Lancaster Physician Summer 2019 - 39

SUMMER 2019

If more aggressive treatment is needed,
patients benefit from significant advancements in stents used to assure arteries
remain open after angioplasty has been
performed to open blocked arteries.
While open heart surgery sometimes is
needed to treat valve conditions, surgeons
often now can deliver a new valve with
a catheter, eliminating that need. And,
advancements in pacemakers and implanted
defibrillators have brought about improvements when treating issues with the heart's
electrical system and improving quality of
life for patients.
"We now have a tiny pacemaker that can
be implanted with a catheter," explained
Polinsky. "We're seeing a lot of advancements in that area."
Cardiac care is no different from many
other areas of medicine, in that researchers
and physicians are learning more all the
time, to the benefit of patients.
Polinsky related that when Franklin Delano Roosevelt was U.S. President during
the 1940s, his blood pressure sometimes
went into the 200s. At that time, a high
blood pressure was thought to be a sign of
a strong heart.
Not only did Roosevelt suffer from severe
heart disease, a month after his blood pressure was measured at 240/130, he died of a
massive cerebral hemorrhage while having
his portrait painted.
"What we've learned over the past century
is really amazing," Polinsky said. "It's a completely different world for cardiac patients."
Still, Polinsky joins other cardiologists
who worry about the incidence of high
blood pressure and cholesterol, diabetes,
and obesity among younger patients, all
of which are risk factors for heart disease.
He urges his patients to consider lifestyle
factors such as not smoking, watching food
intake, and getting or staying active.

Also, he said, it's important to know your
body and pay attention if it's telling you
that something is amiss.
If you're unable to maintain physical
activity, experiencing chest pains or
shortness of breath, or experiencing other
symptoms, contact your care provider.
"Be aware and vigilant of those types of
red flags," Polinsky advised. "Your body
usually will let you know if something is
wrong."
WellSpan Health
Patrick Fitzsimmons, II, a cardiologist
with WellSpan Medical Group who practices out of WellSpan Cardiology, said that
excellent cooperation between WellSpan
physicians assures first-rate care for patients
with immediate or serious cardiac needs.
If a patient is determined to need openheart surgery, for instance, he or she can be
quickly transported to a WellSpan hospital
for treatment.
"Our physicians are all working together in a streamlined way that benefits our
patients," Fitzsimmons wrote in an email.
Doctors also embrace a team approach to
cardiac care, with cardiologists and cardiac
surgeons working together to use drugs
and techniques that most benefit patients.
They employ recent advances in cardiac
treatments, Fitzsimmons wrote, including
minimally invasive procedures that result in
shorter hospital stays and quicker recovery
times for patients.
Transcatheter aortic valve replacement
(TAVR), a procedure that replaces a narrowed aortic valve, is available at WellSpan
York Hospital, Fitzsimmons noted. TAVR
provides a minimally invasive option for
valve replacement surgery, making it ideal
for patients who are at high risk for openheart surgery.
Other minimally invasive techniques used
by WellSpan physicians include installation
of a mitral valve clip, during which a small

LANCASTER

39

PHYSICIAN

metal clip is attached via a catheter onto the
mitral valve to restore function. Teams also
use catheters to insert the Watchman device,
used to block the left atrial appendage in
people who have atrial fibrillation and are
at increased risk for stroke.
Fitzsimmons is excited about advances
in the ability of cardiologists to identify
patients who are at risk for heart attacks
due to the presence of a type of coronary
plaque that ruptures and causes a blood clot
to form, blocking blood flow to the heart.
He predicts that within five to 10 years,
cardiac MRIs will be available that are able
to determine the thickness of plaque and
identify plaque that is likely to rupture.
Along with praise for recent advances
and optimism about the future, however,
Fitzsimmons also has some practical advice
for patients.
Modify the traditional Pennsylvania
Dutch diet-heavy on processed meats
and sweets-to be more like the Mediterranean diet, which emphasizes fresh fruits
and vegetables, healthy fats, whole grains,
legumes, and fish.
If you smoke, find a way to quit that
doesn't involve turning to vaping. Begin or
continue an exercise program that includes
45 minutes of continuous movement every
day. Monitor your blood pressure, blood
glucose, and cholesterol levels. If your
cholesterol is high, get on medications to
lower them.
Doing those things, according to Fitzsimmons, can reduce your risk of heart disease
by 50 percent. Patients who have already
been diagnosed with heart disease also can
benefit from these guidelines.
According to Fitzsimmons, the human
body is like a car, in that if you don't take
care of it, you can blow out the engine and
cause serious problems.
As cardiac care continues to advance and
evolve, much of the burden of that care still
falls on patients.



Lancaster Physician Summer 2019

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