A sophisticated cardiac imaging test revealed a serious — and unexpected — finding in one grateful patient.
When Peter Ciccosanti went to work at Monmouth Medical Center (MMC) one evening in June 2019, he never expected he’d become a patient himself a few hours later. “I got out of the car and was walking into the hospital when I noticed I didn’t feel right,” says Peter, 61, of Matawan, a radiology technician who was working the night shift. “I couldn’t put my finger on it, so I just blew it off.” Over the next few hours, Peter started to experience pain in his chest and left shoulder. “I knew something was wrong, so I walked down the hall to the Emergency Department (ED),” he recalls.
In the ED, Peter underwent a stress test and had blood drawn to check for signs of heart trouble, but the results were normal. Still, cardiologist Ajay Shah, MD, suspected something wasn’t right.
“I suggested that we take a CT scan of his heart,” says Dr. Shah, a member of RWJBarnabas Health medical group.
A surprising discovery
MMC is increasingly using cardiac computed tomography (CT) to identify patients with heart problems without subjecting them to an invasive cardiac catheterization, in which a thin, hollow tube is placed in a blood vessel (often in the groin) and threaded through major vessels that lead to the heart. With a cardiac CT, many X-ray images of the heart are taken. A computer compiles the images into detailed pictures that reveal heart health.
Patients receive a “calcium score,” which indicates whether there’s plaque buildup in the arteries, which can reduce blood flow to the he art. (For more information, see “Noninvasive Cardiac Testing below.”) In Peter’s case, the test revealed substantial plaque buildup in his arteries, so he needed additional testing and treatment. If Peter had not had the cardiac CT scan, he might have been discharged from the hospital thinking he was fine.
“The CT scan completely changed things,” says Dr. Shah. “If someone has a normal stress test, he or she is usually sent home. But a patient like Peter would probably have a major heart attack or cardiac arrest. That’s where the CT scan made a big difference.”
Dr. Shah knew Peter needed more invasive testing, so he sent him to Robert Wood Johnson University Hospital (RWJUH) in New Brunswick for a cardiac catheterization, which allows physicians to open clogged arteries and place stents to keep them open. But the test revealed that three of Peter’s arteries were too clogged for balloon angioplasty and stents to be successful.
Peter needed triple bypass surgery, a major operation to restore blood flow to his heart. “All of this was totally unexpected,” says Peter. “I thought I was perfectly healthy.”
A heart-healthy lifestyle
Peter had triple bypass surgery at RWJUH two days after the catheterization. Since then, he’s been more diligent about leading a heart-healthy lifestyle. He’s cut out red meat and shellfish altogether and now eats more chicken, fish and vegetables. He tries to exercise at least three to four days a week, including going to cardiac rehabilitation at MMC once or twice a week and taking four- or five-mile walks near his home on the other days.
Importantly, he followed doctor’s orders to quit smoking. He’s taking cholesterol medication, a beta blocker and baby aspirin to help ward off future heart problems. Looking back on everything that happened, Peter is grateful that Dr. Shah recommended the cardiac CT scan. And he feels very fortunate that when he became ill, he was in the right place—the hospital he’s worked at for 17 years. “I trusted the people who were treating me,” he says.
Non-invasive cardiac testing
February is American Heart Month, and it’s a good time to pay attention to cardiac health since heart disease is the leading killer of men and women. At Monmouth Medical Center (MMC), serious heart problems can be detected in a quick, accurate and noninvasive way. While a CT scan can reveal plaque buildup in cardiac arteries, in some cases the scan is combined with an angiogram, a test that can generate a clearer view of the heart. With cardiac computed tomography angiography, or cardiac CTA, a contrast dye is injected intravenously and a CT scan is performed. Three-dimensional images of the heart can be produced within 15 minutes.
The images reveal narrowing and blockages in the coronary arteries, the type and degree of plaque buildup, and the size of the cardiac chambers. The results allow physicians to determine which patients need medication or other treatments to prevent cardiac events. In some cases, cardiac CTA enables patients to avoid an invasive cardiac catheterization.
Your heart doesn't beat just for you. Get it checked. To make an appointment with a Monmouth Medical Center (MMC) cardiac specialist, click here or 888.724.7123. To learn more about cardiac CTA, call Cardiac Services at MMC at: 732.923.6546