Travis Shepard never imagined a twisted ankle would save his life, but it did. Shortly after returning to work following a recent battle with the flu, the 44-year-old truck driver twisted his ankle while trying to load a truck bed. Despite the pain, Shepard tried to continue his work, but after he began having trouble breathing, his coworkers convinced him to see a doctor.
Caregivers at Texas Health Harris Methodist Hospital Stephenville Emergency Room immediately connected him to a heart monitor and began tracking his heart rate. Doctors discovered Shepard had a heart rate of 155. He was admitted to the hospital to undergo further testing.
“The first priority was to determine the cause of the irregular heart function,” said Dr. Brandie Williams, cardiologist on the medical staff at Texas Health Stephenville. “A twisted ankle typically doesn’t cause this type of reaction, so we knew there had to be something else going on.”
Dr. Williams knew she had to get Shepard’s heart back to a normal rhythm, but to do this safely, she had to get a better look at his heart. Dr. Williams performed a transthoracic echocardiogram, a cardiac function test that captures images of the heart and chest area that helps doctors determine if the heart is functioning properly. The test showed Shepard had congestive heart failure, a condition that occurs when the blood flow out of the heart slows, causing back up in the blood flow into the heart through the veins, which causes congestion in the body tissues and requires immediate medical attention. In addition, he had atrial fibrillation, a quivering or irregular heartbeat that can lead to blood clots, stroke and heart failure. Combined, the two conditions were causing his heart to only function at 13 percent.
To return his heart to a regular rhythm, Dr. Williams had to perform an electrical cardioversion, a procedure in which a patient is given an electrical shock on the outside of the chest.
The cardioversion test can only be done if no blood clots are present in the two upper chambers of the heart and with Mr. Shepard having congestive heart failure, the risk of having blood clots was high.
“Because the heart is out of its normal rhythm, the shock from the cardioversion “resets” it to a normal rhythm, but if it is done and blood clots are present, it could potentially give the patient a stroke or other complications,” said Dr. Williams.
To find out if clots were present, Dr. Williams performed a transesophageal echocardiogram (TEE), a test that involves swallowing a small ultrasound device that allows a closer view of the atria (top two chambers of the heart). Because it is inserted into the esophagus, which is located closer to the heart, doctors are able to capture more detailed images of the heart and its arteries, which helps surgeons better treat patients with heart failure, one of the leading causes of death in the United States.
“Ultrasound imaging is beneficial because it’s a relatively non-invasive way to look inside the body,” said Dr. Williams. “This technology provides a new dimension for us to view live images of the heart. This will greatly assist in providing more accurate diagnoses and more efficient care.”
Traditional cardiac ultrasound equipment provided only flat, two-dimensional images in black and white. Doctors could only use 3D images of heart valves by looking directly at them during surgery – after the surgical site was ‘open’ and the patient had been put on a bypass machine.
“The live 3D images allow us to see the valves and the heart at work. It greatly increases our ability to understand the heart’s functionality or lack thereof.”
“I was shocked when I learned about my condition,” Shepard said. “I’d gone to the hospital thinking it was my ankle and found out I could have suffered a heart attack at any moment. My ankle injury may have saved my life.”
According to the American Heart Association, there are nearly 5 million heart failure patients in the United States and the number is expected to grow. Knowing the signs and symptoms of heart failure is key as well as having a close to home, high-level care. The 3D TEE system has enhanced the heart capabilities at Texas Health Stephenville.
“This technology will allow us to provide a more individualized course of care, improve efficiency and quality of care and outcomes for our cardiology patients,” said Dr. Williams.
To learn more about Heart and Vascular services at Texas Health Stephenville, visit www.TexasHealth.org/Stephenville or call 254-965-1516.