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Exceptional heart care gave him a second chance

December 27, 2013
Last spring, Thomas Hart, 71, of Piscataway, visited his primary care physician for his annual checkup. “He asked if there were any symptoms I wanted to discuss, and I told him that I sometimes felt short of breath when mowing the lawn and occasionally had some pressure in my chest or back, but it wasn’t painful,” Hart says. As a preventive measure, Douglas Krohn, MD, family practitioner, performed an electrocardiogram (EKG) to check the electrical activity of his heart. It showed a very slight abnormality. So Dr. Krohn referred Hart to Sharan Mahal, MD, a board certified cardiologist with CardioMD, an affiliate of Somerset Medical Center in Bridgewater.

Dr. Mahal performed a stress test in his office and found that Hart wasn’t reaching his peak heart rate during exercise. To get a closer look at the heart, Dr. Mahal scheduled Hart for a nuclear stress test at the new outpatient cardiac testing facility at Somerset Medical Center. With a nuclear stress test, low-dose radioactive dye is injected into a vein and a special camera tracks the flow of the dye through the heart to identify whether there are any blockages. “The test showed he had a very high likelihood of several cardiac blockages,” Dr. Mahal says.

The final test was a diagnostic angiogram at Somerset Medical Center, in which Dr. Mahal inserted a thin tube called a catheter through an artery in Hart’s wrist. “Traditionally, the test is done through an artery  in the groin, but we do it through the wrist as often as possible because it’s more comfortable for patients and has a much lower rate of complications,” Dr. Mahal says. Iodine dye travels through the catheter to the heart and X-ray pictures show where, exactly, in the heart there’s a blockage. Hart’s results were devastating.

Urgent ‘One-Call’ Connection
Three of Hart’s arteries were 80 to 90 percent blocked. “His left main artery, which is known as the ‘widow maker’ because it can kill you instantly when completely blocked, was 90 percent blocked,” Dr. Mahal says. He explained to Hart that the only recommended treatment is open-heart bypass surgery — as soon as possible. He contacted Leonard Lee, MD, associate professor of surgery at Rutgers Robert Wood Johnson Medical School and chief of the Division of Cardiothoracic Surgery at Robert Wood Johnson University Hospital in New Brunswick.

“We don’t do open-heart surgery at Somerset Medical Center, but our close relationship with Robert Wood Johnson means that we make one phone call to the surgeon and everything falls into place,” Dr. Mahal says. For Hart, that’s exactly what happened. An ambulance from Robert Wood Johnson transferred him from Somerset Medical Center to Robert Wood Johnson, where he was admitted. He had additional tests done and was scheduled for surgery with Dr. Lee the very next day. “Everything went as smoothly as it possibly could,” Hart says.

Healthy Heart, Bright Future
The surgery to bypass the blockages and restore blood flow through his heart was successful. Hart was able to go home five days later.

“Not only was the surgery lifesaving, it was also life-prolonging,” Dr. Mahal says. “With the blockages, his chance of surviving three years was close to zero, but now he can live the next 20 or more years.” 

Today Hart is doing well and is grateful for the care he received at Somerset Medical Center and Robert Wood Johnson. “I give a lot of credit to Dr. Mahal for pursuing the problem until he had answers and for contacting Dr. Lee as quickly as he could,” Hart says. “And I credit my fast recovery to Dr. Lee’s great skill, and the many prayers offered for my recovery.”