Area hospitals, patients team up against Number One killer
BY MARILYN OLSON For Sun-Times Media
Heart disease is the No. 1 killer of women. | FILE PHOTO
The Facts, in brief
Every 34 seconds another American dies of heart disease.
35 percent of patients with heart disease show no symptoms at all.
People of African American or Hispanic descent show a higher incidence of heart disease, diabetes, and high blood pressure.
Heart disease affects both men and women, though women tend to be older when they are diagnosed.
Will County has a higher incidence of smokers than any other county in northern Illinois.
Rapid diagnosis of a heart attack and treatment means less damage to heart muscle.
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Heart disease is a formidable enemy. According to the American Heart Association, there is one cardiac event every 25 seconds, and one of those people dies every minute.
Cardiovascular disease, including stroke, is the number one killer in the U.S. and in Illinois. The latest Illinois figures of the American Heart Association (AHA), found that 34,054 deaths were caused by cardiovascular disease in a year, or 33 percent of all deaths. An estimated 82.6 million American adults, more than one in three, have one or more types of heart disease. Almost half are under the age of 60.
Medical professionals battle more than numbers. For one thing, heart disease has been traditionally regarded as a “man’s disease,” a belief aided by the fact that women’s symptoms sometimes differ from those of men. Prevention — a major ally — also is a difficult to bring into the fight because it means making changes, sometimes major, in a person’s habits and lifestyle.
But when heart disease strikes, area residents have an impressive arsenal in their fight against this killer. From risk assessments to diagnostics to treatment options, area hospitals and physicians can provide highly-skilled care and state-of-the-art technology to help return patients to their normal lives as quickly as possible.
Assessing the risk
Clearly, prevention is the best way to “treat” heart disease, but if necessary, there are numerous treatment options available today.
“Heart disease is a disease of lifestyle, as much as a hereditary disease. There are things you can do to prevent heart disease,” said Marybeth Antone, Administrative Director for Surgical and Cardiovascular Services at Silver Cross Hospital in Joliet.
Antone noted that heart disease is an equal opportunity disease, affecting both men and women.
“People think heart disease is a ‘men’s disease’, and that is just not true any longer,” she said. “Heart disease is now the Number One killer of women, killing more than all kinds of cancers combined.”
She said the hospital is seeing more women with heart disease than ever before, including some as young as their 40’s and 50’s.
“Women experience different symptoms than men when they have a heart attack. Typically, in an acute heart event, women usually have vague symptoms, including fatigue, shortness of breath, achiiness. We tend — as women, as caregivers — to think it can’t be me having a heart attack.”
“Women do not experience what I call the ‘Hollywood heart attack,’ with severe chest pain. So we have vigorously trained out ER staff to think of a heart attack in women who come in with those vague symptoms. We have mammograms to check for breast cancer, but sadly, we do not have that kind of testing for women and heart attacks,” Antone said.
Andrea Ramel, supervisor of cardiac rehab at Provena St. Joseph Medical Center in Joliet, noted that women have more subtle symptoms than men with heart disease.
“Women present quite differently,” she said. “They don’t always have the crushing chest pain, but rather seem to show intense fatigue and other symptoms. Also, women develop heart disease later in life, and that may mean their condition is more complicated by other medical conditions as well, including high blood pressure and diabetes.”
To help spread the word, Provena St. Joseph participates in WomenHeart, a national coalition for women and heart disease. The program offers support and education, including emotional support, for women living with heart disease.
Silver Cross has a dedicated center, the LaVerne and Dorothy Brown Cardiovascular Institute, for prevention, diagnosis and treatment of heart problems. The hospital includes a Chest Pain Center, accredited by the Society of Chest Pain Centers.
Speed is essential
“The goal is to get someone suffering from a heart attack into the cardiac catheterization lab as soon as possible in order to stop the attack and prevent permanent damage to heart muscle,” Antone said. “We talk about the crucial time from ‘door to balloon’, meaning how long does it take from the time they enter our doors to when we can stop the heart attack with balloon angioplasty, where we place a balloon in the artery, clear the blockage, and place a stent to maintain the blood flow.”
The goal national average time from “door to balloon” is 90 minutes or less. Silver Cross beats that with an average of 60 minutes, but the hospital has managed a time of 23 minutes.
“We have worked with the municipalities to train their EMT’s to tell us if they think a patient is having a heart attack,” Antone said. “Their starting an EKG even before the patient arrives at the hospital has had a tremendous affect on shortening our times, and helping save crucial heart muscle from damage.”
Improvement of the use of stents to open blocked arteries has meant fewer patients need open heart surgery to bypass closed arteries. Today, only about 1 percent of patients find they need open heart surgery.
“Open heart surgery will never go away,” said Antone. “But today, stents elude medication and patients take anticoagulant medication. Our complication rates for stenting are very low. Also, patients now can take statin drugs to dramatically lower cholesterol, and that is helping prevent heart disease.”
Cardiac rehab a necessity
After a “cardiac event,” most insurance companies cover a series of outpatient cardiac rehab classes. Phase I rehab occurs in the hospital, with the aim to help the patient ready to go home. Phase II is done on an outpatient basis, with patients spending about an hour a day three days a week, on exercise equipment while carefully monitored by medical personnel. Ed on lifestyle changes, including diet, exercise and stress control, is usually included.
“Though only about 32 percent of those eligible for cardiac rehab actually use it, we find patients like being supervised at first as they return to their normal lives after a cardiac event,” said Margaret Downey, Manager of Cardiac Rehabilitation at Provena St. Joseph. “Education is an important part of rehab. In order to make a lifestyle change, you need to address those risk factors that contribute to the disease process.”
Patients who participate in cardiac rehab do better afterward.
“Statistics show there are fewer readmissions to the hospital, and fewer additional cardiac events in those who do rehab,” Downey said. “Their quality of life is better, and they manage their risk factors better.”