Good Medicine - November 2009

By Su Byron November 1, 2009


Heart Smart

When your own heart turns against you, what can you do? David Hunihan never thought he would have to answer that question.

It was 2008, a few weeks before Christmas. Hunihan, then 73, was enjoying his retirement years in Venice with his wife, Virginia (aka “Gail”). An inch shy of six feet, Hunihan weighed in at just 170 pounds. His cholesterol and blood pressure were just what the doctor ordered. He played a vigorous game of golf three times a week, was crazy about his children and grandchildren and devoted to Our Lady of Lourdes Parish Church in Venice. And his family and friends loved him. “He’s just a guy with a big heart,” is how several describe him. But despite his seeming vitality, that heart was anything but healthy.

One day he felt a ripple of pain in his chest. Heartburn, he thought. What else could it be? But his chest kept hurting, so just to be safe, he called his doctor and made an appointment.

His doctor prescribed heartburn medicine but told him to return if the discomfort persisted. After three days, the chest pain remained. His doctor suggested he see a cardiologist, Dr. William Corin, and undergo a nuclear cardiac stress test.

Hunihan took the test. And failed it—miserably.

Corin told him the stress test showed that Hunihan’s pain was angina, not heartburn. Still, he felt healthy. How bad could it be?

Very bad. If you think of the heart as a pump, the nuclear stress test reveals how hard it has to work. After injecting a small amount of radioactive fluid into the bloodstream, the physician can use a special camera to see how well blood is flowing in the heart. Hunihan’s heart was working overtime, laboring to keep his blood going to his heart.

Hunihan’s cardiac team recommended a cardiac catheterization, a test that gives useful data about blood flow, blood oxygenation and heart muscle strength. Once again, Hunihan’s heart failed the test.

The catheterization revealed severely narrowed blood vessels—a 90 percent blockage of Hunihan’s arteries. As Corin suspected, he had three-vessel coronary disease: obstruction in the three main vessels of his heart. It was more bad news—but good information.

There was still time to do something about it. And Corin didn’t want to waste any time.

A Christmas to remember

Dr. Corin recommended immediate open-heart, three-way bypass surgery. Hunihan met with Dr. Matteo Dayo, a cardiothoracic surgeon at the Venice Ocala Heart Institute at Venice Regional Medical Center. He agreed with Corin.

“He’s lucky to be alive at all,” Dayo says. “There’s often no warning. That level of blockage can cause sudden death—or at least a serious heart attack. The so-called heartburn saved him.”

They scheduled Hunihan for surgery—on the day after Christmas.

 “There were Christmas decorations everywhere,” Hunihan recalls. “My wife, children and grandchildren stayed with me. They lifted my spirits and gave me hope. I was ready. My attitude was: ‘Let’s do this.”’

And they did it. The surgical team used two veins from Hunihan’s legs and an artery from behind his breast bone to repair the damage. The operation was a success—to the extent that it can be.

Dayo doesn’t mince words. “Yes, heart surgery can prolong people’s lives. But it’s not a magic pill. We don’t cure the disease; we alleviate its effects. We can give you new conduits. We can’t eliminate the original problem.”

Dayo compares open heart surgery to a NASA mission. “It takes incredible teamwork and sophistication to get a space shuttle into space,” he says. “You don’t break out the champagne until it comes back. A successful operation is just the liftoff. The rest of your life is the return flight.”

In other words, Hunihan’s mission was only beginning. But his odds for success seemed good. To the doctors and nurses at the Venice Regional Medical Center, Hunihan was the perfect patient. He returns the compliment. His still raves about the “amazing” team that took care of him. He’s remained friends with many of them.

“Medical care can be cold and impersonal,” he says. “This was the opposite. They took care of my heart—they also had heart. They went that extra mile.”

After five days in the hospital, Hunihan returned home. His recovery went well, except for some discomfort and an episode of tachycardia that sent him back to the hospital for a day.

Despite these setbacks, Hunihan’s recovery mission looked good. After a few bedridden weeks, he started walking. Dr. Corin gave him permission to enter Venice Regional Medical Center’s cardiac rehabilitation program.

Baby steps

Desiree Chase, RN, leads the cardiac rehab team at the center. She speaks proudly of what Venice Regional offers cardiac patients. The eight- to 12-week comprehensive program is designed for people with heart disease or for patients recovering from heart surgery. Nurse specialists monitor vital signs while patients slowly build up their aerobic capabilities.

“We offer exercise regimens, medical evaluations and lifestyle education, which includes classes on medication and diet,” says Chase. “Our program incorporates psychological support as well. It’s not uncommon after a major heart event that people feel that this is the beginning of the end. They were busy people and then boom, everything changes suddenly.”

Hunihan went to the rehab center every day. He says the staff kept “ratcheting up the workout program.” They also gave his mind a workout. Hunihan immersed himself in seminars and classes on meditation, lifestyle and diet. They pushed him. And he pushed himself.

“Rehabilitation has two sides,” he says. “It’s part physical and part psychological. Either way, there’s no instant gratification. You take baby steps. One day, you wake up and notice how much better you’re doing. “

Now every day is a good day. Almost a year after his surgery, Hunihan is doing great. That’s not just his opinion. His cholesterol and blood pressure are better than most people in their 30s.

“I’m on target,” he says. “And I want to stay that way.”

Corin would prefer that people never develop heart disease in the first place. To paraphrase Sun Tzu, the greatest medical victory is the battle you don’t have to fight.

“Doctors aren’t mechanics or plumbers,” Corin says. “We can’t put in new parts and make you good as new. Cardiac bypass surgery doesn’t give you a new heart. After a major cardiac event, your heart will never be as good. Avoid the heart attack in the first place—that’s the smart thing to do. If you make bad choices, don’t expect your doctor to put Humpty Dumpty together again.”

He’s not knocking doctors. Today’s doctors have a vast arsenal at their disposal, including statins, beta blockers, ace inhibitors and aspirin. “We’re aggressive about modifying risk factors, but you’re the greatest risk factor of all,” Corin says.

Now, more than ever, Hunihan is paying attention to those choices. He intends to do everything he can to keep his heart disease under control. And he believes he was blessed with a wake-up call. “A fatal heart attack was in the cards for me. That chest pain saved me,” he says.

His advice to others?

“Warning signs are a blessing; don’t ignore them. If you have heart disease, don’t give up. Keep fighting. It’s not a death sentence. I have a new lease on life. I’m back to doing things I hadn’t done in years.”


Venice Regional Medical Center has been named one of the nation’s 100 Top Hospitals for cardiovascular care by the Healthcare business of Thomson Reuters. This is the third consecutive year that the facility has been recognized with this honor. 540 The Rialto, Venice; (941) 485-7711.

Venice Regional Medical Center’s Cardiac Rehabilitation Center: (941) 483-7354. Dr. William Corin, South County Heart Center, 1225 Jacaranda Blvd., Suite 1225, Venice; (941) 492-5666


Heart disease risk factors include

Age: Simply getting older increases your risk of damaged and narrowed arteries and weakened or thickened heart muscle, which contribute to heart disease.

Sex: Men are generally at greater risk of heart disease. However, the risk for a woman increases after menopause.

Family history: A family history of heart disease increases your risk of coronary artery disease, especially if a parent developed it at an early age (before age 55 for a male relative such as your brother or father and 65 for a female relative such as your mother or sister).

Smoking: Nicotine constricts your blood vessels, and carbon monoxide can damage their inner lining, making them more susceptible to atherosclerosis. Heart attacks are more common in smokers than in nonsmokers.

Poor diet: A diet that’s high in fat, salt and cholesterol can contribute to the development of heart disease.

High blood pressure: Uncontrolled high blood pressure can result in hardening and thickening of your arteries, narrowing the vessels through which blood can flow.

High blood cholesterol levels: High levels of cholesterol in your blood can increase the risk of formation of plaques and atherosclerosis. Plaques can be caused by a high level of low-density lipoproteins (LDLs), known as “bad” cholesterol, or a low level of high-density lipoproteins (HDLs), known as “good” cholesterol.

Diabetes: Diabetes increases your risk of heart disease. Both conditions share similar risk factors, such as obesity and high blood pressure.

Obesity. Excess weight typically worsens other risk factors.

Physical inactivity. Lack of exercise also is associated with many forms of heart disease and some of its other risk factors, as well.

High stress.Unrelieved stress in your life may damage your arteries as well as worsen other risk factors for heart disease.

Poor hygiene. Not regularly washing your hands and other habits that can help prevent viral or bacterial infections can put you at risk of heart infections, especially if you already have an underlying heart condition. Researchers also believe poor dental health may contribute to heart disease. Germs on your teeth and gums can travel from your mouth to your heart, potentially worsening coronary artery disease.

Source: Mayo Clinic


Warning Signs

Some heart attacks are sudden and intense—the “movie heart attack,” where no one doubts what’s happening. But most heart attacks start slowly, with mild pain or discomfort. Often people affected aren’t sure what’s wrong and wait too long before getting help. Here are signs that can mean a heart attack is happening:

Chest discomfort. Most heart attacks involve discomfort in the center of the chest that lasts more than a few minutes, or that goes away and comes back. It can feel like uncomfortable pressure, squeezing, fullness or pain.

Discomfort in other areas of the upper body. Symptoms can include pain or discomfort in one or both arms, the back, neck, jaw or stomach. 

Source: American Heart Organization

Filed under
Show Comments