Advanced Heart Care Close to Home

In March of 2021, Ashley Martin suffered cardiac arrest, which kills about 90% of people when it happens outside of a hospital. Thankfully, she was already at Wellstar Kennestone Regional Medical Center receiving the compassionate care she’d been seeking to address a long list of symptoms.

Everything began at a hectic time in Ashley’s life. She was 30 and had just gotten engaged. Wedding planning had started with the help of her fiancé and their two young boys. The hope had been to have the wedding toward the end of 2021. But the unexpected happened.

“I was always healthy,” she said. “I grew up playing sports. I was a runner. I used to get headaches, but that was the extent of my medical history.”

Finding the right care when there is more than one symptom

Symptoms of what would ultimately be diagnosed as Guillain-Barré syndrome began in February of 2021. This rare neurological disorder causes the body’s immune system to attack the nerves. 

Ashley started experiencing tingling in the tips of her hands and feet, which moved up her legs and arms as days passed. When intermittent numbness became a symptom, Ashley went to a hospital near her Peachtree City home. A clean CT and MRI meant she went home with plans to see a rheumatologist.

As she waited for her first appointment, she started feeling numbness in her feet.

“At one point, I took a step down the stairs and went tumbling down to the concrete floor,” Ashley said. 

On another trip to the hospital near her home, Ashley was diagnosed with Guillain-Barré syndrome, but treatment was unsuccessful. The numbness continued, spreading to her face. She began using a walker and, soon after, a wheelchair.

“The paralysis had moved to my abdomen,” Ashley said. “I went to sleep one night and woke up abruptly gasping for air.”

Compassionate medical care at a pivotal point

 Later that night, an ambulance brought Ashley to Wellstar Kennestone, where she would finally get the specialized neuro care she desperately needed. She was admitted to the Neurocritical Care unit, staffed by physicians, nurses and a medical team with specialized training in neurological conditions.

Upon arrival, she underwent respiratory failure due to paralysis spreading to her diaphragm. She was stabilized, but shortly after that, she experienced sudden cardiac arrest — the abrupt loss of heart function that stops blood flow to the body.

After a critical care nurse administered CPR, Ashley’s heart started beating again. Life support medications were given to keep her heart pumping.

“The neuro ICU nurses and doctors saved my life,” she said.

Later, her attending neurologist explained that the stress of her nervous system and immune system fighting, paired with respiratory failure, caused such high stress that she had a cardiac arrest.

There aren’t many people out there who can say they survived cardiac arrest at 30. Kevin Miskewicz can.

According to the American Heart Association, more than 90% of people who experience an out-of-hospital cardiac arrest die. Those who survive often have permanent neurological disabilities. But Kevin’s story has an incredibly fortunate ending, thanks to the highly coordinated work of his medical experts at Wellstar.

Recovering from cardiac arrest is something Kevin will never forget. It lives forever as a piece of his health history — one that includes a dedicated healthcare team — and his wife, who was the first to save his life.

CPR to the rescue

Kevin woke up on Labor Day 2017 at 5:30 a.m. to take the dog out. Pausing to adjust the thermostat as he came in, he fell, knocking over a lamp.

He was in cardiac arrest.

With no symptoms and no known pre-existing condition, this was unexpected, but that didn’t stop his wife, Andrea, from jumping into action.

“If it weren’t for me knocking over a lamp when I passed out,” said Kevin, “she would have never woken up and saved my life.”

In addition to calling 911 and unlocking the door for the paramedics, Andrea performed CPR for 10 minutes.

“Kevin’s wife doing good CPR was critical,” said Dr. Arthur Reitman, the interventional cardiologist who was a vital part of Kevin’s treatment team at Wellstar Kennestone Regional Medical Center. “More than five minutes of poor blood flow to the brain can result in permanent irreparable injury from which a patient is unable to recover.”

Coordinating multidisciplinary care to save a life

When paramedics arrived at Kevin’s home, he had no pulse and was not breathing. As the paramedics performed their lifesaving work, he technically died two times.

The ambulance took him to Wellstar North Fulton Medical Center, where he was initially assessed and treated by Dr. David Jacoboff. The interventional cardiologist implanted an intra-aortic balloon pump to stabilize him. Then, he transferred Kevin to Wellstar Kennestone Regional Medical Center for highly specialized heart care.

When Kevin arrived at Kennestone by helicopter, his heart function wasn’t strong enough to support his body. Dr. Reitman and a team of doctors including a cardiologist, a pulmonologist and critical care doctors worked in tandem to put Kevin on an advanced life support system called veno-arterial extracorporeal membrane oxygenation. Better known as VA-ECMO, it took the heart “offline” so it could heal. The technology removed unoxygenated blood from his body, oxygenated it and pumped it back in for the next three days.

“Very few places in the state — only four or five hospitals — have the technology and specialized training to put a patient on ECMO,” Dr. Reitman explained.

A new multidisciplinary program at Wellstar cares for people with aortic conditions, providing both emergency and non-emergent treatment.

The Wellstar Comprehensive Aortic Program brings together a highly-skilled team of experts, including cardiovascular surgeons and vascular surgeons, cardiologists, anesthesiologists, nurse practitioners and physician assistants. These providers share the common goal of diagnosing, treating and preventing aortic diseases and emergencies — making care more comprehensive and improving outcomes for patients.

“Traditionally, aortic diseases have been managed by multiple physicians spread throughout multiple specialties, which can lead to confusion, delays in treatment and competing treatment plans,” said Wellstar Cardiothoracic Surgeon Dr. James Ryan Burke. “Wellstar has created a single, multidisciplinary program to bring together aortic-specific disease expertise and leverage advanced technology.”

Aortic health is crucial to overall wellness

The aorta is the major artery that carries blood away from the heart to the rest of the body. If the aorta is ruptured, then blood does not flow to other areas like the legs, feet and brain, which can lead to lasting brain damage or death.

An aortic aneurysm is an abnormal bulge in the wall of the aorta. Aneurysms are often asymptomatic until they become large, rupture or dissect. However, an aortic dissection, when a tear develops on the inner wall of the aorta, is one for concern. Depending on the aneurysm location, the most common symptom could be one of severe chest pain, back pain, or abdominal pain.  When an aneurysm ruptures or tears, it can lead to death within minutes or hours.

Wellstar’s aortic program takes a proactive approach to prevent aneurysms by monitoring and treating aortic conditions.

“Identifying aortic pathology early leads to better patient outcomes,” said Wellstar Cardiovascular Disease Specialist Dr. Jennifer Giuseffi. 

The program’s team partners with patients to reduce their risk of an aortic emergency. Risk factors include tobacco use, being older than 65, obesity, high blood pressure, high cholesterol, history of coronary artery disease or peripheral vascular disease, family history of aneurysms, certain connective tissue disorders, and certain genetic conditions. Men are also at higher risk than women.

The team of aortic care specialists gets to know each patient and collaborates with them to create a personalized care plan to keep their aorta healthy.

“Every patient is different. Every aorta is different. The risk factors and complications with every aorta are different,” Dr. Giuseffi said. “Within our group, we’ll be able to address all of our patients’ issues individually.”

Wellstar’s approach to aortic care brings together experts from multiple specialties, allowing patients to have all their questions answered and get multiple perspectives.

“All patients with aortic diseases being cared for at Wellstar will benefit long-term through the program’s unique collaboration of health care practitioners from cardiology, cardiac surgery and vascular surgery all working together to ensure the best possible care and outcomes for patients with these complex heart conditions,” said Vascular Surgeon Dr. Michael Corey.

Managing aortic emergencies

While the program includes an outpatient component to help patients manage aortic conditions or recover from aneurysms or dissections, the systemwide team is also prepared to save lives and step into action during emergencies.

The program offers treatments including aortic root and aortic valve surgery, thoracic aortic surgery and thoracoabdominal aortic surgery.

If you experience any of these symptoms of aortic disease, call 911:

• Severe, sudden pain in the chest, back, abdomen or groin area
• Pulsating feeling in the abdomen similar to a heartbeat
• Cold, numbness or tingling in the hands, legs or feet
• Drop in blood pressure, dizziness or feeling faint

While the team performs procedures at Wellstar Kennestone Regional Medical Center, care teams at all Wellstar hospitals are trained in how to address aortic emergencies and transfer patients if needed. Kennestone was the first hospital in Georgia and only fourth in the country to receive the highest certification in cardiovascular care — the Comprehensive Cardiac Care Center Certification — by The Joint Commission and American Heart Association.

Receiving care from the Wellstar Comprehensive Aortic Program

To see a provider in the aortic program, patients can either be referred by their physician or call the office to make an appointment. The team will help patients determine which provider they should see first, depending on their health history or aortic condition. Call (770) 590-4180 to make an appointment or learn more about the program.