Heart Health

It was a cold morning in late February, but those who got out of the house early to take advantage of a Penn State Health St. Joseph HEALTH4cast event received a bonus – a chance to ask questions and receive advice from cardiologist Andrew Waxler.

Dr. Waxler, a member of Penn State Health Medical Group – Berks Cardiology, was on hand in the lobby of the Bern Township Campus from 7 to 9 a.m., fielding questions and chatting about heart health.

He talked to visitors and staff members about preventing cardiac problems by quitting smoking, maintaining appropriate weigh and body mass index, controlling blood pressure and cholesterol, and exercising regularly.

The opportunity was part of Penn State Health St. Joseph’s February Heart Health recognition.

Dr. Waxler’s advice was encouraging. Even small changes such as adding more fruits and vegetables to your diet and taking a daily walk can make a big difference in your health, he advised.

“You don’t have to do anything too drastic,” he said. “Just go for a walk and watch what you eat. Losing just five or 10 pounds will lower your blood pressure a couple of points.”

Cutting down on processed foods, simple carbs and red meat and replacing them with vegetables and whole grains can help people avoid diabetes, a disease that greatly increases the risk of cardiovascular problems.

In addition to consulting with Dr. Waxler, staff and guests were able to assess their risk for diabetes and cardiovascular diseases such as heart attack and stroke by participating in Penn State Health St. Joseph’s HEALTH4cast screening program.

Using simple tests and procedures, staff is able to provide participants with four critical numbers that aid in predicting future health. Numbers are: body mass index, blood pressure, total cholesterol and blood sugar/glucose.

Together, those numbers indicate a person’s risk factor for developing a major illness that could negatively impact life.

Once the numbers have been collected, HEALTH4cast participants receive recommendations for improving their health with lifestyle changes such as cutting back on sodium intake, losing weight, reducing stress and exercising more.

Brenda Rivera of Wyomissing braved the cold to take advantage of the HEALTH4cast program.

With a family history of high blood pressure and diabetes, Rivera was grateful for the opportunity to have her health assessed.

“I don’t see my primary care provider on a regular basis, but I want to take care of myself,” Rivera said. “So, it’s really nice to have this screening as a resource. It’s a great event, and it’s all free.”

Haley Fidler, who works with cardiac rehab patients at Penn State Health St. Joseph’s Spring Ridge campus, was on hand to tell participants about the hospital’s FIT150 Program.

“It’s basically an initiative we have to encourage people to get 150 minutes of exercise a week,” Fidler said. “Exercising for 30 minutes, five days a week, is an easy way for people to keep track of their fitness.”

If you are ready to kick off the spring with a free health evaluation and take the FIT150 pledge, mark your calendar and join us for our next HEALTH4cast event on Saturday, April 6 from 8am – 11am! HEALTH4cast is proud to be a part of the 2nd Annual BCIU Apple a Day 5k & Family Fun Run/Walk to benefit the United Way of Berks County at Penn State Berks. Attendees will be served on a first come, first served basis. And remember no need to fast!

It was a Sunday in August, and Robert Clay had just made a putt on the 15th green of the Rich Maiden Golf Course near Fleetwood.

From what he’s been told, as he reached down to retrieve the ball, he sank down onto one knee and said to his golf partners, “something isn’t right.”

Clay recalls none of that, nor much of what happened to him for the next 12 hours. What he does know, however, if not for the speedy and capable efforts of other golfers, the EMTs who treated him, and Penn State Health St. Joseph’s Emergency Department and Heart Institute staff, he would not be alive after suffering cardiac arrest.

“They told me when I woke up in the hospital that I was really lucky,” Clay said during a recent interview. “They said that most people who have the kind of heart attack I had don’t make it. I hate to think what would have happened if I had been home by myself, or out in the woods hunting.”

After Clay fell onto the golf course, one of his golfing buddies started CPR. No one in the foursome had a cell phone, so a player behind them called 911.

Northern Berks Emergency Medical Services was on the scene in less than 10 minutes, and paramedics treated Clay en route to Penn State Health St. Joseph. On two different occasions, they could detect neither a pulse nor a heartbeat.

“They told me that I flat-lined twice, but the EMTs used the paddles on me and brought me back,” Clay said. “Then, when I got to the hospital, they were all ready for me in the Emergency Department.”

After being treated and stabilized in the ED, Clay was moved to the St. Joseph’s Heart Institute, where a stent was placed to open a blocked artery. He was released three days later, grateful to be going home.

The Spring Township resident, who is 60, had very few symptoms before the cardiac arrest, which he was told was triggered by a blood clot caused by heart arrhythmia.

“I didn’t have any pain, or anything like that,” he explained. “The only thing I can think of is that for about a week before it happened, I felt really sluggish. Like, I’d wake up in the morning and feel still tired.”

Clay, whose father and two brothers died of heart disease, currently is in cardiac rehabilitation at Berks Cardiology, and says he is feeling well.

He is changing his diet to avoid fats and salts, and has stopped smoking cigarettes.

“I sent my son to my house while I was in the hospital to get rid of all the cigarettes,” Clay said. “I’m wearing a patch now. Every now and then I crave a little bit, but then I think about something else and it’s okay. I should have given them up a long time ago.”

Reading food labels is time consuming, said Clay, who lives alone, but he’s doing his best. Changing his eating habits won’t be easy, but he’s determined.

“I’m Pennsylvania Dutch, so I like some shleck,” he said. “And, what I’m really going to miss is my all-time favorite, fresh-cut French fries.”

Clay, however, who is the father of a son and a daughter and the grandfather of five, is determined to improve his health.

“I’ve got my family, and I just retired from Car Tech last year,” Clay said. “I’ve got a lot to live for, and I want to stick around for a while and enjoy it.”

Penn State Health St. Josephs Heart Institute and Emergency Department
have demonstrated expertise and commitment to quality patient care by meeting American Heart Association’s stringent criteria as a Heart Attack Receiving Center. If you’re having chest pain or other heart attack symptoms, call 9-1-1 and seek medical attention immediately. Any other questions, contact The Heart Institute at 610-378-2340.

Excerpt from Reading Eagle story by Matthew Nojiri

February is American Heart Month, and it puts the spotlight on an important issue. About 34 percent of American adults have high blood pressure, and heart disease accounts for one in seven deaths, according to the American Heart Association.

Dr. Andrew Waxler, a cardiologist with Berks Cardiologists Ltd., Wyomissing, discussed heart disease and the ways to live a healthy life.

About heart disease

Coronary artery disease is the biggest heart issue, Waxler said.

The buildup of plaque and the hardening of the arteries around the heart can be an insidious problem as artery disease doesn’t always come with symptoms,” said Waxler, who also serves as president of the Berks County Medical Society. “Coronary artery disease is incredibly common.

“We’ve known the process of arteriosclerosis, the hardening of the arteries, starts early. People get to my age, 50, and they have a heart attack, but the process has been going on for years.”

Coronary artery disease makes up about 45 percent of all cardiovascular disease, but some people don’t know it’s an issue until later in life.

“In some people, their first warning is a heart attack,” Waxler said. Others will notice tightness or pressure in the middle of the chest or shortness of breath from doing everyday tasks, Waxler said. “I never ask about chest pain,” he said. “It’s about tightness, pressure and discomfort.”

Preventive steps

Some aspects of health cannot be changed.

Family history and genetics fall into that category. Ethnicity is another. Those factors can make you more likely to suffer from heart disease. Still, there are things that are within your reach. For one, you can decide to quit smoking, Waxler said.

“The whole world knows smoking can cause emphysema and lung cancer,” he said. “I don’t think the American public knows how detrimental it is to the heart. It causes injury to the lining of heart arteries, which promotes more blockages. It also causes constriction of blood vessels, which can lead to a heart attack.”

Penn State Health St. Josephs Heart Institute and Emergency Department
have demonstrated expertise and commitment to quality patient care by meeting American Heart Association’s stringent criteria as a Heart Attack Receiving Center. If you’re having chest pain or other heart attack symptoms, call 9-1-1 and seek medical attention immediately. Any other questions, contact The Heart Institute at 610-378-2340.

Cardiologists leading the way in various trials leading to innovative treatments

Cardiologists at Penn State Health St. Joseph are always looking for better and more effective methods of treating patients who have coronary disease. To that end, St. Joseph is participating in a cutting- edge clinical trial designed to compare the performance of a dissolvable heart stent with that of a non-dissolvable stent currently in use.

Depending on trial outcomes, the dissolvable stent could soon be approved by the U.S. Food and Drug Administration (FDA) for use in the United States. And that, said Dr. Guy N. Piegari, Jr., a cardiologist with Berks Cardiologists, Ltd. and Medical Director of the Cardiac Catheterization Laboratory at Penn State Health St. Joseph, could be significant.

“We’re always moving toward something better,” Piegari said. “The stents that we have are really very good, but we’re always in a continual state of improvement for our patients.”

St. Joseph and Berks Cardiologists have been participating as a team in the randomized control trial, sponsored by Abbot Vascular, a division of Abbott Laboratories, since 2013. The Abbot trial is designed to compare the performance of the company’s new dissolvable stent, Absorb™ Bioresorbable Vascular Scaffold (BVS), with its non-dissolvable stent, XIENCE.

A dissolvable stent could provide significant benefits to patients, Piegari said, because it enables an artery to return to its natural state once it has healed. Currently, some patients whose arteries have narrowed due to buildup of plaque are treated with metal stents containing a medicine that, when released into the artery, prevents the plaque from reforming.

The stent holds the artery open, which enables blood flow. Because it remains in the body, however, it prevents the artery from working as it naturally would. A dissolvable stent is designed to remain in place until the medicine to prevent the rebuild-up of plaque has been dispensed over time, and then gradually disappear. “Arteries are designed to dilate and constrict according to the needs of the body, but they can’t do that well when you’ve got a metal stent in,” Piegari explained. “If the stent dissolves, then there’s nothing left in the artery to interfere with its normal function.”

The clinical trial is required by the FDA before the Absorb stent can be approved in the United States. Absorbable stents are already in use in Europe. The Abbott trial is one of two in which the hospital is currently involved.

St. Joseph and Berks Cardiologists also are involved in a trial sponsored by Swiss-based Biosensors Europe, testing a drug coated, non-absorbable stent known as BioFreedom™. More patients were enrolled in that clinical trial at St. Joe’s than at any other trial site in the country – a significant achievement for the hospital.

“We are the leading contributor in that study,” Piegari said. “If it gets approved, it’s definitely due to our participation.”
These clinical trials involving heart stents are just two of many in which Penn State Health St. Joseph has participated during that past 16 years. “We’ve been conducting clinical research since 1999,” said Lori Shober, Director of Cardiovascular Services. “We’ve been involved in some very cutting-edge research.” Most of the clinical trials have occurred within the Heart Institute and Cancer Center, and have involved hundreds of patients.

Some trials conducted within the Heart Institute have directly contributed to approval by the FDA of devices used in angioplasty and stenting of the carotid, coronary, renal and leg arteries. Participating in clinical trials is time consuming and complex, but the effort that the hospital undertakes is well worth it, Shober said. Trial participation not only increases the profile of St. Joseph, it also helps with advances in the medical field. “It’s just awesome to be involved in research that results in life-saving medical advances,” Shober said. “It’s what we’re about.”

Guy N. Piegari Jr., MD, FACC, FSCAI, is a cardiologist with Berks Cardiologists, Ltd.
He is a Board Certified in Cardiovascular Diseases, Internal Medicine, Interventional Cardiology, and Critical Care Medicine. He can be reached at 610-685-8500.