

Cases like Carol’s — where the condition is more complicated than heart failure caused by a bad pump, or a straight-forward chemotherapy to cure a common cancer — can be almost impossible for a single doctor to diagnose and treat. It requires a team of specialists, and Carol found one such team at Froedtert & the Medical College of Wisconsin. Dr. Nunzio Gaglianello, a doctor on Carol’s team, explains that Froedtert is a quaternary care center, offering advanced levels of medicine that are highly specialized and not widely accessed. 

“There are experts at your disposal all the time,” he says.

According to Gaglianello, as many as a half dozen specialists in the oncology, cardiac and other fields are monitoring Carol’s case on an ongoing basis.

He says Carol has responded well to the initial chemotherapy meant for her myeloma. She will undergo a stem cell transplant with hopes of solving the Factor 8 and amyloidosis problems. After that, there is the possibility of a heart transplant in her future.

But that’s OK with Carol. From her perspective, she’s already a winner, as she’s outlived the initial three-month prognosis. Doctors are optimistic about the success of the stem cell transplant, but Carol remains humble. “If it doesn’t help me, maybe it’ll help somebody else,” she adds.

*Patient last names omitted for privacy.







 


This story ran in the February 2017 issue of: