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Article Category: PeopleCare

KevinCare

Surviving sudden cardiac death—and living life to the fullest

Published on January 24, 2023

Last updated 01:40 PM January 08, 2024

Doing good CPR is critical to save someone from 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.

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

CPR to the rescue

Kevin woke up on Labor Day 2017 at 5:30 AM 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 for highly specialized heart care.

When Kevin arrived at Wellstar 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.

Kevin’s wife doing good CPR was critical. 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.

- Dr. Arthur Reitman

Interventional cardiologist, Wellstar Kennestone Regional Medical Center

Preventing sudden cardiac death in the future

Dr. Reitman worked closely with Dr. Rajnish Prasad, Wellstar medical director of cardiovascular critical care services and Dr. Bryan Piedad, Wellstar electrophysiologist, to decide which treatments would give Kevin the best life moving forward.

Despite an extensive workup, there is no known cause for Kevin’s cardiac arrest. And there’s a chance it could happen again. If there’s ever a “next time,” Kevin’s doctors want him to survive.

“A defibrillator is meant to protect the patient once they leave the hospital,” said Dr. Piedad, who implanted the device. “Because Kevin was so young, we elected to put in a subcutaneous defibrillator—it’s implanted around the heart rather than inside it.”

The defibrillator constantly reads and interprets Kevin’s heart rhythm, preventing a future episode of sudden cardiac death by shocking the heart muscle if needed.

Kevin continues to follow up with Dr. Piedad once a year to make sure everything is looking good, to get his defibrillator checked and occasionally replace the generator.

“Dr. Piedad is one of the most brilliant people I’ve ever met!” Kevin said.

Kevin also initiates a weekly transmission of data between his defibrillator and the Wellstar electrophysiology device clinic to help the team monitor his heart.

Understanding the bigger picture

There still isn’t any link that doctors—at Wellstar and other healthcare facilities—can say caused Kevin’s cardiac arrest.

Cardiac disease is often exacerbated by certain risk factors like cholesterol, obesity or diabetes/insulin resistance syndrome—none of which Kevin has. A genetic disorder is another possibility.

“Many people believe there are genetic disorders that have not been discovered yet that may predispose patients to cardiac arrest,” said Dr. Piedad. “His genetic testing is negative, but it doesn’t detect what hasn’t been discovered.”

That’s why Kevin is extra careful with his own daughter. Born after Kevin’s cardiac arrest, she got her first annual EKG when she was just three weeks old.

 

Returning to life as normal

After two weeks in the hospital, including six days in a medically-induced coma and eight in the intensive care unit, Kevin was finally ready to go home.

“In walks Dr. Reitman,” Kevin remembered about discharge day, “and he said, ‘It’s nothing short of a miracle that you’re walking out of here!’ That stuck with me. I’m incredibly grateful for the care I received and the quality of care at Wellstar.”

Years later, Kevin said it feels like it never happened. He’s returned to doing what he loves most—traveling. The next big trip on the calendar is all for his little girl—their family of three is heading to Disney. Then, it's off to Europe for their next adventure.

“I remain extremely grateful that I’m here today,” Kevin said.

Learn more about our integrated and collaborative heart care program.

Tags

Bryan Thomas Piedad Arthur Brian Reitman Rajnish Prasad
David Jacoboff North Fulton Medical Center Kennestone Regional Medical Center PeopleCare Heart Care Pulmonary Care
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Robert, a new grandfather, poses proudly with his daughter and her infant son. With Wellstar helping him manage his HCM, he can keep making memories with his growing family.

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Robert Frederick was living a typical life, going to work and spending time with his mother, siblings and children. But then it became hard to breathe when walking short distances or climbing stairs. He got dizzy. Perhaps most disturbingly, he passed out several times—once at a Braves baseball game he attended with his siblings.

"I didn't know what was going on!" Robert recalled.

Difficulty controlling AFib with medication

After passing out the first time, he went to urgent care and was then taken to the hospital by ambulance. He learned his symptoms were caused by atrial fibrillation (AFib), an irregular heartbeat.

Robert began to see Dr. David Caras, a Wellstar general cardiologist, and learned AFib is related to high blood pressure. Successfully managing high blood pressure often helps people keep AFib under control. Despite their efforts, AFib sent Robert to the emergency room two more times.

Suspicion of HCM

Dr. Caras reviewed Robert’s hospital records and found he had increased wall thickness of the left ventricle and a gradient—a pressure difference between the left ventricle and the aorta when the heart pumps. These findings were consistent with a condition called hypertrophic cardiomyopathy (HCM). Characterized by abnormal thickening of the heart muscle, this disease makes it difficult for the heart to pump blood effectively.

Dr. Caras referred Robert to Dr. Melissa Burroughs, an HCM specialist at Wellstar. As a Center of Excellence designated by the Hypertrophic Cardiomyopathy Association, Wellstar is one of the leading providers of comprehensive HCM care in Metro Atlanta.

"We have physicians in the group—designated HCM specialists—that are the point person of the patient’s care," Dr. Burroughs explained. “This includes close communication and collaboration with electrophysiologists, surgeons, advanced heart failure specialists, social workers and behavioral health professionals.”

A rare finding leads to Mayo Clinic Care Network collaboration

Robert said, “Dr. Burroughs wanted to do genetic testing to verify that I had HCM."

But genetic testing revealed a rare genetic variant—one not known to be associated with HCM. Dr. Burroughs called it a “diagnostic conundrum.” The genetic variant found was typically associated with a different cardiac disease that Robert did not have. However, he did have clear signs of HCM.

To investigate further, Dr. Burroughs collaborated with other HCM experts through the Mayo Clinic Care Network, of which Wellstar is a member. Mayo Clinic, which is also an HCM Center of Excellence, provided access to its unpublished database, finding Robert’s rare mutation was present in two other family groups with HCM.

“It’s very important that we add to the science—that we include our patients in the registry to enhance what is already known about HCM,” Dr. Burroughs said.

Robert added, “Dr. Burroughs is very persistent. She wanted to know, ‘Why are you having these problems? What’s the root cause?’ She went above and beyond to find that out.”

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Doctor listening to patient's heart with stethoscope

Newsroom

Top Marks for Heart Care at Wellstar Kennestone Regional Medical Center

Wellstar Kennestone Regional Medical Center has received several major commendations highlighting the high level of heart care continuously provided to patients—putting Wellstar’s cardiothoracic surgery program among the top in the nation. The Marietta-based heart care program received:

  • The coveted three-star rating in the following key areas from the Society of Thoracic Surgeons (STS): isolated coronary artery bypass grafting (CABG, or open-heart surgery), aortic valve replacement (AVR), AVR + CABG, and multiprocedural cardiothoracic surgeries. This is the highest category of quality, placing Wellstar Kennestone among the best programs for heart surgery in the U.S. and Canada. 
  • The prestigious Comprehensive Cardiac Care Certification—the highest distinction awarded by The Joint Commission and the American Heart Association. Wellstar Kennestone was the first in Georgia to receive this certification.

These recognitions demonstrate Wellstar’s commitment to keeping advanced heart care close to home.

“These accomplishments speak volumes about the skill, precision and teamwork of our cardiothoracic team,” said Dr. Richard Myung, medical director of cardiothoracic surgery at Wellstar Kennestone. “We’re proud to deliver exceptional outcomes for patients from across the Southeast who have some of the most complex heart conditions.”

Three-star STS rating

STS ratings reflect not only surgical excellence, but also the quality of care patients receive in the critical 30-day period following surgery. 

“This extraordinary recognition reflects the world-class quality of care offered by Wellstar,” said Lorrie Liang, president of Wellstar Kennestone and Wellstar Windy Hill. “To achieve this gold standard, a health system must demonstrate both clinical excellence and rigorous standards for follow-up care. At Wellstar, we provide all of this, along with a warm, people-centered experience. It’s what we call ‘PeopleCare.’”

These results highlight the importance of a multidisciplinary approach—one that includes surgeons, anesthesiologists, perfusionists, nurses, cardiologists, respiratory therapists, rehabilitation specialists, critical care specialists, hospitalists, advanced practice providers and many others.

“This achievement is a testament to the entire care continuum,” said Steve Cermak, executive director of cardiovascular service line and hospital operations at Wellstar Kennestone. “From the operating room to recovery and rehabilitation, every team member plays a vital role in delivering outstanding outcomes.”

Among the three-star rankings is CABG. This procedure is commonly performed to treat people having a heart attack or other conditions including coronary heart disease with chest pain, multiple blocked coronary arteries or serious heart failure. The procedure is performed by cardiovascular surgeons at Wellstar Kennestone—Dr. Theresa Luu, Dr. James Burke and Dr. Richard Myung—who work as part of a large multidisciplinary team to give every patient the highest quality care at every step of the process, from diagnosis through surgery and recovery.

“This amazing recognition is about the great lengths we go to care for our patients, and why people travel from across the region to receive their care at Wellstar Kennestone,” added Director of Wellstar Cardiothoracic Surgery Services and the Structural Heart and Valve Program Karrie Davis. “We care for every patient like they’re a family member or close friend. That’s why we hold ourselves to the highest standards.”

Wellstar Center for Cardiovascular Care offers patients care close to home across Georgia communities at more than 25 cardiovascular locations, with more than 110 cardiologists and cardiothoracic surgeons standing ready to provide heart care for both routine and complex heart conditions. Wellstar also has one of the largest cardiovascular rehabilitation programs in Georgia, which helps patients improve their long-term outcomes.

Certification by The Joint Commission

The Joint Commission has also awarded Wellstar Kennestone with a Gold Seal of Approval in conjunction with the American Heart Association’s Heart-Check mark and certification as a Comprehensive Cardiac Center for the third consecutive time.

For the certification, Wellstar Kennestone underwent a rigorous, unannounced onsite review. During the visit, a team of Joint Commission reviewers evaluated compliance with related certification standards including evaluating the care of the cardiac patient at every touch point in the cardiac care continuum with ongoing process improvement and health promotion for patients, as well as the community. Joint Commission standards are developed in consultation with healthcare experts and providers, measurement experts and patients. The reviewers also conducted onsite observations and interviews. 

The hospital first received the two-year certification in 2019. This recertification makes the third cycle—or sixth year—it has remained in place. Wellstar Kennestone was the first hospital in Georgia and remains the only one in the state to hold the comprehensive certification.

From prevention to post-cardiac event recovery, our well-connected and collaborative heart care team is dedicated to empowering you to regain your strength and independence. We offer top-quality cardiovascular care including diagnostics, treatment, psychological support and ongoing monitoring all focused on your well-being. Learn more about award-winning heart care at Wellstar.

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At 26, Maria receives chemotherapy as part of her breast cancer treatment plan, determined to complete her interior design degree on time.

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Maria Fernanda Ortiz was a college junior, pursuing a degree in interior design. But at just 26 years old, her life took an unexpected turn. She discovered a lump in her breast, which led to a cancer diagnosis and expert, multidisciplinary care at Wellstar that would shape her professional aspirations in the future. Maria feels her hopeful attitude and compassionate care team at Wellstar helped her come through treatment with positive outcomes.

Feeling heard in healthcare

After Maria discovered a lump, she initially saw a doctor who went through the motions but didn’t seem to take her concerns seriously. 

“He was so sure it was nothing because I am so young,” she remembered. “I didn’t think it was cancer, but I wanted someone who would get to the bottom of it.”

She then saw her OB/GYN who referred her to Dr. Laura Pearson, a Wellstar breast surgeon at Wellstar North Fulton Cancer Center, for a second opinion. 

Maria got what she was looking for: a doctor who listened and would help her find answers. 

“Maria is the perfect example of a patient advocating for themselves,” Dr. Pearson said. “She did exactly what she was supposed to do for someone her age who finds a lump. When it didn’t go away, she got it looked at. When she didn’t feel like she was being heard, she didn’t let it go.”

 

A surprising cancer diagnosis

Dr. Pearson immediately performed an ultrasound in the office, followed quickly by a biopsy, which came back positive for cancer. 

"The diagnosis was scary," Maria said. “Dr. Pearson made it as simple as possible to understand by making sketches. She took the time to answer my questions—and she gave me hugs.”

Dr. Pearson added, “I try hard to be methodical and build a story: ‘This is what this means. This is how it applies to you.’ It’s important for patients to understand their plan and how it’s based very specifically on their situation.”

Maria was diagnosed with stage 2A breast cancer, meaning it was a small tumor but had spread to a nearby lymph node. 

“The stage helps us understand how the patient is going to do with standard treatment,” Dr. Pearson explained. “At stage 2A, we’re looking at a 90% survival rate.”

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