Our headline is not in the least bit misleading. Stick around for an intriguing tale from the annals of modern medicine.
Michael LeBalanc, 40, was an healthy man who fainted one day. He began to get weaker and weaker as time passed and occasionally blacked out. It became obvious to doctors that something was wrong with his heart and they theorized that a virus may have caused his heart to weaken. One potential cause of a heart attack is a malfunctioning sinoatrial node, the heart’s natural pacemaker.
Brief biology lesson: The sinoatrial node is a clump of cells in the right atrium of the heart which generate the impulse controlling the heartbeat. Interestingly, these cells in the sinoatrial node are modified version of cardiac myocytes (human muscle cells), yet they do not contract.
Mr. LeBlanc had an internal pacemaker implanted which would give his heart a brief jolt to correct any abnormality in its rhythm, thereby preventing a heart attack. That type of pacemaker is formally called an Implantable Cardioverter Defibrillator (ICD). Dr. Helen, a Knoxville based psychologist, suffered a heart attack at the tender age of 37 and an ICD is responsible for keeping her alive today. However, her heart problem was not properly diagnosed right away:
Despite the fact that I was short of breath and shaking like a leaf, the doctor decided I was allergic to something in the gym and gave me a shot of benadryl. Actually, I later learned that shortness of breath and a sense of impending doom or death were signs (especially in women) of heart problems. I felt ok once I left the hospital and even for a week or two later. I was on vacation in Charleston, South Carolina when I again got short of breath and could not walk. I was so dizzy, scared and light-headed that I spent the day in bed until finally that night, I went to an emergency room.
There is a whole lot more to the story, so go read the whole thing. Fortunately, it has a happy ending and is a strong endorsement for the effectiveness of ICDs.
Unfortunately for Mr. LeBlanc, his ICD was working a little too well because his heart was deteriorating too quickly:
To keep me going, I qualified for a defibrillator, which basically shocked me if my heart rhythm started to get worse,” Mr. LeBlanc said. “But as I got sicker, the defibrillator kept going off, and it was awful.”
Even with the defibrillator, Mr. LeBlanc suffered a heart attack in April, followed by a stroke in July. Luckily, he was able to get to an emergency room before the stroke did too much damage.
Since Mr. LeBlanc was in otherwise good health and relatively young, UT Southwestern Medical Center in Texas decided he would be a great candidate for the newest generation of implantable heart saving devices, the Left-Ventricular Assist Device (LVAD).
“Mr. LeBlanc has cardiomyopathy, which causes the heart to dilate. The muscle becomes weaker, and it can’t pump efficiently,” said Dr. Dan Meyer, professor of cardiovascular and thoracic surgery at UT Southwestern and Mr. LeBlanc’s surgeon. “UT Southwestern has always had a presence in studying new mechanical assist devices, so we were honored to be only one of two sites in the state selected to implant the HeartWare LVAD as part of a national clinical trial.”
The pump is designed to rest inside the patient’s chest. A small cable attached to the device exits the body and connects to an externally worn controller. The controller is powered by a battery pack. The HeartWare LVAD has only one moving part, which contributes to its diminutive size. The lack of mechanical bearings is expected to lead both to longer-term device reliability and to a reduced risk of physical damage to blood cells as they pass through the pump, said Dr. Meyer, also director of the mechanical support program at UT Southwestern.
“The size of the device means the incision is also smaller. The entire implantation surgery takes about four hours,” Dr. Meyer said. “Mr. LeBlanc is a really great patient. He’s otherwise very healthy, and we believe he will do very well with the LVAD until he can get a new heart.”
Ok, as promised, here is where the story takes a left turn into “unusual land”:
He’s still adjusting to some of the stranger side effects of his new device, including no pulse. The LVAD keeps blood moving continually with no pulsation, so he no longer has a palpable heart beat or traditionally measurable blood pressure.
Think of all the mischief you could get into with an LVAD. Apparently, the infamous castle of Vlad the Impaler (the inspiration for Bram Stoker’s Dracula) is up for sale. With the right outfit and a bit of makeup you could show up and simply claim ownership.
Habsburg: I own it.
You: No, I do.
Habsburg: Not unless you’re some kind of vampire.
You: Check my pulse.
Habsburg: ::: runs away :::