February 19th, 2015

Charles Southall, Sentara Heart Patient

Charles Southall knows the classic signs of a heart attack—pain or numbness in the chest or arms, shortness of breath, nausea. But what he felt after doing yard work on Sept. 13, 2014 didn’t fit with these tell-tale clues. “I had this dull ache between my shoulder blades,” Charles says.

Still, he knew that a heart attack was a possibility even at his age, 48. “My dad was 39 when he survived a heart attack, yet I kept coming up with reasons for why I couldn’t be experiencing the same thing,” Charles recalls. “I was trying to convince myself that I was fine.” When the pain and nagging doubts persisted for hours, Charles went to Sentara CarePlex Hospital in Hampton. There, an EKG confirmed his fear: He was in the throes of a heart attack.

A heart attack occurs when a clot or other artery restriction cuts off blood flow to the heart. With the blood and oxygen supply stopped, heart muscle starts to die. A medical team must act fast to save the heart muscle from irreversible damage and to save a patient from possible death.

Sentara CarePlex Hospital is one of a growing number of medical centers nationwide that sends EKG results to a doctor’s cellphone to speed diagnosis. “Immediately after I received this information and confirmed Charles’ heart attack via phone, our cardiovascular team at Sentara assembled to begin life-saving procedures,” says Dr. Allen Ciuffo, Southall’s cardiologist at Sentara.

Charles’ EKG indicated that he was having a type of heart attack known as ST-segment elevation myocardial infarction or STEMI. A large part of his heart muscle was unable to receive blood due to a large blockage in a coronary artery. Ciuffo and his team had to swiftly perform a heart catheterization to open up the blocked artery and get blood circulating to his heart again.

Up to 95 percent of heart catheterizations in the U.S. involve accessing the coronary artery through a femoral blood vessel in the groin. But a less invasive approach, transradial catheterization, uses a blood vessel in the wrist as the entry point. Sentara was the first hospital in the region to offer this minimally-invasive approach 10 years ago. “We train doctors from other hospitals in the procedure,” Ciuffo says.

At Sentara, surgeons always opt for the transradial approach whenever possible because of the many benefits for the patient. There’s less risk of bleeding, a faster recovery time and a shorter hospital stay.

With transradial catheterization, a surgeon inserts a long thin tube called a catheter through the radial blood vessel located in the wrist. When the catheter reaches the heart, an injected contrast dye works like an ink that makes blockages along the artery stand out for the surgeon as he watches on an X-ray. To save Charles’ heart, Ciuffo inserted three expandable wire mesh tubes called stents to open up his clotted arteries and allow blood to flow freely again.

Charles was up and moving mere minutes after the 30-minute surgery was over, which is typical for patients who undergo transradial surgery. Patients who undergo traditional cardiac catheterization through the femoral artery must lie flat for two to six hours afterward to prevent bleeding at the surgical entry point.

Charles went home the next day and was back to work two weeks later. He also started a cardiac rehabilitation program at Sentara Therapy Center-CarePlex where he participates in supervised exercise programs three times a week and receives nutrition counseling. “The day before my heart attack, my lunch was two chili dogs and a bag of chips,” Charles confesses. “Today I eat more salads, chicken and fish. I go for 4-mile walks with my daughter. I’ve lost 45 pounds in three months and feel healthier than I did when I was in my thirties.”

Had he waited much longer to seek help, Charles’ outcome could have been much different. Unfortunately, most people wait an average of three hours before seeking medical attention for symptoms of a heart attack. “The longer an artery is blocked, the greater the potential damage to the heart muscle,” Ciuffo says. “The sad thing is that we have the tools to save people who are having heart attacks, but they have to get to us first.”

The damage to Charles’ heart is minimal and today he has the same heart function as someone who never had an attack. “I realize now that my stubbornness about seeking medical care could have cost me my life or greatly affected my quality of life,” he says. “The cardiac rehabilitation team at Sentara has given me the confidence to live every day without constantly worrying about whether I’m going to do something to bring on another heart attack. I’m able to do everything that I love with the ones I love.”