May 13, 2022
A Methodist Hospital radiology employee is an attestation of his own work after a new cardiac imaging technology helped save him from a potentially fatal heart condition.
Donald Hooker, 49, Director of Radiology for Methodist Hospital, feared the day he would be diagnosed with a cardiac condition after his older brother, 52, passed of a heart attack. His brother’s identical twin also had a cardiac stent placed several years ago. Because Donald had a family history of diabetes and heart disease, he made a commitment to live a healthy and active lifestyle, eating a healthy diet and regularly screening with his primary care physician.
After Donald started experiencing what he believed to be COVID-19 symptoms, he presented himself to a local clinic for evaluation. He was ordered a COVID PCR antigen test for higher accuracy and a panel of tests, to include an EKG. The results were alarming. His heart rate was low and he had an abnormal rhythm. Donald informed his physician that he had recently started experiencing sporadic and sudden rapid heartbeats that would last a few seconds each time.
With his family health history and current heart symptoms, Donald was advised to immediately make an appointment with his cardiologist to examine his heart health and assess his cardiac risk.
“I thought, ‘No way could I be having a heart attack.’ I always assumed a heart attack would feel like a stabbing chest pain that would continue until treatment. That wasn’t like my symptoms at all,” commented Donald.
The following day, Donald visited with his cardiologist, Dr. Nandish Thukral, Medical Director for the Methodist Cath Lab and Director for Complex Percutaneous Coronary Intervention who ruled out a heart attack after an EKG was administered. Dr. Thukral then ordered a coronary CT angiogram (CCTA) with simulated fractional flow reserve (FFR), a new artificial intelligence technology that Donald introduced to Methodist Hospital under the direction of Dr. Michael Lane, Chief of Cardiac Radiology and Director of Advanced Cardiovascular Imaging for Methodist Healthcare. This new technology would help physicians identify blockages in the arteries, also known as coronary artery disease. These blockages can lead to a heart attack.
Donald was brought back for the CCTA and given a tablet of nitroglycerin to help the CCTA scan better visualize the coronary arteries by dilating the vessels and a beta blocker, a medication that slows the heart rate safely. IV contrast material is administered into the arm vein and the patient then undergoes the CCTA/Heart Scan. The CCTA images are sent directly to HeartFlow where artificial intelligence algorithms, trained analysts and computational fluid dynamics are used to create a personalized, digital 3D model of the patient’s coronary arteries. It then uses powerful computer algorithms to simulate blood flow and assess the impact of blockages on blood flow to the heart. Within hours, the analysis is delivered to the patient’s physician via a secure web interface and provides information on the extent of a patient’s arterial blockage and the impact the blockage has on blood flow to the heart. The entire process is dynamic and can be viewed by both physicians.
“Before I knew it, I was discharged and sent home,” said Donald. “The CCTA FFR was noninvasive, requiring no hospital stay nor hospital admission.”
Historically, physicians and cardiologists must decide which diagnostic test is best suited for each individual cardiac patient to examine the blood flow to the heart through the coronary arteries. Identifying blockages early before a heart attack or during episodes of atypical chest pain are critical. Many different diseases can simulate coronary artery disease and or cause chest pain. The most accurate test is heart catheterization. This exam is especially important when the physician or cardiologist is confident that the patient is having a heart attack or is unstable. The CCTA with simulated FFR is an opportunity to look for coronary artery blockages very accurately without the more invasive procedure of a heart catheterization.
Methodist Hospital is the first facility in South Texas to adopt a first-of-its-kind technology, enabling physicians to diagnose patients with suspected coronary artery disease (CAD), the most common form of heart disease. The non-invasive personalized cardiac test provides unprecedented visualization of each patient’s coronary arteries, enabling physicians to best determine whether medical management or an invasive procedure is necessary.
“Currently Methodist Healthcare offers patients access to the most advanced CT scanners in Texas, operated by an elite group of cardiac experienced technologists. This new technology will provide an assessment of physiology of the coronary artery stenosis in addition to the current characterization of the anatomy, therefore, improving the earlier detection of significant coronary artery disease and hopefully providing improved treatment guidance,” commented Dr. Lane.
Donald was diagnosed with minimal arterial stenosis in his left anterior artery and is regularly monitored by his cardiologist. The CCTA FFR technology is not only enhancing the lives of cardiac patients under Methodist Hospital’s care, but has enhanced the life of one of their own.