Quick Cardiac Care Saves Patient at Franklin Hospital and LIJ Medical Center
"It felt like there was a dagger in my back,” said 47-year-old Noel Riley. The Valley Stream resident had woken up with chest pain and intermittent searing pain across his back, and when the pain would not go away, he headed to Franklin Hospital, where Mollie Williams, MD, made a diagnosis that would save his life. Mr. Riley was experiencing an ascending (type A) aortic dissection which, without treatment, is fatal for 90 percent of patients within 48 hours. Mr. Riley required emergency surgery to prevent rupture and was transferred to LIJ Medical Center’s specialized cardiac team for immediate surgery.
Symptoms of Aortic Dissection
Aortic dissection happens when a tear inside the layered wall of the aorta (the largest artery of the body) causes bleeding into and along the wall, forcing the layers apart. Symptoms are varying and similar to those of other heart problems — such as a severe ripping or tearing pain from the shoulder blades or back and extending to the chest, loss of consciousness, shortness of breath, sweating or overall weakness — which can make proper diagnosis difficult. Mr. Riley “did not have chronic hypertension, his EKG [electrocardiography] and blood work were normal, and he looked healthy,” said Dr. Williams, who treated him in Franklin’s emergency department. Considering his symptoms, she ordered a computed tomography (CT) scan, a test commonly used to diagnose aortic dissection, and discovered the seriousness of his condition.
Quick Actions Lead to Survival
The team at Franklin quickly transferred Mr. Riley to LIJ Medical Center’s Department of Cardiothoracic Surgery. There, a team of clinicians rushed him into surgery, where Jacob Scheinerman, MD, associate chair of the department, removed the damaged segments of the ascending aorta, replaced the tissue with a graft and, along with Robert Palazzo, MD, repaired the damaged aortic valve. “Mr. Riley’s type A dissection, which involves the root of the aorta, is the most dangerous type,” said Dr. Scheinerman. “The key to his survival was how quickly Franklin’s team made a diagnosis and got him to our operating room. Many people never even make it to the hospital.”
The risk factors for aortic dissection include a history of uncontrolled hypertension, aortic aneurysm, a dilated aorta or congenital connective tissue disorders, such as Marfan syndrome or Ehlers-Danlos syndrome, explained Dr. Scheinerman. Mr. Riley had none of these risk factors.
As an orthotist (a medical field specializing in the design of orthopedic appliances), Mr. Riley was familiar with the condition aortic dissection but was shocked by the diagnosis. “Dr. Williams’ ability to listen was pivotal to my survival,” said Mr. Riley. Her quick actions to explore all causes of his pain are the reason he made it to surgery in time, and the collaboration of the healthcare teams at Franklin Hospital and LIJ Medical Center saved his life.
“Mr. Riley’s case highlights the benefits patients receive from the collaboration of North Shore-LIJ hospitals,” said John Rohe, MD, director of emergency medicine at Franklin. “Our facilities truly work together to save lives.” Mr. Riley’s survival is also a testament to the health system’s cardiac care and each hospital’s access to that care, well evidenced by Dr. Williams calling in the expertise of LIJ Medical Center’s cardiac Emergency Medical Services (EMS) transfer team and Aortic Surgery Center physicians. Mr. Riley has nothing but praise for the care he received at both Franklin Hospital and LIJ Medical Center. “It was nothing short of excellent,” he said. “They saved
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