Allergies or Afib? One patient’s journey to diagnosis
HOUSTON, TEXAS (July27,
Joe Chapman has lived in Houston for most of his life, which is why he was puzzled when he was diagnosed with severe allergies for the first time just a few months ago.
It started with shortness of breath, chest pressure and a bit of heart fluttering. Those symptoms, combined with a chronic cough and congestion, resulted in visits to several Urgent Care Centers, where he was prescribed a number of allergy medications. After three months of taking medications without an improvement in his symptoms, Chapman decided to visit his Primary Care Physician (PCP) for another opinion.
At Chapman’s appointment with his PCP, Jeff C. Wang, M.D., they discussed his sudden onset of allergies, but Dr. Wang also discovered an irregular heart rhythm. Dr. Wang immediately consulted with his colleague Nilay Mehta, D.O, a cardiovascular disease specialist affiliated with Memorial Hermann Northeast Hospital, to determine what was going on.
“Mr. Chapman is a healthy man with minimal risk factors for a heart condition. In his mind, his symptoms were consistent with what he thought were allergies,” said Dr. Mehta. “And he’s not alone. Overlapping symptoms can sometimes delay a diagnosis. However, once we got him into our office and conducted a full exam, we were able to identify the issue quickly.”
Chapman’s electrocardiogram (EKG) showed Atrial Fibrillation (A-Fib), a heart rhythm abnormality that can lead to congestive heart failure, stroke or even death. Upon an exam and further testing, Dr. Mehta also diagnosed him with severe mitral valve prolapse, also known as “leaky” valve, where the mitral valve flutters allowing blood to leak backwards into the left atrium. When the blood leaks back in the left atrium, the chamber dilates, which can lead to A-Fib.
To relieve Chapman’s symptoms, Dr. Mehta started him on a diuretic, as well as a medication to slow his heart rate. Further testing, including a heart catheterization, was completed at Memorial Hermann Northeast Hospital to look for blockages and assess pressures in the heart. Additionally, a trans-esophageal echocardiogram was completed to provide detailed images of the damaged mitral valve. When the workup was complete, it was time to discuss treatment options.
“One of the biggest benefits to being a patient in the Memorial Hermann system is the continuum of care and access to worldwide experts in their fields,” added Dr. Mehta. “While we can handle a large majority of the care here locally, having the most advanced treatment options available down the road in the Texas Medical Center is very handy.”
“In this case, the best treatment option for Mr. Chapman was available at Memorial Hermann Heart & Vascular Institute-Texas Medical Center with Dr. Tom Nguyen, one of the nation’s leading specialists in minimally-invasive valve surgery and mitral repair.”
A few days later, Chapman and his wife met with Dr. Nguyen, a UTHealth cardiothoracic and vascular surgeon who specializes in complex minimally-invasive heart valve surgery. In early May, he performed the minimally-invasive mitral valve repair (Mini MVR) on Chapman.
“I liken mitral valve prolapse to a sail that is flapping in the wind,” said Dr. Nguyen. “During a Mini MVR, I repair the chords of the mitral leaflet so the sail no longer flaps and the valve works again without leaking. I’m able to do this through a very tiny incision that provides a faster recovery than traditional heart surgery.”
In a Mini MVR, Dr. Nguyen creates a small incision between the ribs on the right side of the chest to access and repair the mitral valve. The minimally-invasive procedure can result in a quicker recovery and shorter hospital stay compared to standard open surgery, where the chest is cracked open.
“Mr. Chapman’s surgery went very well. We successfully repaired his valve and he was back to feeling good and functioning normally within days,” added Dr. Nguyen.
Chapman agrees. “It’s been a little over eight weeks since surgery and I’m feeling great. Looking back, I probably ignored some of my symptoms. My advice to others would be to listen to your body and go see a doctor promptly if something seems off.”
For more information about heart and vascular care at Memorial Hermann, visit http://heart.memorialhermann.org/. To schedule an appointment with a heart specialist, visit http://heart.memorialhermann.org/schedulenow/.