It’s 2 am. A man calls 911 experiencing chest pain, lightheadedness and vomiting. When EMTs arrive, they take an electrocardiogram (EKG). The patient is having a heart attack. Timing is crucial. The sooner doctors get the blood vessel open, the more heart muscle they’ll be able to save.

On the way to the hospital, the EMTs transmit the EKG to Southcoast Health to alert the heart team. By the time the patient arrives, the team is ready. Not all hospitals have this technology — Southcoast is one of the few in the region that does.

When the patient arrives, interventional cardiologists insert a tube called a stent to open the blocked coronary artery. Southcoast performs this procedure at extraordinarily high volumes, taking referrals from across the region.

“We’re one of the busiest interventional labs in the region. And Southcoast Health’s Charlton Memorial Hospital is designated as a regional STEMI Center, which is specially equipped and staffed to treat acute heart attacks,” says Dr. Peter Cohn, Interim Physician-in-Chief of the Cardiovascular Care Center for Southcoast Health. 

Southcoast Health has a multidisciplinary heart care program with services in cardiovascular disease, which includes cardiac interventions, electrophysiology, cardiac surgery, both surgical and non-surgical treatment of valvular heart disease, and vascular surgery. Five years ago, Southcoast started performing trans-aortic valve replacements, an alternative non-surgical intervention. “Since the program began,” Dr. Cohn says, “We have performed more than 300 of these procedures.”

Here is an overview of Southcoast’s cardiovascular services.

Interventional and Invasive Cardiology

Southcoast Health’s door-to-balloon time — counted from when a patient having a heart attack arrives at the hospital to when the blocked vessel is opened — is well below the national standard. “During a heart attack, time is muscle,” Dr. Cohn explains.

In addition, the Cardiac Cath Lab offers cutting-edge technology in interventional cardiology. For example, the chronic total occlusion (CTO) program, led by Dr. Nosheen Javed, Director of Program Development, enables cardiologists to open up chronically blocked blood vessels.

Echocardiography

An echocardiogram (ECHO) is a painless procedure that uses sound waves to produce an image of the heart. It provides a full assessment of the size and contraction of the heart, as well as the four heart valves and aorta. ECHO is used to diagnose problems, particularly with malfunctioning valves, but also as visual guidance during certain procedures.

“We use the most advanced imaging techniques to help diagnose and manage many types of cardiac conditions,” says Dr. Christopher Abadi, Medical Director of Echocardiography. “We work closely with the other cardiology service lines to help deliver the highest quality care. Our specialized team also provides imaging using transesophageal echocardiography (ultrasound probe inserted in the esophagus) and state-of-the-art 3-D imaging to help support and guide cardiac device implantation, cardiac rhythm management, and heart valve replacement and repair. Working in collaboration with the general cardiologists, structural heart specialists, electrophysiologists and cardiac surgeons allows a true multidisciplinary approach to cardiac care.”

Cardiac Arrhythmia Services

When the heart’s electrical impulses become disordered, the heart’s regular rhythms go awry. Patients can experience this as a flutter in the chest, a “flip-flop” sensation or a racing heart. When rhythms aren’t regular, it disrupts regular blood flow and oxygenation. This can lead to such symptoms as dizziness, shortness of breath, chest pain, sweating or fainting.

The cardiac arrhythmia program is devoted to addressing heart arrhythmias, such as bradycardia, tachycardia and atrial fibrillation (A-fib). “Southcoast’s service is special because we have a formal multidisciplinary approach to managing A-fib,” says Dr. Ramin Davoudi, Medical Director of Cardiac Arrhythmia Services. “As a result, your arrhythmia specialist will work more closely with cardiac surgeons and other heart specialists to provide comprehensive care in managing A-fib. An example of this includes our collaboration with the structural heart program to create one of the first centers in New England to be able to offer left atrial appendage occlusion devices. These devices are implanted in the heart and help prevent strokes. They are a great alternative for patients who cannot tolerate blood thinners.”

Structural Heart Program

The valves inside the heart act like doors that close off each chamber so the blood flows in the proper direction as it enters and leaves the heart. Sometimes a valve can weaken and fail to close properly. In certain cases, this failure can lead to symptoms that affect everyday activities. If this isn’t corrected, more serious problems, like congestive heart failure or stroke, can occur.

There are other heart structures that can work improperly. Some of these can be defects that are present from birth and others can develop over time. In either case, the physicians at Southcoast Health have a range of techniques to correct the problem.

“Many of the patients we see have debilitating symptoms such as shortness of breath, fatigue, chest pressure, lightheadedness or loss of consciousness and, as a result, frequent hospitalizations. One of our main goals in treating patients with structural heart disease is to relieve these symptoms and improve their quality of life,” says Dr. Adam Saltzman, Medical Director of the Structural Heart Program. “When you are dealing with a cardiac issue that may require an invasive therapy or procedure, it is important to feel comfortable with your healthcare team and the environment where you are receiving care,” he continues. “Our excellent outcomes and low complication rates are remarkable when compared to other centers of varying sizes in our region and nationally. If you combine these exceptional outcomes with the realities of having your care locally, with family support and continuity of care with your other healthcare providers, it would seem to be an easy choice to have your cardiac care at Southcoast Health.”

Cardiac Surgery

The skilled surgeons in Southcoast’s cardiac surgery program have treated more than 5,000 patients with ailments like coronary artery disease, valvular disease, cardiac defects or tumors. The comprehensive surgery program performs a variety of surgical procedures, including coronary artery bypass grafting (which is the best treatment for severe coronary artery disease), valve repair and replacement, and heart failure surgery. At the same time, the program supports structural heart and electrophysiology interventions.

“Our cardiac surgery team has always been committed to innovation and has safely and efficiently introduced new technologies, such as minimally invasive surgical approaches, ventricular assist devices, extracorporeal membrane oxygenation, transcatheter valve options and advanced arrhythmia surgery,” says Dr. Iraklis Gerogiannis, Chief of Cardiac Surgery. “However, our strongest characteristic, above and beyond any new technology or cutting-edge equipment, is our relentless dedication to excellent individualized patient care. Our outstanding staff of surgeons, anesthesiologists, advanced practice providers, nurses and support personnel is absolutely committed to providing our patients and their families with the highest quality modern care with a human face.”

Vascular Surgery

Using state-of-the-art medications and technology, vascular surgeons can treat blockages, embolisms and aneurysms throughout the body — even treating stroke and cerebrovascular disease. Dr. David Gillespie, Chief of Vascular Surgery, and Dr. Richard Pin, treat all aspects of vascular disease outside the heart, including major artery blockages in the neck and legs. In addition, Southcoast has a vein center where doctors use minimally invasive techniques to treat painful varicose veins.

“Our vascular surgeons deal with blood flow outside the heart, including blockages in the carotid and other major arteries of the neck, deep vein thrombosis in the legs, abdominal aortic aneurysm [a dangerous bulging in the main artery leaving the heart] and more,” says Dr. Cohn. “Our surgeons operate at high volume and with exceptional outcomes.”

Visit the Southcoast Heart Center to learn more.

Health+ Winter 2019