Lancaster Physician Summer 2019 - 38

L A N C A S T E R M E D I C A L S O C I E T Y.O R G

Perspectives

In the case of some obese patients, bariatric surgery may be recommended.
"We have to be vigilant with our
patients," he said. "Patient care comes first
here and our whole goal is patient service
and improving quality of life."
As a cardiologist, Hutt sometimes gets
frustrated by the cost of health care, particularly when he has patients who can't afford
medications that would be advantageous
to them.
"We have patients calling all the time
who can't afford their medications," he said.
"It's sad when we know there's a certain
medication that could help them, but they
can't afford it."

Patients are treated more aggressively
early on with cardiac catheterization, angioplasty, and stents. Studies have shown that
early cardiac catheterization and stenting
are preferred over the use of clot dissolving
medication, such as tissue plasminogen
activator (tPA), to dissolve coronary clots.
While tPA or other drugs sometimes
are used, they are rarely in conjunction
with catheterization, angioplasty, or stents,
advised Hutt.
"We know that the best thing to do is
get someone right into the cath lab," Hutt
said. "The sooner that happens, the better."
Thanks to minimally invasive procedures
and other treatment advances, along with a
better understanding of the needs of heart
attack patients, recovery times are much
shorter and hospital stays greatly reduced.
"In the 1960s, treatment of a heart attack
patient would be total bed rest for 10 days to
two weeks. Now we have them up and moving
and home within 48 hours," explained Hutt.

Another area of improvement in cardiac care is that many patients are better
educated than they were in the past. Hutt
believes that is particularly true of women.
"Heart disease used to be a man's disease,"
he said. "But, women now know that their
risk of dying from cardiovascular disease is
greater than from all cancers combined."
Heart education campaigns have raised
awareness about heart disease and how to
prevent it, but despite that, many people
remain at risk. Smoking is still a problem
among some of his patients, Hutt said,
and the increasing incidence of obesity and
diabetes is a worrisome trend.
He advises his patients to watch what
they eat and to try to get some exercise
every day.
"I think walking just 20 to 30 minutes
a day goes a long way toward improving
health," Hutt said.

LANCASTER

38

PHYSICIAN

Looking down the road, Hutt predicted
continual improvement in medications and
technology used to develop devices such
as ventricular assist devices. Overall, he
said, cardiac care will keep getting better
as doctors continue to learn more about
the causes and treatments of heart disease.
Penn State Health
Recognizing and addressing symptoms
of heart disease early on enables physicians
to monitor patients and keep symptoms
under control before they present as major
problems. That, according to Dr. Ronald
Polinsky, a Penn State Health cardiologist
who is on staff at the Lime Spring Outpatient Center in Lancaster, has been a
notable improvement in how cardiac care
is practiced.
"We're probably more proactive now than
before with acknowledging certain symptoms that might not have been addressed
in the past," Polinsky said. "As a specialty
in general, we're diagnosing people with
coronary disease earlier.
Once a problem or potential problem
has been identified, patients benefit from
the availability of advanced imaging, medications, stress tests, monitoring, and other
diagnostic tools and treatments.



Lancaster Physician Summer 2019

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