One of every four deaths in the United States is caused by heart disease. A leading cause of death for men and women, heart disease is an umbrella term used for a variety of cardiac issues. Heart disease can present differently in individuals, and treatments vary. Knowing and reducing your risk for heart disease, paying attention to warning signs, and getting the appropriate treatment and intervention as soon as possible can be the difference between life and death.
It’s easy to say you’ll pursue these protective measures, but it’s not always as easy to do, says Dr. Michael Mack, a cardiothoracic surgeon and chair of the Cardiovascular Service Line for Baylor Scott & White Health. This is because heart disease can be confusing to understand and difficult to protect against if you’re not familiar with it—especially if you don’t know you have it. If you have been diagnosed with heart disease, Dr. Mack advises learning as much as you can about it by asking questions. “Asking about the experience of the providers who are giving you care and inquiring about the access they have to the latest innovations in treatment are all reasonable questions,” Dr. Mack says. “Oftentimes, you don’t know about a disease, including heart disease, until you need treatment for it.”
The first place to begin your quest is to know which type of heart disease you have. Heart valve disease, high blood pressure and cholesterol, congestive heart failure, coronary artery disease, arrhythmia, peripheral vascular disease, congenital heart disease, cardiomyopathy—all these types of heart disease require a different treatment approach. “There are many kinds of cardiac issues, but they all often get generically lumped into one disease—heart disease,” Dr. Mack says. “It’s like saying you have lung disease, but it could actually be emphysema from smoking or even lung cancer.”
For some, heart disease means a blockage of the coronary arteries that supply the heart muscle with blood. Blocked arteries can cause a heart attack. Some heart attacks can be silent and cause progressive damage, which usually results in a diagnosis of congestive heart failure. Heart disease also can be caused from viral instances, including COVID-19. Abnormal heart rhythm is also classified as heart disease. It’s not uncommon for someone to be born with a heart murmur that isn’t detected until sudden death or during a routine physical or screening much later in life. A malfunction with the two main valves of the heart is considered a serious form of heart disease. “All these heart problems can end up being fatal unless they addressed in an expert manner,” Dr. Mack says. “Unfortunately, many people aren’t aware they have heart disease until they experience a cardiac incident. By far, the most common form of heart disease is blockage of the arteries, and too often, the first time someone becomes aware of it is when they present with a heart attack. The onset of chest pain is their first symptom.”
Once someone is diagnosed with heart disease, treatment is the next step. Heart disease management under the guidance of a cardiologist through diet, exercise, healthy lifestyle habits, and medication is the first line of defense. If the cardiac event is severe, sudden, or untreatable with noninvasive measures, intervention becomes necessary. Among the most significant and groundbreaking cardiac interventions today is the ability to replace heart valves without open-heart surgery, called trans-aortic valve replacement (TAVR.)
Dr. Mack’s early involvement in TAVR led to FDA approval for the procedure in low-risk patients, opening the surgery to virtually all patients with aortic stenosis. The procedure avoids open-heart surgery by inserting a collapsed heart valve near the hip and guiding it through an artery until it is in place in the aortic valve, where it is expanded. Baylor Scott & White is the largest provider of this therapy in the state and a pioneer in Dallas-Fort Worth for replacing heart valves without surgery, performing nearly two-thirds of these procedures in North Texas. It has two of the largest TAVR programs in the area: Baylor Scott & White The Heart Hospital – Plano has performed more than 1,500 TAVR procedures, and the team at Baylor Scott & White Heart and Vascular Hospital – Dallas has performed 1,300.
When valve replacement is performed via open-heart surgery, recovery time usually lasts up to six weeks, but TAVR patients can be out of the hospital the following day. “This is a momentous shift to have a disease that’s historically been mainly treated by open-heart surgery now treated with a catheter-based approach,” Dr. Mack says.
Physicians at Baylor Scott & White began using TAVR in 2004 in partnership with a hospital in Germany because, at that time, it still couldn’t be performed in the U.S. TAVR was approved by the FDA in 2011. In the past decade there have been more than 300,000 patients in the U.S. who have had a main heart valve replaced using this technique. “Today, TAVR is the most common way to replace a patient’s heart valve,” Dr. Mack says. “Some patients still require open-heart surgery due to age or particular issues with their heart valve, but in my opinion, TAVR is by far the biggest advance that has occurred over the last decade in the treatment of heart valve disease.”
Baylor Scott & White’s Dallas program is also one of the world’s leaders in treatment of heart failure through transplant and ventricular assist devices, such as LVAD. The Dallas team includes clinicians at Baylor Scott & White Heart and Vascular Hospital – Dallas who perform transplants at Baylor University Medical Center. It is the largest heart transplant program in Texas and is one of the top 10 transplant programs in the country. In fact, the hospital just completed its 1,000th heart transplant and 500th LVAD, and there are plans in the coming year to be one of the first to implant the latest total artificial heart available in the United States. “Despite the COVID-19 pandemic, our team has been able to train and undergo the necessary preparation for a new total artificial heart transplant program,” Dr. Mack says. “Because of our successful transplant and LVAD programs, we have also built a successful ECMO program. This enables us to place patients in need of temporary support on a heart/lung machine until their own heart or lungs recover. The ECMO takes over the function of the heart and lungs, giving them a chance to recover.”
ECMO, extracorporeal membrane oxygenation, uses a pump to circulate blood through the lungs and back into the bloodstream, providing heart-lung bypass support outside of a patient’s body. Baylor Scott & White’s ECMO advances have enabled many patients with COVID-19 to recover. Baylor’s unique ECMO program will be detailed in an upcoming academic medical journal article in the Annals of Thoracic Surgery. Baylor’s primary hospital for treatment of COVID-19 patients has been Baylor University Medical Center, where many of the more than 30 COVID-19 research trials are taking place. Baylor Scott & White transports patients between hospitals so they can get a higher level of care from within the system and outside the system. “At the beginning of the pandemic, we thought this disease was universally fatal once patients reached this advanced stage, but we quickly learned ECMO is an effective treatment, for some patients” Dr. Mack says. “Approximately three-quarters of the patients with COVID-19 we have placed on ECMO have been able to recover. It has been a significant arrow in the quiver of fighting COVID-19.”
With so many types of heart disease and various treatments to address it, Dr. Mack says he understands how a disease that affects so many people can be overwhelming to understand. Having a family history of heart disease, sudden or gradually increasing chest pain, shortness of breath, being morbidly obese, smoking, and becoming easily fatigued for no apparent reason are all signs and risk factors that may indicate you have an unhealthy heart. Once heart disease is suspected, how do you learn more? Where do you go for help?
Says Dr. Mack, “The most common questions I get from friends or family are about where to go for a certain treatment and how to know if the advice they are getting is the right advice.” He recommends researching public reporting of the outcomes of cardiac programs from U.S. News & World Report and Consumer Reports. These publications rate hospitals on their heart care and their heart surgery program outcomes. For example, Baylor Scott & White The Heart Hospital – Plano has the fourth largest heart surgery program in the country. In addition to those in Dallas and Plano, Baylor Scott & White’s Heart Hospital programs have locations in Fort Worth, Denton, and McKinney.
“Look into the outcomes of these programs,” he says. “Ask questions about the experience of the surgeon, cardiologist, or institution you are considering. Ask how many heart procedures your surgeon or cardiologist has performed in the last year. No provider should be reluctant to answer your questions. Nowhere else in life are you an uninformed consumer. When it comes to heart disease, you should be just as informed, if not more so.”
Heart Disease
Early detection increases chances for a cure
Chest pain, occasional shortness of breath, unexplained fatigue—these are all possible signs of heart disease. A nagging ‘what if’ worry and well-meaning intentions to make an appointment with a cardiologist linger, but too often, the mere thought of navigating a maze of doctors and medical tests can lead to even further procrastination. There is a quick way to discover if you have signs of heart disease with a heart scan from Advanced Body Scan of Texas. With locations in Plano and Oklahoma City, Advanced Body Scan of Texas offers heart scans, as well as lung and body scans and virtual colonoscopies, that can all be completed within minutes. Preventive screening is crucial for early detection of disease and being armed with knowledge can help you make informed decisions about next steps in care. If you are over the age of 39 and have diabetes, are obese, experience high stress, have high blood pressure and cholesterol, smoke, have prolonged exposure to second-hand smoke, or have a family history of heart disease, you are a candidate for a 4D CT heart scan.
“If you catch it early, you can treat it early,” says Steve Marler, founder of Advanced Body Scan of Texas. “With more than 60,000 heart scans, we have learned there are many people with heart disease who show absolutely no signs or symptoms. They were all grateful to know they were at risk, so they could seek immediate advice and treatment from a doctor. If you are up against silent killers, such as heart disease or lung cancer, early detection can increase your chances of survival.”
Advanced Body Scan of Texas offers heart scans using 4D CT technology. These advanced tools provide fast, easy, and accurate scans to assess heart health and may detect coronary artery disease and cardiovascular blockage. They can also check heart valve calcification, heart size, and the pericardium. In many cases, a heart attack is the first sign of heart disease. Unlike traditional diagnostic imaging that only detects large deposits, Advanced Body Scan’s 4D CT may reveal much smaller deposits. During the noninvasive screening, you lie comfortably in the machine while it completes the scan. All preventive scans are quick, noninvasive, and scan the body at an extremely high speed to capture images of the heart. The scan can also zoom in on various areas to ensure a more accurate study. The heart scans can efficiently detect calcium in the coronary arteries. Coronary artery disease is a progressive disease caused by the buildup of cholesterol and plaque within the arteries that supply blood to the heart. This can lead to a heart attack, which can result in permanent heart damage or death. The scans may also detect abdominal aortic aneurysm and thoracic aortic aneurysm, which can both lead to organ damage, stroke, and heart attack.
The scans are read by an on-staff, board-certified, fellowship-trained radiologist. Once the scan is complete, the radiologist will review the report provide a calcium score which represents if there coronary calcification buildup. Because the sophisticated 4D CT heart scan creates such precise results, your doctor and/or cardiologist can use the report to determine the next steps you should take. Having the report in hand often speeds up the process of finding a healthcare provider to pursue further treatment. “The scans offer peace of mind if the report is clear, but also peace of mind because you have knowledge about your health you didn’t have the day before,” Marler says.
Appointments at Advanced Body Scan of Texas can be scheduled for same or next-day with just a simple phone call or email. The 4D CT machine is open, which means there is a reduced chance of feeling claustrophobic during the scan. The heart scans require no preparation—no shots, no dyes and no medications prior to the appointment. Most patients are finished with their heart scans in less than 10 minutes. There is also an option for a combination heart/lung scan available. To learn more, visit advancedbodyscan.com.
