in Symptom-Free 81-Year-Old Patient
(October 11, 2019) Hackensack, NJ - When 81-year-old Rosalin Scott of Old Tappan, New Jersey, went to visit her cardiologist at Hackensack Meridian Health Hackensack University Medical Center in July 2019 for a routine annual checkup, she had no idea that she was living with a serious cardiac condition that — if left untreated — could have caused her to experience a life-threatening cardiac event.
Fortunately for Rosalin, her cardiologist, William D. Salerno, M.D., director of the Advanced Cardiovascular Assessment Program (ACAP) at Hackensack University Medical Center, ordered a new, non-invasive test called HeartFlow® Analysis. The test was able to detect problems with blood flow to Rosalin’s heart caused by a blockage in her coronary arteries before her condition resulted in bothersome symptoms or a potentially deadly heart attack.
An Abnormal Result
When Rosalin went to see Dr. Salerno, she said she was feeling fine and had no symptoms of a cardiovascular problem. As part of her routine cardiovascular screening, Rosalin had an electrocardiogram (ECG) to measure the electrical activity of her heart. Her ECG showed an abnormality called a left bundle branch block, a condition that can occur in patients with hypertension and coronary artery disease (CAD) which carry an increased risk of heart attack.
Because a left bundle branch block can be caused by an underlying cardiovascular condition, Dr. Salerno ordered additional testing to help him determine what the next steps should be for Rosalin’s treatment.
“Being the thorough and outstanding physician that he is, Dr. Salerno ordered further studies — including a HeartFlow Analysis at Hackensack University Medical Center,” said Rosalin.
About HeartFlow Analysis
Hackensack University Medical Center was the first facility in New Jersey to offer HeartFlow Analysis to its patients. HeartFlow Analysis is a noninvasive, painless test that uses images from a computed tomography (CT) scan to create a computerized, 3D model of each patient’s coronary arteries. Computer algorithms are then used to simulate blood flow and calculate the impact of any blockages in the coronary arteries on blood flow to the heart.
“When it comes to coronary artery disease, it’s not just about blockages. We’re also looking at blood flow, because blood flow is a better predictor of patient outcomes,” said Dr. Salerno. “Like Rosalin, approximately three-quarters of people with a blood flow problem won’t experience chest pain or other symptoms that would point to CAD.”
Before the availability of the HeartFlow Analysis tool, Dr. Salerno said cardiovascular specialists would rely on stress testing, ultrasound and nuclear imaging to determine whether patients had blood flow problems. Although these tests are noninvasive and still have a place in cardiovascular testing they have a lower accuracy in detecting blood flow problems associated with coronary artery disease.
In the past, if stress testing with nuclear imaging suggested that there may be a problem with blood flow to the heart, the next step was for a patient to undergo an invasive cardiac catheterization procedure, which involves threading a catheter into the arteries to look for — and possibly treat — blood-flow-limiting blockages. However, studies have suggested that a significant number of patients who undergo cardiac catheterization based on the results of less-accurate noninvasive tests don’t have blood-flow-limiting blockages at all, and therefore have no need for this type of intervention.
HeartFlow Analysis is a tool that provides cardiovascular specialists with the advantage of seeing both blockages and blood flow disturbances so they can more accurately determine whether a cardiac catheterization procedure is necessary. And, HeartFlow Analysis results are available to physicians within hours, meaning that patients who have significant CAD can quickly receive a diagnosis and appropriate treatment.
A Necessary Intervention
In Rosalin’s case, her HeartFlow Analysis revealed an abnormality that warranted further exploration with a type of cardiac catheterization procedure called a coronary angiogram.
Although she felt very anxious before the procedure, Rosalin said she knew she was in good hands when Dr. Salerno referred her to Pranaychan J. Vaidya, M.D., an interventional cardiologist at Hackensack University Medical Center, who performed her coronary angiogram.
“Dr. Vaidya explained the procedure in very simple terms so that I, a non-clinician, could understand the intent of the procedure, the steps, and the recovery period,” Rosalin said.
Rosalin described the procedure as “quick and, thankfully, uneventful” and said that she did not need stents, which are hollow tubes that hold arteries open after blockages are removed.
Dr. Salerno said that Rosalin’s HeartFlow Analysis results matched perfectly with the findings during her coronary angiogram.
“Rosalin’s experience shows us that HeartFlow Analysis can be useful in predicting whether certain patients need cardiac catheterization. If the HeartFlow Analysis suggests that there may be a blood flow problem, there is a high likelihood that we will see that abnormality during the cardiac catheterization,” said Dr. Salerno. “Also, certain carefully selected patients who do not have evidence of blood flow problems on their HeartFlow Analysis may be able to safely avoid further testing which is an invasive procedure.”
A Major Shift in Care
According to Dr. Salerno, HeartFlow Analysis represents a major shift in cardiovascular care, allowing physicians to diagnose CAD in certain patients without the need for invasive testing.
“Rosalin’s condition placed her at a high risk of having a life-threatening cardiac event,” said Dr. Salerno. “By using HeartFlow Analysis, we were able to identify and treat Rosalin’s cardiovascular disease before she even had symptoms — and it’s always better to prevent a cardiac event than to start treatment after an event occurs.”
Today, Rosalin said she is feeling great — and relieved. She said that she is grateful to Dr. Salerno, Dr. Vaidya, and her entire care team for intervening before she developed complications.
“Were it not for Dr. Salerno’s exceptional assessment skills and the innovative HeartFlow Analysis capability that Hackensack University Medical Center offers, my story could very well have had a different outcome,” Rosalin said. “Hackensack University Medical Center is second to none.”
“HeartFlow Analysis is one more tool in our toolbox that we can use to provide the best care for our patients,” said Dr. Salerno.
About Hackensack Meridian Health Hackensack University Medical CenterHackensack Meridian Health Hackensack University Medical Center, a 781-bed nonprofit teaching and research hospital located in Bergen County, NJ, is the largest provider of inpatient and outpatient services in the state. Founded in 1888 as the county’s first hospital, it is now part of the largest, most comprehensive and truly integrated health care network in New Jersey, offering a complete range of medical services, innovative research and life-enhancing care, which is comprised of 35,000 team members and more than 7,000 physicians. Hackensack University Medical Center is ranked #2 in New Jersey and #59 in the country in U.S. News & World Report’s 2019-20 Best Hospital rankings and is ranked high-performing in the U.S. in colon cancer surgery, lung cancer surgery, COPD, heart failure, heart bypass surgery, aortic valve surgery, abdominal aortic aneurysm repair, knee replacement and hip replacement. Out of 4,500 hospitals evaluated, Hackensack is one of only 57 that received a top rating in all nine procedures and conditions. Hackensack University Medical Center is one of only five major academic medical centers in the nation to receive Healthgrades America’s 50 Best Hospitals Award for five or more years in a row. Becker’s Hospital Review recognized Hackensack University Medical Center as one of the 100 Great Hospitals in America 2018. The medical center is one of the top 25 green hospitals in the country according to Practice Greenhealth, and received 26 Gold Seals of Approval™ by The Joint Commission – more than any other hospital in the country. It was the first hospital in New Jersey and second in the nation to become a Magnet® recognized hospital for nursing excellence; receiving its sixth consecutive designation in 2019. Hackensack University Medical Center has created an entire campus of award-winning care, including: John Theurer Cancer Center, a consortium member of the NCI-designated Georgetown Lombardi Comprehensive Cancer Center; the Heart & Vascular Hospital; and the Sarkis and Siran Gabrellian Women’s and Children’s Pavilion, which houses the Joseph M. Sanzari Children’s Hospital and Donna A. Sanzari Women’s Hospital, which was designed with The Deirdre Imus Environmental Health Center® and listed on the Green Guide’s list of Top 10 Green Hospitals in the U.S. Hackensack University Medical Center is the Hometown Hospital of the New York Giants and the New York Red Bulls and is Official Medical Services Provider to THE NORTHERN TRUST PGA Golf Tournament. It remains committed to its community through fundraising and community events especially the Tackle Kids Cancer Campaign providing much needed research at the Children’s Cancer Institute housed at the Joseph M. Sanzari Children’s Hospital. To learn more, visit www.HackensackUMC.org.