Employees of Carpenter Library found themselves exercising during the Thursday, Oct. 22, 2009 tour of the Heart Center at Wake Forest University Baptist Medical Center.
Starting in the Cardiac Catheterization Lab on the fourth floor of Ardmore (Brenner's) Tower, tourists learned that these are the "plumbers" for heart patients. Heart Center physicians and staff are assessing the heart by inserting catheters into the heart and injecting dye to acquire images of the coronary arteries as well as the chambers of the heart. Depending upon the findings, the physicians may then insert a stent to open up the coronary artery blockage. Many of these stents are coated with special medications designed to help keep the blockage open.
Rich Lundy, Director of the Heart Center, said since they started using medicated stents, the percentage of patients coming back to WFUBMC for revision of their stent within the first year has decreased from nearly 25% to less than 5%. A stent is a mesh-like scaffolding mounted over a tiny balloon that expands once inserted into the coronary artery. The stent is expanded into place, the balloon is withdrawn allowing for improved blood flow to the heart and better pump function. There are four adult catheterization labs and one pediatric catheterization lab. The pediatric lab is a bi-plane lab which means the equipment has two cameras on it, allowing for more angles/photos of the heart and less radiation exposure for the patient. WFUBMC was the first in the country to purchase this particular bi-plane equipment from Siemens, a German company.
Still walking but now from Ardmore to the Ground floor of Reynolds Tower where the Cardiac Ultrasound/Stress Testing lab is located. This lab houses the echocardiogram equipment which uses sound waves to produce images of the heart, including 3-D images. Clinical staff and physicians look for heart abnormalities and determine the effectiveness of the beating heart. Some patients are put under cardiac stress via exercising on a treadmill, stationary bicycle, or with drugs. Images of the heart are acquired at rest and at peak exercise and analyzed for abnormalities.
The next stop is at the Electrophysiology (EP) Lab and Heart Station. EP physicians are often referred to as the “electricians” focusing on diagnosis and correction of abnormal heart rhythms. The Implantable pacemakers, defibrillators, and cardiac rhythm devices of all sizes are located here as well as portable EKG machines. Patients of this area return often during the long-term treatment to have EKG or pacemakers checked or for therapy, including advice about their different medicines. Mr. Lundy helped partner with Pharmacy and Cardiology to set up an anticoagulation clinic for patients who need frequent monitoring and adjustment of their anticoagulation medications. Pharmacists provide point of care lab testing and can give patients immediate feedback and adjust medications as needed.
Making way through various hallways and up to the first floor of Reynolds Tower to the Cardiovascular Imaging Center where MRI's are taken of the heart. Of the several areas of the entire Heart Center, this is probably the least busiest with six to eight patients per day, compared to the 110 patients per day in the Cardiac Ultrasound/ECHO lab. Physicians though are able to read multiple types of tests (ECHO, Cardiac MRI, Cardiac CT) in two separate areas, one in each lab. There is also a live-feed into the stress echo testing rooms allowing quick physician consultation with the echo staff during procedures. Like in the ECHO lab, patients are put under stress via a treadmill or drugs and then the MRI is performed.
The final trek is to the Sticht Center where Mr. Lundy showed the tourists the Cardiac/Pulmonary Rehabilitation department. Once again, treadmills and stationary bicycles lined the long, rectangular room with oxygen tanks and accessories along the walls. The rehabilitation of hearts was started over 30 years ago as a joint project between the Bowman Gray campus and Reynolda campus. It was the first in the country. Cardiac and pulmonary rehabilitation patients participate in a 12-week program that teaches them about lifestyle changes after experiencing heart or lung problems.
Not seen by the tourists were the several nursing units for heart patients, the outpatient clinics and the cardiothoracic surgery area. As administrative/business director for the Heart Center, Mr. Lundy works closely with all the nursing units, clinics and surgical departments. He serves on the Heart Transplant evaluation team which meets every Tuesday to determine if someone meets the criteria for a heart transplant. WFUBMC does about 10 heart transplants per year and there are 16 people waiting for a transplant.
While the Heart Center is physically scattered, the employees of all the areas are definitely the opposite - always working as a team, which was a heart-warming sight to fellow coworkers here at WFUBMC.