Coronary Artery Disease: A Challenging Condition

The heart is the most vital and hardest working organ in the human body. Shielded by the armor of the sternum and rib cage, the heart works to nurture every tissue in every organ system. The heart requires some special sustenance of its own that is provided by the coronary arteries. Coronary arteries are delicate-looking vessels that snake across the outer surface of the heart. They appear to cup the heart and gently hold it. They are the heart’s own personal circulatory system, as vital to the heart as the heart is to the body.

While only inches long, the three coronary arteries are some of the most critical inches in the body. If there are deposits of plaque within a coronary artery or one of its branches, it may become stenotic (narrow) or even occluded (closed), reducing the flow of blood to the heart. This condition is referred to as ischemia. Ischemia causes chest pain which can be problematic. If ischemia is not treated, the affected tissue can be starved of oxygen and dies. This is essentially what happens when someone has a heart attack.

Ryan W. Zuzek, M.D., a interventional cardiologist at St. Clair Hospital, focuses on treating coronary artery disease by maintaining or restoring the flow of blood through the coronary arteries to the heart muscle. According to Dr. Zuzek, treatment for coronary artery disease keeps improving, and St. Clair Hospital is on the cutting edge of the latest breakthroughs in technologies and approaches to treatment. This includes the treatment of left main coronary artery disease, the most complex and challenging type. Left main coronary artery disease is treated at St. Clair by Dr. Zuzek and other interventional cardiologists with percutaneous coronary intervention, or PCI ? the non-surgical, minimally invasive treatment of coronary arteries through small incisions in the groin or the wrist. This includes balloon angioplasty and the placement of stents, all of which take place in St. Clair’s Cardiac Catheterization Lab.

A Patient in Dire Need

About a year ago Mark Bowman, 56, of Bethel Park  was enjoying a Sunday night Steelers game when he suffered a massive heart attack. As a pharmaceutical sales representative who specializes in cholesterol-lowering drugs, Mark knew enough about heart disease to immediately recognize that the “incredible pain” in his chest and upper arms was a heart attack. He took some aspirin, laid down on the floor and instructed his wife to call 911.

When the paramedics arrived, Mark was unconscious and going in and out of ventricular tachycardia, an abnormal heart rhythm that can be fatal. He was taken the short distance to St. Clair Hospital’s Emergency Department, and was placed in the care of Dr. Zuzek. Dr. Zuzek diagnosed a 100 percent occlusion of the left main coronary artery, leaving the two major arteries on the left side of his heart without any blood flow.

The blockage was initially treated with balloon angioplasty to resume some blood flow and help stabilize him. Since Mark had a high risk of operative mortality associated with his condition, Mark was not a candidate for cardiac surgery. Instead of surgery, Dr. Zuzek placed a stent (a small mesh tube designed to hold open a blocked coronary artery) in Mark’s left main coronary artery, extending into the left anterior descending, and positioned an intra-aortic balloon pump to help keep his blood pressure stabilized. The stent propped open the vessel, allowing blood to flow again to Mark’s severely injured heart muscle. Dr. Zuzek knew that, given the extent of the damage, the situation was grave. “Mark had an acute left main occlusion and a massive myocardial infarction,” Dr. Zuzek says. “I have only seen this a few times, and he is the only patient I have seen who survived that kind of severe event. He was in critical condition.”

To build his strength and tolerance for activity, Mark attends the Cardiac/Pulmonary Rehabilitation program at St. Clair three times a week. He says it has been a godsend.  “Cardiac rehab has benefitted me greatly. I chose St. Clair’s rehab program because I heard tremendous things about it, and it was exactly the place I needed to go.”

Thanks to Dr. Zuzek and Marks determination to recover fully, Mark can enjoy being a first-time grandfather, and walk his youngest daughter down the aisle at her wedding next fall.

RYAN W. ZUZEK, M.D.

Dr. Zuzek earned his medical degree at the National University of Ireland in Galway. His postgraduate training includes an internal medicine residency at the Cleveland Clinic, where he was later an attending physician. He completed cardiology and interventional cardiology fellowships at Brown University hospitals in Providence, R.I. Dr. Zuzek is board certified in internal medicine, general cardiology, interventional, and nuclear cardiology. He practices with US Heart and Vascular, P.C.

To contact Dr. Zuzek, please call 412.429.8840.

This story is an edited version of a full report recently published in our Winter 2017 edition of HouseCall. If you want to read the full write-up – which includes more information  – you can visit our website and download a copy of our Winter 2017 HouseCall here.