Surprised by Heart Attack
Jim Violante is naturally enthusiastic, active and outgoing, qualities that have served him well in retirement. An avid exerciser, Jim works out at his gym up to five times a week. As a result, he was so sure of his fitness that when he experienced sharp chest pains and sweating last year he dismissed them as symptoms of a gall bladder attack. He took a few aspirin, laid down for a while, and then, when his symptoms subsided, drove to the gym and swam for an hour. As an afterthought, he decided to check in with his general practitioner, and ultimately wound up at HackensackUMC at Pascack Valley for tests.
Dr. Perminder Grewal, a cardiologist, took one look at his EKG—and sent him immediately by ambulance to HackensackUMC. Jim Violante had had a massive heart attack. While en route, Dr. Rajiv Singh, an interventional cardiologist at HackensackUMC, and his team were briefed and prepared for Jim’s arrival. The team was able to unblock his coronary arteries with a series of stents.
“Jim is really quite fortunate,” Dr. Singh says. “Because he was in such good shape, he tended to minimize the possibility that he could have had a heart attack.” As it turns out, he inadvertently put his life at risk by not seeking medical attention at the onset of symptoms.
Physicians open blocked coronary arteries by inserting a very thin, hollow tube called a catheter into a blood vessel and threading it through the arterial system until it reaches the site of the blockage. They then push a stent through the catheter, expanding it to open the artery and locking it in place. Most interventional cardiologists use a large artery in the groin as a starting point, but Dr. Singh uses a relatively new technique, starting the catheter at the wrist.
“Although it takes more expertise, this procedure is considered to be safer for patients,” he says. “It is also more comfortable and requires less sedation. Patients are able to sit up and follow the X-ray images of the procedure as we perform it.” Jim took full advantage of the opportunity. “Dr. Singh took the time to explain to me what was going on as it happened,” Jim says. “It’s an amazing procedure.”
Jim approached his recovery with his customary thoroughness and zest. As soon as Dr. Singh cleared him to exercise, Jim became one of the first patients to enroll in the newly-opened Cardiac and Pulmonary Rehabilitation Center at HackensackUMC at Pascack Valley. The program not only helps people recover their strength and stamina but it gives them the tools they need to make heart healthy lifestyle changes. The program heightened Jim’s vigilance about watching his diet and provided an exercise routine that he now follows at his own gym. “The team at the center was extremely knowledgeable and professional,” he says. “I’m definitely a lot more careful now about watching my weight and my diet.”
Jim’s heart attack was a source of amazement for many of his friends. “You of all people!” they exclaimed when he told them about it. Jim’s experience demonstrates that exercise by itself may not prevent heart disease in the face of such risk factors as high cholesterol and high blood pressure. It may help explain, however, why Jim has made such a complete recovery. “On his echocardiogram, there is no sign that he has ever had a heart attack. It’s as if nothing had happened,” says Dr. Singh. “But in fact, a great deal has happened, and I told him that enjoying his recovery means keeping that in mind.”