Lancaster Physician Summer 2019 - 37

SPRING 2019

Heart disease is responsible for one in
four deaths among Americans and-with
a rising prevalence of obesity and diabetes,
including among younger people-many
physicians are concerned that it will continue
as a serious threat to health in this country.

"There are lots of medications for the
general population, but now also for these
more difficult to treat groups," Wood said.

The costs of heart disease are high, both
in lives lost and fees for medical services,
medications, and lost productivity. The
CDC estimates that heart disease costs
America about $200 billion every year.

While the traditional practice has been
for patients to receive care for specific
conditions from doctors in different disciplines, those disciplines are now coming
together to provide a continuum of care,
Wood explained.

Lancaster Physician reached out to representatives of Penn Medicine Lancaster
General Health, UPMC Pinnacle, Penn
State Health, and WellSpan Health to
learn more about advancements in cardiac
care, patients' attitudes regarding cardiac
health, cardiac problems that specifically
affect Lancaster County residents and other
cardiac-related topics.
Penn Medicine Lancaster General Health
While advances in medical technology
tend to take center stage in the cardiac care
arena, Dr. Todd Wood, division chief of
cardiology at Lancaster General Hospital,
also is excited about new medicines to treat
cardiac-related conditions and increasing
collaboration between medical disciplines
that can improve care for patients.
"The technology always seems to get
the limelight, but there are a lot of other
exciting things happening in the field of
cardiac care," said Wood, an interventional
cardiologist with The Heart Group of
Lancaster General Health.
New and better medications are being used
to treat niche patient populations for whom
earlier drugs were not particularly effective.
This is significant in Lancaster County,
according to Wood, where there are pockets
of patients who suffer from familial hyperlipidemia, an inherited disorder that causes very
high levels of cholesterol and triglycerides.
Aggressive new medications also are available
to treat patients who have had trouble with
glycemic control and treating hypertension.

Wood also is optimistic about a shift
in the delivery of care to cardiac patients.

For instance, cardiologists and oncologists
are beginning to work together to treat or
prevent heart problems in patients who have
been treated for cancer and are susceptible
to conditions caused by chemotherapy,
radiation, or certain cancer drugs.
Patients suffering from congestive heart
failure can be monitored by primary care
providers or remotely, while internists can
screen patients at risk for aneurysms.

"We're starting to see
a much greater degree
of collaboration,"
Wood said. "It's
becoming much more
of a team sport."

While medications are advancing and
Wood is encouraged by changes in how
patients receive care, advances in technology
over the last 35 years have most dramatically
changed the field of cardiac care.
An increasing prevalence of minimally
invasive procedures such as vale repair and
replacement means that patients who are
too sick to tolerate surgery and others can
be successfully treated with positive results
and shorter recovery times.
"Surgery will always have a role," Wood
said, "But minimally invasive is now a
theme at Lancaster General Health."

While optimistic and excited about the
future of cardiac care, in which he envisions
more genetic-driven therapies, increased
collaboration and minimally invasive
procedures, Wood also has concerns about
rising rates of cardiac disease in younger
patients, many of whom suffer from obesity
and/or diabetes.
Patients who may want to take care of
themselves by eating well and exercising
sometimes have trouble accessing healthy
foods or finding means of physical activity.
"Social challenges sometimes trump the
desire to do what's good for you," Wood said.
He also expressed frustration with fluctuations in insurance plans that sometimes
make it necessary to adapt treatments that
have worked well for patients and with the
overall regulation of medicine that requires
reporting and other practices that may take
away from clinical care.
"It's no longer enough to take excellent
care of your patient," Wood said.
UPMC Pinnacle
Dr. Gordon H. Hutt, a UPMC Pinnacle
provider cardiologist at Cardiac Consultants
in Lancaster, has been practicing medicine
for more than 30 years and has witnessed
huge advancements in cardiac care.
The biggest strides, he said, have been in
the treatment of coronary disease and heart
failure, and the ability to control cholesterol
levels among most patients.
"These areas have gotten much, much
better over the past 20 to 30 years," Hutt said.
Improvements in stents and the ability to place them, new coronary bypass
techniques, and increased ability to repair
and replace heart valves also have vastly
improved outcomes for patients.
The way a patient who has suffered a heart
attack is treated has changed dramatically
over past decades.
Continued on page 38

LANCASTER

37

PHYSICIAN



Lancaster Physician Summer 2019

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