Patient Story - Cardiology
He’s young, he’s happy, he’s healthy — he had a heart attack
On this warm and sunny Friday afternoon, life was good for 42-year-old Rick Sassara. The high school track team he helps coach had just completed a productive practice. He felt great and was looking forward to a leisurely weekend with his wife and young daughter.
As he wheeled toward home on his bicycle, Rick had no idea that just a few hours later, he would be wheeled away in an ambulance with a suspected heart attack.
Something doesn’t feel right — but what?
As Rick was getting ready for dinner, he didn’t feel quite right. He wasn’t hungry, which was unusual. And he felt anxious, which was another oddity. As the owner of a financial services business and an assistant coach for the local football and track teams, he feels his share of stress. But he is not prone to anxiety, nor did he have anything to be particularly anxious about. After a few hours of trying — and failing — to fend off his unease, Rick called his family doctor.
Summoning the courage to call 911
Rick’s physician told him to take his blood pressure. Because he has a family history of heart issues, Rick keeps a home blood pressure test kit. “If it’s high,” instructed his doctor, “call 911 immediately.”
Rick’s blood pressure was indeed elevated, but he felt no pressure in his chest, no radiating pains in his arms or neck. He was not short of breath, nor was he was perspiring. Was this some sort of anxiety attack? Or was his body trying to tell him that something was seriously wrong?
Rick listened to his inner alarm and called 911. As it turned out, that call saved his heart — and possibly his life.
The medic unit arrives and quickly leaves — with Rick inside
The medics arrived within five minutes of Rick’s call. They immediately connected him to their portable electrocardiogram machine and discovered that something wasn’t right. They whisked Rick into their waiting ambulance and headed straight for the ferry.
Because Rick and his family live on Vashon Island, a trip to the hospital — especially late at night — can be a challenge. The medics called the ferry terminal, where the captain held the boat until they arrived.
The cardiac team leaps into action
While en route, the medics wasted no time. They gave Rick some medication to stabilize his condition, then called the emergency department at Swedish’s Cherry Hill campus — home of the Swedish Heart & Vascular Institute — to alert them that a patient with a possible heart attack was on his way. They also transmitted Rick’s ECG results directly from their mobile unit to Swedish, so the emergency room physician could read the results and begin to assemble the rapid response team.
Meet Dr. Westcott — a master of minimally invasive heart procedures
The cardiac specialist on call that night was Dr. Jeffrey Westcott, an interventional cardiologist who also runs Swedish’s cardiac catheterization lab. “My specialty is taking pictures of — and opening blockages in — coronary arteries,” explains Dr. Westcott.
He and his team practice interventional cardiology — minimally invasive procedures that are performed in a “cath lab” instead of a conventional operating room. “Because this surgery is less invasive,” continues Dr. Westcott, “the recovery time is faster, pain and suffering are less, and the patient can get on with his life much more quickly and easily.”
An angiogram confirms the culprit — a blocked artery
When the medic unit arrived at Swedish’s Cherry Hill campus, Rick was taken first to the emergency room and then rushed to the cath lab, where the swiftly assembled cardiac team was ready to meet him.
Dr. Westcott greeted Rick, reviewed his history and quickly formed a game plan. He already knew from Rick’s ECG that his back wall artery was blocked. He performed an angiogram, a procedure that uses fluoroscopy — an X-ray movie of sorts — to see inside his heart’s blood vessels and confirm the diagnosis. “We spotted the blockage right away,” explains Dr. Westcott, “so we immediately performed an angioplasty.”
A miniature balloon opens the artery and allows blood to flow
“We inserted an extremely narrow wire that we can torque and guide precisely where we want it,” continues Dr. Westcott. “We steered it across the blockage, then inflated a tiny balloon to open the artery and restore the blood flow. We then placed a stent, or a tiny stainless steel coil, to make certain the artery will stay open.”
In football, track and heart attacks, speed is everything
From the time Rick arrived at Swedish until Dr. Westcott opened his artery was a remarkable 58 minutes. “That’s what we call the door-to-balloon time,” explains the cardiologist. “We count the minutes from the time our patient enters Swedish until we inflate the balloon to open his artery.
“And that was in the middle of the night,” he exclaims. “During the day, when we’re fully staffed, it can be much quicker. The national door-to-balloon standard is 90 minutes, and our number is currently around 48 to 50 minutes, which is extraordinary. We can do that only because we have created an exceptionally efficient, organized and coordinated team.”
For heart attack patients, fast door-to-balloon times are everything. “If you can save 30 minutes in opening an artery,” states Dr. Westcott, “that translates to a significant savings of heart muscle. And if you look at what that means to a patient over the next five or ten years of his life, it’s an incredible difference.”
Staying the course to a healthy heart
Rick stayed in the hospital until Sunday afternoon, then headed home and was back at work first thing Monday morning. He hasn’t missed a step since. He takes his bike for a 45-minute spin nearly every day, watches his weight and regularly chooses chicken and fish over cheeseburgers and fries. Rick also checks in with his new cardiologist — none other than Dr. Jeffrey Westcott.
Sometimes, laughter really is the best medicine
Coach Rick still spends countless rewarding hours on the football field and at track meets. Most important of all, he treasures the time he shares with his wife and daughter. And believe it or not, this fulfills one of Dr. Westcott’s key prescriptions for a healthy heart. Ask the doctor what he feels makes the biggest difference in leading a long, healthy life, and he’s quick to answer: “Live a life of joy.”
That’s one prescription Rick Sassara is happy to take each and every day.
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