THE GOOD HEART ATTACK; CARDIOLOGISTS TURN OLD ENEMY LOOSE ON DEBILITATING BLOCKAGE.Byline: Phil Davis
He couldn't work. He could barely walk. The simple act of bending over to feed the dog left Armando Figueroa dizzy and breathless. An overly thick heart muscle was strangling the blood supply to his body. And medications weren't helping. A heart attack was his best hope. Indeed, the very thing doctors have worked for decades to prevent is showing promise as a solution for 50,000 Americans - including Figueroa - who suffer from a heart condition called hypertrophic Hypertrophic Enlarged. Mentioned in: Heart Failure hypertrophic characterized by a state of hypertrophy. hypertrophic pulmonary osteoarthropathy see hypertrophic osteopathy. obstructive cardiomyopathy Cardiomyopathy Definition Cardiomyopathy is a chronic disease of the heart muscle (myocardium), in which the muscle is abnormally enlarged, thickened, and/or stiffened. . On March 23, the 61-year-old Whittier pharmacist became the first Southern Californian to undergo a controlled heart attack. The experimental procedure - called a septal septal /sep·tal/ (sep´tal) pertaining to a septum. sep·tal adj. Of or relating to a septum or septa. ablation - employs a mild heart attack to pare down the muscle that divides the two chambers of the heart. Two days later, Figueroa walked out of Cedars-Sinai Medical Center Cedars-Sinai Medical Center is a world-renowned hospital located in Los Angeles, California. History Cedars-Sinai is the result of a merger in 1961 between two major Los Angeles hospitals, Cedars of Lebanon and Mount Sinai Home for the Incurables, with Steve Broidy as in Los Angeles feeling like a new man. ``When I came out of surgery, my wife immediately noticed color had returned to my face,'' he said. ``That afternoon, I went for a half-mile walk. I hadn't been able to do that for a year and a half. It's nothing short of a miracle.'' Only four years ago, Figueroa's only treatment option, if drugs failed, was for surgeons to cut open his heart and pare down the overgrown overgrown said of a part that has not been kept trimmed. overgrown hoof overgrown hooves put unusual stresses on bones and tendons and allow for distortion of the wall and sole. muscle with a scalpel. Open heart surgery is risky and dangerous. Recovery time is measured in months. Cedars-Sinai cardiologist Raj Makkar said many with Figueroa's condition fear open heart surgery so much that they opt to live with the pain and accept the chance the ailment ail·ment n. A physical or mental disorder, especially a mild illness. could kill them. But Makkar, who had just returned from Houston after learning how to induce the so-called ``good heart attack,'' decided Figueroa was a strong candidate to participate in a national study evaluating the effectiveness of septal ablation. The nonsurgical procedure was pioneered by Swiss physician Ulrich Sigwart in 1994. Cardiologists have long known that heart attacks thin heart muscles. Sigwart came up with the concept of harnessing a heart attack in a controlled setting and using it to pare down the overly thick interventricular septum interventricular septum n. The wall between the ventricles of the heart. . Doctors feed pure alcohol through catheters into the specific arteries that feed the interventricular septum, creating a mild heart attack in only that muscle. The procedure is monitored by ultrasound. The results of the 90-minute procedure are immediate. ``It's dramatic. You see the obstruction go away before your very eyes,'' said Makkar, one of only a handful of U.S. surgeons at two dozen hospitals participating in a clinical evaluation clinical evaluation Medtalk An evaluation of whether a Pt has symptoms of a disease, is responding to treatment, or is having adverse reactions to therapy of the procedure. The American study is being led by Houston cardiologist William Spencer, who trained Makkar. Figueroa was awake under local anesthetic local anesthetic n. An agent that, when applied directly to mucous membranes or when injected about the nerves, produces loss of sensation by inhibiting nerve excitation or conduction. during the procedure. ``I felt a twinge twinge n. A sharp, sudden physical pain. v. To cause to feel a sharp pain. , sort of like a leg cramp. After that - nothing at all,'' he said. ``When I came out of the operating room operating room n. Abbr. OR A room equipped for performing surgical operations. , I was already feeling better.'' There are risks. The alcohol can be toxic to other heart muscles, so physicians must know exactly where to administer the injection and follow it on monitors. Not all people with hypertrophic obstructive cardiomyopathy qualify for the study. Also, the procedure is so new, there is no information on how patients fare in the long run. Only a few hundred people - mostly in Europe - have undergone the procedure. In a 1998 German study of the 25 patients who received the treatment, one 86-year-old woman died eight days after the surgery and five patients required permanent pacemakers. The rest recovered fully, according to a Feb. 7 article in the British Medical Journal The British Medical Journal, or BMJ, is one of the most popular and widely-read peer-reviewed general medical journals in the world.[2] It is published by the BMJ Publishing Group Ltd (owned by the British Medical Association), whose other the Lancet. The procedure has since been refined, and doctors like Makkar are cautiously optimistic. He has performed the procedure on two patients so far. ``We are very enthusiastic about this procedure, but I am also curious about how this will pan out in the long term,'' Makkar said. ``I caution patients that this is an investigational procedure and, while three of four patients benefit from it, we still need information on what happens 10 to 15 years down the road.'' Figueroa has no regrets. ``Anytime they're working on your heart, you're going to be apprehensive,'' he said. ``But my quality of life had gone down so far I was getting depressed. This seemed a lot better than going through a drastic heart operation. I thought the odds were in my favor.'' Figueroa returned to work this month and is feeling good about the future. He's even planning to play a little golf and take a vacation. ``Right now, I'm still recuperating,'' he said. ``I feel like an athlete who is out of condition. But I'm going for walks with my wife and doing things I had not been able to do for a long time.'' Why heart must work harder What is hypertrophic obstructive cardiomyopathy? An inherited condition that causes excessive muscle growth in the interventricular septum, the muscle that separates the two chambers of the heart. The condition restricts blood flow from the left ventricle left ventricle n. The chamber on the left side of the heart that receives the arterial blood from the left atrium and contracts to force it into the aorta. to the aorta, the main valve of the heart. This means the heart must work harder to move the blood. What are the symptoms? Shortness of breath Shortness of Breath Definition Shortness of breath, or dyspnea, is a feeling of difficult or labored breathing that is out of proportion to the patient's level of physical activity. , dizziness, fainting and chest pain. Some patients experience abnormal heart rhythms that can lead to death if untreated. Who gets it? The condition is found in 50,000 Americans, mostly young people. How is the condition treated? In many cases, the condition can be treated with beta or calcium channel blockers Calcium Channel Blockers Definition Calcium channel blockers are medicines that slow the movement of calcium into the cells of the heart and blood vessels. - drugs that help the heart function. When drugs fail, the only options are open heart surgery or the new, nonsurgical procedure called septal ablation. Open heart surgery requires surgeons to actually cut down on the overgrown muscle. The relatively untested septal ablation requires feeding pure alcohol through catheters into the arteries that feed the interventricular septum, causing a mild heart attack that thins the affected muscles. - Phil Davis CAPTION(S): 2 Drawings, Photo, Box Drawing: (1--Cover--Color) Cheating Death Doctors discover a beneficial use for heart attacks (2) no caption (Heart) Dionisio Munoz/Daily News Photo: Pharmacist Armando Figueroa of Whittier is back at work after becoming the first person in Southern California to undergo a controlled heart attack. Here, he confers with pharmacy technician Ines Sanchez. Charlotte Schmid-Maybach/Daily News Box: Why heart must work harder (See text) |
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