Lifesaving Diagnosis and Care for Gilbert’s Aortic Emergency

When Gilbert Jorgensen, 58, collapsed at his Pipersville workplace, his colleagues immediately called 911, setting off a series of events that helped save his life.

Though no one knew it at the time, Gilbert’s aorta, the main artery that carries blood from the heart to the rest of his body, was tearing apart.

Emergency Medical Services providers assessed his condition and, transported Gilbert via ambulance to Doylestown Health, a facility that has the capabilities to treat aortic catastrophes immediately – something not all hospitals are equipped to do. They notified our Emergency Department (ED) of Gilbert's impending arrival and health status. This vital information allowed the ED to prepare and line up resources.

A Crucial Diagnosis

Gilbert was unconscious when he arrived. “At first, we suspected a stroke, but Gilbert had low blood pressure and no pulses in his wrists or groin — a scenario we realized could be a cardiovascular catastrophe including massive pulmonary embolism, ruptured abdominal aortic aneurysm, or aortic dissection,” says Dr. Charles Fasano, an emergency medicine specialist. “It was important to make the diagnosis and get Gilbert to the operating room quickly because the odds of survival with this condition drop with every passing hour.”

A CAT scan confirmed that Gilbert had a type A aortic dissection, a tear in his aorta that started in his aortic arch, where smaller blood vessels branch off to the brain. A tear like this can lead to problems including brain damage, lack of blood to the extremities, stroke, and life-threatening internal bleeding, notes Dr. Fasano.

“Time is of the essence; because almost 90% of patients will not survive the first 24 hours if they don’t get to a place where they can be treated,” says cardiothoracic surgeon Dr. Richard Highbloom.

Connecting with Family

Gilbert’s wife, Lisa, a church secretary, was working when she got the news. “I knew he had passed out and that they were taking him to Doylestown, but I was not expecting anything traumatic,” says Lisa. “Within an hour, we were dealing with a life-or-death situation, and Gil had no prior symptoms. Dr. Highbloom gave me a good indication that this was serious, including statistics, without making me panic. They told me it was going to be a very long day.”

“We needed to make Lisa aware of the significance of a catastrophic medical event and a six-to-seven-hour operation where Gilbert could have a devastating outcome,” says Dr. Highbloom. “In the best hands and at the best institutions, this procedure still carries one of the highest mortality rates, along with a high risk for stroke or brain injury following the operation.”

Rebuilding Gilbert’s Aorta

To replace the damaged section of Gilbert’s aorta, Dr. Highbloom stitched in a synthetic tube (graft) and repaired blood vessels that run from the aortic arch to the brain. In addition to the heart-lung bypass machine, the team cut off all blood flow to Gilbert’s brain so Dr. Highbloom could operate on nearby blood vessels, protecting the brain by keeping it at a very cold temperature.

Waiting for News

Two of the couple’s adult children, a son and daughter, were with Lisa at the hospital while their older son connected by phone from Texas. “We sat around the fireplace. The people at the welcome desk checked on us and shared updates from the Operating Room,” says Lisa.

A Successful Surgery

Gilbert’s surgery was a success. Lisa went to the Cardiovascular Intensive Care Unit, where Gilbert was still out. He was being carefully monitored, and a nurse remained with him so he wouldn’t be alone when he came to. “I can’t imagine what it must have been like for him to wake up and find out all these crazy things happened while he was unconscious,” Lisa says.

Time to Recover

“I don’t remember anything from the time I collapsed to when I woke up after a really long operation,” says Gilbert. “I was disoriented at first, but once I was alert, Dr. Highbloom stopped by with a physician’s assistant and spent an hour reviewing what happened and what to expect. He has a great bedside manner.”

“In the six days that Gil was in the hospital, it was clear that the doctors, physician assistants, X-ray technicians, and nurses were a team. The communication at shift change was impressive, and anything we needed was there before we even thought about it,” says Lisa. “For major heart surgery, it could not have been a better experience.”

Exactly Where He Needed to Be

“I read that the actor John Ritter passed away from an aortic dissection,” says Gilbert. “People can die if they are misdiagnosed. I’m grateful that my co-workers called 911, and I recognize the importance of getting to the ED, getting the correct diagnosis and being at Doylestown Health, where a cardiothoracic surgeon was able to perform the emergency repair.”

“If any of those things had gone a different way, we might not be telling the same story,” Lisa says. “We feel blessed.”

“Gilbert had a miraculous recovery in that he walked out of the hospital a week later with no signs of stroke or damage to his brain,” says Dr. Fasano. “It was great teamwork with continuity of care by EMS, the ED, Nursing, Radiology, Cardiology, CT Surgery, Anesthesiology, and Critical Care. Dr. Highbloom saved Gilbert’s life.”

Gilbert continued his recovery with outpatient cardiovascular rehabilitation. He will see a cardiologist for routine monitoring and follow-up care moving forward.

Next up, Family Fun

Before Gilbert’s emergency, the Jorgensens rented a mountain house for a summer vacation with their children and grandchildren. “I’m looking forward to a great time,” says Gilbert. “We had our three kids at Doylestown, and I never knew they had a cardiac unit — It certainly worked out well for me.”