During a cardiac emergency, speed matters. The sooner you can get the treatment you need, the better. But when you're living with ongoing heart disease, you also need experienced care tailored to your individual needs. There's a lot to know, and you'll need a team that takes the time to explain your options and guide your care.
Get the treatment you need for both urgent and ongoing cardiology concerns at Lake Regional Health System. Our heart care specialists are committed to excellence in the treatment of heart attack, heart failure and other forms of cardiovascular disease.
Time is Muscle
To help patients receive the best care possible in the shortest amount of time, the State of Missouri has identified hospitals that are well-equipped to treat a heart attack. Lake Regional Health System is proud to announce it is one of these hospitals, earning the designation of Level II STEMI Center.
STEMI stands for “ST segment elevation myocardial infarction,” a serious heart attack caused by an obstruction of blood to the heart.
Because Lake Regional has earned this designation, EMS providers can bring heart attack patients to Lake Regional. In addition, rather than having to transfer heart attack patients on to another hospital, Lake Regional can receive transfers from other care centers.
Cardiology Experience that Counts
Our heart care team includes board-certified interventional cardiologists, a cardiovascular-thoracic surgeon, and registered nurses and X-ray technologists who specialize in cardiac care. Our team works together, collaborating to ensure that you get the care you need when you need it.
When you have a medical emergency, our team springs into action to help you. And they work remarkably fast. In 2017, our median door-to-balloon time was 43 minutes, which is better than nine out of 10 hospitals nationwide. Door-to-balloon is the amount of time that passes between a patient arriving in the Emergency Department with a heart attack and the heart care team opening the blocked vessel in the Cardiac Catheterization Lab.
We also offer a number of diagnostic tests that can help you understand your heart issue and what you'll need to do to get better. When you have a test, your cardiologist will take the time to explain the results and answer your questions, so you'll know just what to do next.
The cardiologists at Lake Regional are skilled at evaluating and treating all types of cardiovascular disease and disorders, including:
- Heart attack
- Heart failure
- Valve problems
- Peripheral artery disease (PAD)
When your heart issue requires surgery, our team can help. We offer a number of cardiac surgeries, including:
- Balloon angioplasty
- Cardiac stenting
- Implantable cardioverter defibrillator (ICD) placement
- Digital cardiac catheterization
- Coronary artery bypass
- Heart valve repair and replacement
- Mechanical thrombectomy
- Pacemaker placement
- Peripheral stenting
- Placement of peripheral left ventricular assist device (LVAD)
- Rotational atherectomy
Your heart issue might be treated within our Cardiac Catheterization Lab. It features state-of-the-art equipment that can help your cardiologist diagnose and treat cardiac and peripheral vascular disease. Our lab is the first in the state to acquire flex vision technology, providing the best imaging quality available. We treat nearly 1,900 patients in our lab each year—and we offer each patient personalized care.
Heart Attack, Sudden Cardiac Arrest and Congestive Heart Failure
All three of these heart problems are serious, but their causes are different and they require different treatments. Learn how to recognize each one and what to do if any of them is suspected.
A heart attack happens when there’s a sudden blockage in the flow of blood to a section of the heart muscle. If blood flow isn’t restored quickly, the affected section of the heart begins to die.
The leading cause of heart attack is coronary heart disease, also called coronary artery disease. In this disease, plaque builds up inside the coronary arteries. A blood clot can form on the plaque’s surface, and if the clot grows too big, it can mostly or completely block blood flow.
The most common symptoms of heart attack — in both men and women — are chest pain and discomfort; upper body discomfort; and shortness of breath. Other possible symptoms include breaking out in a cold sweat; feeling unusually tired for no reason, sometimes for days; nausea and vomiting; and light-headedness or sudden dizziness.
If you think you or someone else may be having a heart attack, call 911. Immediate treatment is needed to restore blood flow to save the heart muscle.
Sudden Cardiac Arrest
Someone having a minor heart attack might be able to continue activities, even as the restricted blood flow damages the heart. In contrast, there’s no such thing as “minor” sudden cardiac arrest, which happens when the heart suddenly stops beating.
With no heartbeat, blood stops flowing to the brain and other vital organs. As a result, untreated sudden cardiac arrest usually causes death within minutes.
Sudden cardiac arrest has different causes. People who have heart disease are at higher risk, and sudden cardiac arrest can happen during a heart attack. But, it also can happen in people who seem to be healthy.
If you suspect someone is suffering from cardiac arrest, call 911. If the person is not breathing, give CPR.
There’s usually not time to get to a hospital for treatment. That’s why it’s important for people in the general public to have access to and training with automated external defibrillators. These devices — often found in malls, churches, schools and other public spaces — send an electric shock to the heart to try to restore normal rhythm. To use an AED, turn it on and follow the prompt.
To learn how to give CPR and use an AED, sign up for an AHA Heartsaver class from Lake Regional.
Congestive Heart Failure
Congestive heart failure is a chronic condition and can last several years. The heart is still pumping but not as well as it should be.
In some cases, the heart can’t fill with enough blood. In other cases, the heart can’t pump blood to the rest of the body with enough force. Some people have both problems. In all cases, the body does not receive enough blood flow to meet its needs for blood and oxygen, resulting in fatigue, breathing problems and weight gain from fluid buildup.
The most common causes for heart failure are coronary artery disease, high blood pressure and diabetes. Other causes include heart muscle disease, heart valve disease, irregular heartbeat, congenital heart defects and injuries to the heart muscle.
Treatment depends on the condition’s severity but usually include lifestyle changes — such as eating healthier and losing weight — medication and ongoing care. Patient and caregiver education is essential for successful management of heart failure. As complications arise, early intervention can prevent setbacks and hospitalizations. This requires at-home monitoring and knowing when to seek care.
Pay attention to your breathing, heart rate, blood pressure, appetite, weight and foot/ankle/leg swelling. If any of these worsens, alert your doctor.
Other Resources to Help Your Heart
Adjusting to a serious health problem often takes time. You may experience depression or anxiety. Through our Mended Hearts support group, you will learn you are not alone. Lake Regional's Mended Hearts group meets the second Thursday of each month at noon on the hospital's second floor.
We also provide a continuum of care through our accredited Cardiac Rehabilitation Program, which helps patients more quickly recover from heart attacks, heart surgeries and other cardiac problems.
Managing one chronic condition is hard enough, but most people with heart disease have other ongoing medical issues. Lake Regional’s Chronic Care Management program provides extra one-on-one support. This Medicare-covered service connects you with a registered nurse who serves as your case manager. This individual works with you and your various health care providers to ensure everyone is on the same page. Your nurse case manager also calls you at least once a month to see how you are doing, and you can call your nurse as often as needed with questions. Learn more.
Meet Our Cardiologists
To find out more about our cardiologists, visit our Provider Directory. You don't need a referral to visit our cardiology clinics.
Return to the Finish Line: John Wolfe
An avid runner finds his footing after a serious heart scare
John and Jill Wolfe have made a lot of memories running together.
“Our whole family runs, our son and daughter and their spouses, too,” John says.
The family has entered several races, from 5Ks to half marathons. Lake Regional’s 2016 Fun Run/Walk is one run none of them will soon forget — because it came less than three months after John had triple bypass surgery.
“He could’ve run it,” Jill says of her husband . “He slowed down for us.”
Signs and Symptoms
John’s incredible recovery followed a terrible scare. In January 2016, the then-48-year-old was running four to six miles a day to train for the Bridge & Dam Half Marathon in Lake Ozark. He became concerned when he noticed he was getting slower and more out of breath.
“I thought I had the flu,” he says. “I felt achy and had bronchial symptoms and chest pains.”
He took a week off and then went to his treadmill. But his first workout triggered severe jaw pain, chest pain and a strange headache. Jill insisted he go the next day to see his doctor, Lake Regional’s James Neill, M.D.
John easily agreed. Despite being a runner and in great shape, he knew his heart could be in trouble. Several of his family members — including two siblings, a parent and two grandparents — had experienced a heart attack or needed heart surgery, or both, by the age of 40.
Aware of this history, Dr. Neill referred John on to Lake Regional Cardiologist Zubair Khan, who ordered an echocardiographic stress test to check John’s heart’s function. Irregular results prompted Dr. Khan to order an angiogram to get more information about the blood flow to John’s heart.
With the ordering of the second test, John expected to hear he had a minor blockage, or blockages, that would require one or more stents, a minimally invasive procedure. But the results revealed a more serious situation.
Three of John’s arteries into his heart had significant blockages. That meant he needed open heart surgery to create three new paths for blood to flow to his heart — or triple coronary artery bypass grafting.
Getting Up and Getting Out
The first emotion John felt when Dr. Khan delivered the diagnosis was anger at himself.
“Because I had been working hard the last 10 years not to be in that position,” he explains, adding he had started running to avoid heart problems. He also had been careful with his diet.
Dr. Khan understood John’s frustration and assured him all of his effort had not been for nothing.
“His heart disease is genetic, so no amount of exercise was going to prevent it,” Dr. Khan explains. “But, it was still good that he had exercised. For one thing, if he hadn’t exercised, he likely would’ve had problems earlier. Second, because he was in good shape, his surgery risks were lower. And third, he was in better shape for recovery.”
Soon enough, John realized Dr. Khan was right. He had surgery on a Sunday morning, spent three days in the ICU — “The whole ICU staff was amazing,” he says — and went home that Wednesday.
“One week after I was released, I was walking three miles,” he says. “That doesn’t mean it was easy. It would’ve been very easy to just sit in the recliner. But the more I did, the better I felt. Being a runner, I knew the hardest part is getting up and getting out the door.”
The morning of the 2016 Lake Regional Fun/Run Walk, John and Jill were joined by their entire family — their son and his wife, their daughter and her husband, and their two grandsons — and to John’s surprise, everyone had matching shirts.
“I was really touched,” John says. “I’m blessed to have a family that would stick it out with me. They’ve been there every step.”
Now more than a year after his surgery, John is doing great, with no symptoms. This past summer, he even took a 10-day backpacking trip in Colorado with his son and a friend.
“I am just living my life without worrying about heart trouble slowing me down,” he says.
Join the Fun Run/Walk!
The 10th Annual Lake Regional Health System Fun Run/Walk, benefitting Cardiopulmonary Rehabilitation, is Saturday, May 6. Click here for details and to register.
Close to the Heart: Bob Bueltmann
Bassing Bob shares his heart story.
Bob Bueltmann was having lunch with his son Robbie and friend Marcus Sykora when the chest pain started.
"We were out on the deck, overlooking the lake, and talking about some fishing event coming up," says Bueltmann, an avid angler known around the lake as Bassing Bob.
The pain felt similar to esophageal spasms, which had previously bothered Bueltmann, so he took a nitroglycerin to ease the contractions. Five minutes later, he took another. Then another. And a few minutes later, still another. When 30 minutes passed and the pain had not eased, Sykora told Bueltmann he was taking him to Lake Regional Hospital.
"I knew we had good care right down the road, and I just don't take any chances," Sykora says.
Lake Regional Cardiologist Zubair Khan, M.D., FACC, says it was a good thing Bueltmann did not wait.
"He was having a small heart attack but was on his way to a big heart attack that could cause permanent damage to the heart muscle," Dr. Khan says. "It was imperative that he receive care."
Bueltmann was already a patient of Dr. Khan's, having established care with him at Lake Regional Heart and Vascular in 2012. Bueltmann had moved to the lake from St. Louis after retiring at age 55 from a successful career in technology sales and business development.
Not ready for a full retirement, Bueltmann decided to combine his passions for entrepreneurship and bass fishing. He launched BassingBob.com, now a popular website for Lake of the Ozarks anglers.
Bueltmann quickly found a local cardiologist because he had a history of cardiac problems. Between 2009 and 2010, while still in St. Louis, he had multiple stents to improve blood flow in minor arteries. Six months after he began seeing Dr. Khan, he received another stent.
When Bueltmann arrived at the Emergency Department on Sept. 2, 2015, his chest pain was at a nine. An electrocardiogram, or EKG, taken within minutes of his arrival showed that although he was not having an acute heart attack, his heart was not receiving enough oxygen. The care he received in the ED was "phenomenal," Bueltmann says.
Just 37 minutes after arriving in the ED, Bueltmann was taken to the catheterization lab, where Dr. Khan discovered that Bueltmann's ramus artery—a branch of the left main coronary artery—was 99 percent blocked. Dr. Khan placed a stent to restore the artery's blood flow. He also saw that Bueltmann's right coronary artery was 90 percent blocked; he did not place that stent then but scheduled a second procedure for Sept. 22. Bueltmann was able to go home from the first stent about 24 hours after he had arrived in the ED. For the second stent, he spent one night at the hospital. Both procedures went well.
Throughout his care, Bueltmann says, he took great comfort from the personal connections he felt with the Lake Regional care team.
"It was easy to build a rapport with people," he says. "I love that about this hospital. I grew up in St. Louis and had gone to much larger facilities. I would never say those doctors didn't care—it's just not the same feeling I have here. There's this community here."
Having witnessed Bueltmann's care, Sykora reports similar feelings.
"It was comforting to see the professionalism and care that we have right here, locally," he says. "It's so reassuring, and we're thankful to have Lake Regional here to help us."
Keeping Good Habits: Bill Washburn
Living with heart disease is never easy. But Bill Washburn has learned keeping fit makes his life a lot better.
A retired local attorney and municipal court judge for Osage Beach, Lake Ozark and Eldon, Washburn has lived with heart disease for 25 years. His most recent heart surgery was in December 2016, and ever since, he’s been working out with other heart patients at Lake Regional Cardiopulmonary Rehabilitation.
“Exercising here encourages me to do it all the time,” he said. “That’s a big part of being successful.”
Washburn’s rehab began with a 12-week prescription. That completed, his doctor prescribed a maintenance phase to help Washburn continue his good cardiac habits.
Better stamina helps keep him motivated. So do the friendships he’s made, both with the nurses who keep watch over him and with his fellow patients.
“When we’re done exercising, we sit down and talk for 20 to 30 minutes,” he said. “One guy and I found out we’re three months apart in age and were in Vietnam about the same time.”
Although committing to a rehab program can seem inconvenient, Washburn said he would encourage people to follow their doctor’s orders and give it a go.
“If you need it, you need it,” he said. “Go. They will build you up.”
Benefitting from HK’s
Washburn is one of more than 3,000 patients who will benefit from the Lake Regional Cardiopulmonary Rehabilitation department in 2018, and this year’s HK’s Hospital Benefit Golf Tournament will support them all by raising funds for a new heart monitoring system. With the new system, the department will be able to accept twice as many new patients into the program. Plus, the new system monitors oxygen levels more comfortably and consistently during exercise, and it includes hand-held technology, so nurses will be able to monitor their patients while standing next to them. Currently, nurses must monitor patients from a central station.
The 40th Annual HK’s Hospital Benefit Golf Tournament is set for June 1–3 at The Lodge of Four Seasons. It will be a memorable weekend of golf, sports celebrities and a not-to-be-missed auction. See an event schedule at www.HKsGolf.com.
Take Her to the Lake: JoAnn Chapman
JoAnn Chapman, 70, was driving from her farm near Doolittle, Missouri, to a friend’s house in Richland when her chest started to hurt.
“Tippy, I’ve got that indigestion again,” she told her beagle, riding along with her.
For weeks, Chapman, a retired teacher, had felt tightness and burning in her chest. It would come and go, but this time was worse.
“It was hurting so bad, it was crushing me,” she said.
Time is Muscle
She didn’t know it, but Chapman was having a heart attack. During a heart attack, also called a myocardial infarction, there’s a blockage in blood flow to part of the heart. The amount of damage to the heart muscle — and how quickly it happens — depends on the size and location of the blocked vessel. It also depends on whether the blockage is partial or complete.
“The faster a heart attack patient seeks treatment, the better their chances are for survival and a good recovery,” said Julia Hudler, Lake Regional’s STEMI coordinator. (STEMI stands for “ST segment elevation myocardial infarction,” a particular kind of serious heart attack.) “We say, ‘Time is muscle,’ because the more quickly we restore blood flow, the more heart muscle we can save.”
“Take Her to the Lake”
As Chapman’s pain worsened, she pulled off the road into a parking lot and called her son, Geoff Heavin. Chapman told Heavin she was in Waynesville and something was wrong — she didn’t know what. Then she quit talking.
Heavin is an emergency medical technician paramedic for MU Health Care’s ambulance service. So he knew what to do. He called Pulaski County dispatch and asked them to ping his mother’s phone to find her. Then he took off from Doolittle to Waynesville. When he arrived, his mother had just been loaded into a Mercy Life Line Air Medical Service helicopter. Heavin jumped inside and told them to take her to MU. But the flight nurse, Jennifer Isenburg, told him no, they were going to Lake Regional. Heavin started to argue, but Isenburg pointed to the monitor — which showed Chapman’s heart was in serious trouble — and said: “You know time is muscle. The lake is 15 minutes closer.”
“You’re right,” Heavin said. “Take her to the lake.”
Beating the Clock
Treatment for heart attack requires opening the blocked artery in a cardiac catheterization lab. A doctor threads a thin tube with a tiny balloon through blood vessels to the blockage. The balloon is then inflated to push plaque aside and restore blood flow. “Door-to-balloon” time measures how much time passes between the patient arriving at an emergency department and the care team restoring blood flow. Nationwide, the median door-to-balloon time is 60 minutes.
“We’re proud that our 2017 median door-to-balloon time at Lake Regional was 43 minutes,” Hudler said. “That is better than nine out of 10 hospitals nationwide.”
Chapman’s flight took 18 minutes. When she landed, Lake Regional’s heart attack team met her at the door. Chapman was in cardiogenic shock, which happens when the heart can’t pump enough blood to the body. It is fatal if not treated immediately. The team started her on medications for this life-threatening condition while going to work on finding the cause of her heart attack. Testing revealed the artery on the heart’s right side was completely blocked. Lake Regional Cardiologist Zubair Khan, M.D., FACC, quickly inserted a balloon to open the artery and then placed a stent to hold it open.
Fifteen minutes after her arrival at Lake Regional, Chapman had complete blood flow restored to her heart muscle and her cardiogenic shock started to improve. She went home just two days later, on April 8, 2018, and her heart was back to normal functioning.
“The people and the care were just wonderful,” said Chapman, who is happy to be back home on her farm, where she cares for several rescued dogs and cats. Her son the paramedic agreed she went to the right place.
“I was very impressed with the lake hospital,” Heavin said. “They understand the timeframes that have to be met, and it worked flawlessly.”
Level II STEMI Center
To help heart attack patients receive the best care possible in the shortest amount of time, the State of Missouri has identified hospitals that are well-equipped to treat heart attack. Lake Regional was among the first hospitals to become a Level II STEMI Center this spring.
Because Lake Regional has earned this designation, EMS providers can bring heart attack patients to Lake Regional. In addition, rather than having to transfer heart attack patients on to another care center, Lake Regional can receive transfers from other hospitals.
Lake Regional Health System is the only hospital between Columbia and Springfield that is a state-designated center for trauma, stroke and heart attack.