Doylestown Health experts quickly diagnose and treat a man's uncommon--but life-threatening--cardiac condition.
It is an evening Andrew Charlesworth will never forget.
The 40-year-old husband and father of three was driving that day in April when he felt pain in his chest, back and jaw.
"Because I had no left arm pain, I was thinking it didn't feel like a heart attack," says Andrew, a chef.
When the symptoms persisted, he called his wife and asked his parents to drive him to Doylestown Hospital – a decision that saved his life.
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Making an Unusual Diagnosis
When Andrew arrived at the Doylestown Hospital Emergency Department, his attending physician ruled out heart attack.
"Mr. Charlesworth is young, reported minimal pain and was in no apparent distress," says emergency medicine physician Robert Slade, MD. "So while we went through the protocols to rule out heart attack – EKG (electrocardiogram), cardiac enzyme studies and chest X-ray – I was not expecting anything to show up."
Considering the remote possibility of an aneurysm, Dr. Slade ordered a d-dimer, a test to rule out the presence of an inappropriate blood clot. While no blood screening exists for aneurysm, an association has been shown between a high d-dimer reading and aneurysm. Based on the results, Dr. Slade ordered a Computerized Tomography (CT) scan, which revealed a tear in the inner lining of Andrew's aorta (aortic dissection).
The aorta is the large blood vessel that branches off the heart. An aortic dissection occurs when the inner layer of the aorta tears. Blood gushes through the tear, which causes the inner and middle layers of the aorta to separate (dissect). If the blood-filled channel ruptures through the outside aortic wall, aortic dissection is often fatal.
Aortic dissection is a relatively uncommon condition that usually happens in men in their 60s and 70s. Andrew had a type-1 aortic dissection, which begins right at the aortic valve. His life was in immediate danger.
Andrew’s Story: Taking Cardiac Symptoms to Heart [Video]
Lifesaving Cardiac Surgery
Joseph S. Auteri, MD, medical director of the Richard A. Reif Heart Institute and chief of Cardiac Surgery, was called that night to perform emergency surgery. He replaced the damaged ascending aorta with a woven Dacron tube graft, and replaced Andrew's damaged aortic valve with a mechanical valve.
"Type-1 aortic dissection requires immediate surgical intervention," says Dr. Auteri. Without the repair, Dr. Auteri estimates Andrew would have ruptured his aorta within 24 to 48 hours, which would have been immediately fatal.
Choosing the Right Hospital for Cardiac Care
"Never in a million years did I think anything like this would happen to me," says Andrew. "I'm thankful to everybody at Doylestown Hospital for looking for things that some may have overlooked, and for reacting as fast as they did."
"The nurses were super attentive, and Dr. Auteri made me feel comfortable," adds Andrew. "He told me exactly what was going on. I was so glad to have Dr. Auteri and his partner, Dr. McClurken, for follow-up care. The whole team was there for me from start to finish."
Doylestown Health even followed up with Andrew at home with a visit from a cardiac surgery CVICU nurse (with over 20 years of open heart experience), who checks on patients in their home after their hospital discharge.
Andrew continues to focus on recovery. He participates in Doylestown Hospital's medically monitored Cardiac Rehabilitation program and has quit smoking.
"I feel good," he says.
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About Doylestown Health's Heart Institute
Expert cardiologists and cardiac surgeons assist patients and physicians with managing risk factors for heart disease, offer advanced treatment options and provide outstanding emergency cardiac care. The multidisciplinary team at the Heart Institute is dedicated to providing the highest level of quality care and patient safety.
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