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New Cardiac Procedure at St. Francis Hospital Saves Patient’s Life

June 24th, 2020
Joe Nolte with wife and dog

“Honey, honey…what does a heart attack feel like?” 

Joe Nolte awakened at 2 am one Tuesday morning with an intense pressure on his chest. It felt like a hand was pushing him into the bed.  

His wife, a physician, replied, “That’s exactly what a heart attack feels like,” when he described his symptoms.  She explained that the pain could also radiate to the arms or jaw and suggested they go to the hospital. But, Joe wasn’t experiencing all of the symptoms of a heart attack. 

“I got up, drank a couple of glasses of water and went back to sleep,” he recalled. “I was fine the rest of Tuesday, Wednesday and Thursday morning.” 

At work on Thursday afternoon, he experienced shortness of breath and had difficulty walking down the sidewalk and up a flight of stairs. He decided to wait until he was home to worry about it. 

That night while they were getting ready for bed, Joe shared the day’s events with his wife and asked if she thought he should make a doctor’s appointment.  This time there was no discussion or negotiation. 

“I told him, ‘get in the car, we’re going to St. Francis!’” said his wife, Executive Director of the National Gianna Center for Women’s Health and Fertility Anne Nolte, MD.  

Dr. Nolte acknowledges that family members always ask their physician family members for medical advice. She laughed. “I think I’m on speed dial for my siblings.” 

But not for her husband.  

He never complained or asked questions and, until this event occurred, he had never been admitted to a hospital. 

“As a physician caring for family members, you don’t want to miss the worse thing, and you don’t want to overreact.  When he told me what was going on, I knew there were only two things that were going to cause symptoms like that, and they were both bad,” she said. “He was either having a heart complication or a pulmonary embolism and both are emergencies that require immediate treatment.” 

The couple arrived at the hospital just before midnight on Thursday and, after several hours of testing, Dr. Nolte’s fears were confirmed: her husband had a pulmonary embolism, a condition where a blood clot that typically forms in the leg, travels through the heart and lodges itself in the arteries to the lung thus impeding blood flow. 

He was immediately placed on blood thinners, but that wasn’t enough. 

“The pulmonologist told me that his case was quite severe,” said Dr. Nolte, “The blood clot was so big that it was blocking most of the blood vessels on the right side of his chest and some on the left side. Due to the clot’s size, his heart was having difficulty pumping.”

That’s when they learned about a new procedure at St. Francis that could save Joe’s life.   

“It’s called EKOS, and it’s a minimally invasive procedure where we thread catheters from the leg or arm up into the pulmonary arteries directly into the clot,” explained Kiran Reddy, MD, an interventional cardiologist at Catholic Health Services’ St. Francis Hospital, The Heart Center®. 

Pulmonary embolisms are traditionally treated using medication such as heparin or an oral blood thinner. The alternative for more severe embolisms, such as the one Joe was experiencing, is thrombolytic medicines, powerful clot busters which work well, but can cause very severe bleeding and, in a small percentage of cases, can lead to other significant issues such as stroke and possible death. 

“EKOS emanates ultrasound waves to open up the clot and allow the powerful clot-busting medicine to enter directly into the clot in the lungs,” said Dr. Reddy. “With the clot opening up and putting the catheter directly into the clot, we’re actually able to use a much lower dose of medicine, which significantly reduces the risk of bleeding.” 

The only issue? The procedure was so new it had never been done before at St. Francis. 

“Joe was really excited, and we couldn’t have asked for a better first patient,” said Dr. Reddy. “He understood the condition he was in, and at the same, he thought this might make him famous and he’d be on TV,” Dr. Reddy chuckled. 

“I couldn’t believe that I was going to be a part of this groundbreaking heart procedure at a place like St. Francis,” said Joe. “I told Dr. Reddy that we should make a commercial together.”  

The Nolte family can laugh now, but looking back, they say that everything about their stay at St. Francis, from the comforting staff to the crucifix in every room, put them at ease. 

“It’s so new, even as a doctor I hadn’t heard of it, but Dr. Reddy was wonderful and explained it in a language that both myself and my husband could understand,” said Dr. Nolte. “They showed us a video of the procedure beforehand and it was amazing.”

Dr. Reddy and his team performed the procedure on Friday evening. They removed the catheters around midnight and by Saturday morning, Joe’s condition has significantly improved. 

“When we arrived at the hospital, Joe was struggling to breath. His oxygen was so low that he couldn’t walk without becoming so short of breath. He would almost faint,” recalled Dr. Nolte. “Twenty-four hours later, he’s racing around the Intensive Care Unit with his IV pole. It was a miraculous recovery.”

Now, several months later, Joe’s prognosis is “excellent,” according to Dr. Reddy. 

Although he’s back to his old self now, the Noltes understand their circumstances could have been very different. They recall numerous times when St. Francis physicians warned them that if they had waited until the next day to come in, things could have been much worse. It’s a point that’s emphasized by the major life milestone that will be forever connected to this eventful night.  

“Joe’s pulmonary embolism happened on our 8th wedding anniversary,” said Dr. Nolte. “He had this crisis on our anniversary, and we just feel profoundly blessed that we’ll be able to celebrate a 9th one.” 

For more information on cardiology services available at CHS, please visit https://www.chsli.org/cardiac-care

Watch as Joe shares his story:

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