We’re all familiar with the expression “serious as a heart attack.” Heart attacks are, indeed, a serious matter in southeastern Iowa. Nearly 20 times each month, on average, someone suffering a heart attack arrives at Great River Medical Center’s Emergency Department in West Burlington, Iowa.

Heart attacks are serious, but heart-related health problems go far beyond heart attacks. To diagnose and treat those diseases, Great River Medical Center created the Heart and Vascular Center. A television documentary will be broadcast this month to explain how the center and its staff can help improve patients’ heart health..

PulseBeat will air at the following times/dates:

Saturday, April 19 6:30 p.m. – KLJB (FOX) Saturday, April 26 6:30 p.m. – KHQA (CBS) Sunday, April 27 11:30 p.m. – KLJB (FOX)

The Heart and Vascular Center combines cardiac testing, radiology and nursing care with physicians who specialize in cardiology, interventional radiology and general surgery to provide a level of comprehensive care that’s unmatched in southeast Iowa.

“We’re doing things that 20 years ago, nobody thought we should ever do,” said Elizabeth Yore, RN, CCRN, director, Heart and Vascular Center and Critical Care Services.

Physicians from throughout southeast Iowa and parts of Illinois and Missouri refer patients to the Heart and Vascular Center at Great River Medical Center.

Thorough diagnosis is crucial
When a patient arrives at the Heart and Vascular Center, a cardiologist thoroughly evaluates the heart and circulatory system. “When we know whether the heart is or is not the problem, then we plan our treatment,” said interventional cardiologist Abdullah Alwahdani, M.D.

To diagnose the condition, a cardiologist orders preliminary blood tests that will point the way toward more sophisticated – but still noninvasive – diagnostics:

• Echocardiogram (echo) – to measure the heart’s pumping and valves activity
• Electrocardiogram (EKG or ECG) – to measure the heart’s rhythm
• Holter monitoring – to track a heart’s activity during daily activities
• Stress test – an EKG or echo performed while the patient is exercising

“If we don’t see a significant abnormality on the noninvasive tests, we may not need to do invasive tests,” said interventional radiologist Jay Radhakrishnan, M.D.

But if these tests don’t give physicians a clear picture of a patient’s coronary arteries, they turn to cardiac catheterization – “the gold standard” for diagnosing heart disease. The Heart and Vascular Center has two catheterization laboratories. After the test, the patient rests for a few hours, and can go home if there’s no problem.

Variety of treatment choices available
If the tests find a problem, physicians move to the next step – intervention. Because they have found the abnormality, they can go right to it.

“If the patient has significant blockage in the heart vessels, we have two choices: either medicine or revascularization,” Dr. Alwahdani said. “Revascularization has two choices: bypass surgery, or balloons and stents. It all depends on the patient’s risk factors, clinical presentation and anatomy of the coronary arteries.”

“We address primarily problems in the lower extremities and carotid artery disease,” said general surgeon Michael Niehaus, M.D. “Sometimes it needs surgery, and sometimes it can be done with the balloon.”

The Heart and Vascular Center at Great River Medical Center provides an expanding variety of noninvasive and minimally invasive procedures, and vascular bypass surgery. If cardiac surgery is called for, the patient is transported to the Heart Institute at Genesis Medical Center, Davenport, or University of Iowa Hospitals and Clinics, Iowa City.

“We’re evolving in this minimally invasive world,” said Donna Wirt, RN, M.S.N., supervisor, Heart and Vascular Center. “Techniques and equipment are changing almost daily. We’re fortunate to have sophisticated, high-technology, supportive equipment.”

“Patients wonder about this because we’re not a huge medical center in a large city,” said interventional radiologist Joseph Marshall, M.D. “But here, you’re one-to-one with experienced people. And every year we update our knowledge.”

“The time it takes some patients to get to treatment is a hardship,” Yore said. “But being here, we cut travel time in half for many patients.”

Rehabilitation addresses changes to way of life
Treatment of heart or vascular patients doesn’t end with intervention. After surgery or a procedure, the focus shifts to outpatient care at the Great River Center for Rehabilitation. Research shows patients in cardiac rehabilitation with exercise experience:

• Less severe angina, and less need for medicine to control it
• Lower blood pressure, cholesterol and triglycerides
• Lower risk of significant heart problems – or death
• Reduced need for hospitalization and physician visits

The goal of cardiac rehabilitation, such as the Great River Medical Center program, is to help patients return to a healthy, active life after treatment. It has three phases.

Phase I introduces the patient to the new status as a heart patient – while the patient is still in the hospital after a procedure.

In Phase II, patients work out in 90-minute classes that meet Monday, Wednesday and Friday. Patients are monitored throughout exercise, which builds slowly to 30 minutes of sustained cardio exercise, with warm-ups before and cool-downs afterward. After the exercise, patients receive about a half-hour of cardiac-care education.

“We talk about various areas of cardiac care,” said Sandy Ford, RN, a nurse specialist with the Cardiac Rehabilitation Program at the Center for Rehabilitation. “We tell them they have coronary artery disease, and they need to work on their risk factors.”

Sessions cover diet, smoking cessation, diabetes, cardiac medicines, exercises and other topics.

“An important part of our education is helping patients make changes to their ways of life to prevent a future problem,” Ford said.

Phase II lasts at least six weeks. When patients graduate, they can continue to exercise in Phase III – sort of like an athletic club with a rehabilitation focus – for as long as they’re physically able. The Phase III program also welcomes cardiac patients from area communities on Tuesdays and Thursdays.

Prevention is a ‘personal responsibility’
“Preventive cardiology is a huge part of our practice,” said cardiologist Mark Woodard, D.O. “The principal areas of prevention are blood pressure, cholesterol levels, smoking and exercise – the ideal amount is at least 30 minutes a day, seven days a week.”

“Patients have to take personal responsibility,” said cardiologist Anthony Lazar, M.D. “Atherosclerosis can affect every vessel in your body – your heart, your brain, carotid arteries, your kidneys, your legs. Prevention is an important factor. You must watch your diet, exercise, quit smoking and take your medicine.”

To help people prevent heart-related diseases, Great River Medical Center sponsors community health-education events and meetings throughout the year, including the Go Red for Women and Stroke Awareness health fairs in May, and monthly meetings of Mended Hearts, the support group for heart patients.

“There’s nothing worse than a heart attack, a stroke or losing a limb because of blocked blood vessels,” Dr. Alwahdani said. “If the idea of having a stroke, a heart attack or an amputation does not motivate you to eat healthy, exercise, check your blood pressure and see your physician frequently, I don’t know what will.”

The Lake Geode Challenge triathlon is scheduled to begin at 7:30 a.m. Saturday, July 12, at Geode State Park in Danville, Iowa. The Olympic-distance event will provide triathletes of all abilities with a challenging race. The Lake Geode Challenge is a USA Triathlon-sanctioned event. All USAT rules will be enforced. The race also is p art of the He art of America Triathlon Series.

The event st arts with a 1.5 kilometer clockwise, out-and-back swim from the sandy beaches of Lake Geode. The swim is followed by a challenging 40 kilometer bike course that takes p articipants on a scenic loop outside Geode State Park. The race concludes with a 10 kilometer run on asphalt roads throughout the park. Chip timing will be used.

Prize money will be awarded to the top three male and female winners. Additional awards will be given to the top three male and female winners in 15 age-group categories, and the top three in the Clydesdale and Athena divisions. Team awards will be given to all members of the top three teams in the male, female, coed and Corporate Challenge categories. In addition, all p articipants will be eligible for door prizes.

The Drake restaurant on the Mississippi River in Downtown Burlington is event headqu arters for check in from 4 to 8 p.m. Friday, July 11. Official race lodging is provided by AmericInn Motel and Suites in West Burlington, (319) 758-9000.

The Lake Geode Challenge is organized by Team BEAST (Burlington Endurance Athlete Sports Team). Lead sponsor for the event is Great River Medical Center, West Burlington, Iowa.

The cost for the Lake Geode Challenge is $60 for individuals and $108 for teams. Spectators are welcome at the viewer-friendly event. P articipants may register for the Lake Geode Challenge on getmeregistered.com. If you have questions or would like to volunteer for the event, please e-mail the race director at racedirector@teambeast.org.

Health professionals from Great River Medical Center will provide information about the diagnosis, treatment and prevention of cardiovascular and peripheral vascular disease during the Cardiovascular Health Fair and Program. Reduced cost lipid and glucose screening also will be available. The event is scheduled Saturday morning, April 26, in the Mercy Plaza, 1225 S. Gear Ave., West Burlington, Iowa.

Presentation schedule:

• 9 to 9:20 a.m. – Know Your Numbers, Gary Mansheim, M.D., family practitioner, Burlington Area Family Practice Center
• 9:20 to 9:40 a.m. – Exercise and Healthy Eating – Jamie Dengler, M.B.A., manager, Health Fitness, Great River Center for Rehabilitation
• 9:40 to 10 a.m. – So What Does Diabetes Have to Do With My Heart? – David Carlson, M.D., family practitioner, Burlington Area Family Practice Center
• 10 to 10:30 a.m. – Break/Displays
• 10:30 to 11 a.m. – Coronary Artery and Peripheral Vascular Disease – Abdullah Alwahdani, M.D., interventional cardiologist, Great River Heart and Vascular Center
• 11 to 11:30 a.m. – Stroke Diagnosis and Treatment – Anil Dhuna, M.D., neurologist, Great River Medical Center

Educational displays ( 8 to 10:30 a.m.):

• Blood pressure
• Cardiopulmonary Rehabilitation
• Diabetes Education
• Great River Heart and Vascular Center
• Great River Medical Center Library
• Great River Sleep Disorder Center
• Great River Wound and Hyperbaric Clinic
• Health Fitness with body-fat analysis
• Heritage Medical Equipment and Supplies
• Nutrition
• Stroke warning signs

Lipid profile and glucose screenings will be offered from 8 to 10:30 a.m. The lipid profile measures total cholesterol, HDL cholesterol, LDL cholesterol, LDL/HDL ratio and triglycerides. The glucose screening measures blood sugar. Fasting for eight to 12 hours is required for accurate test results. Participants may drink water or black coffee and take medicines as scheduled. Results will be mailed in two weeks. Screening cost is $25.

Door prizes will be available. Winners, who must be present, will be announced at the conclusion of the program. Appointments are not necessary for the lipid profile and glucose screening. To register for the presentation program, please call Great River Medical Center’s Corporate Education Department at (319) 768-4070.