Heart Institute

No More Pain at the Mile Mark

No More Pain at the Mile Mark

When you meet Seattle resident David Oguns, 34, one of the first things you notice is that he’s the picture of health and happiness. He runs several miles each week, he’s young, optimistic, eats a healthy diet and he’s definitely not obese. You would never guess that just a few months ago he couldn’t walk from his plane to baggage claim at SeaTac without stopping to catch his breath.

David didn’t know one of his arteries was blocked. Over a period of months, his body had been sending him warnings and finally, he listened.

image descriptionDavid Oguns races without chest pain.

A Seattle resident for the past six years, David started participating in Ragnar events, where small teams work together to meet distance and fitness goals. “Training for the Ragnar motivates me to focus on my running,” he explains. On one of the early cold fall mornings, he had only run a mile when his chest started to hurt.

“As a runner it’s easy to ignore pain when you’re used to running five or so miles consistently. You have to fight off some discomfort and say ‘well this just happens,’ and keep going. But as I ran the next half mile I thought, this feels different. I don’t need to push myself today. So I stopped and walked,” he says. “I thought it might be the cold air that was bothering me.”

David moved his running indoors to the treadmill. Within a mile he felt the discomfort again. “For the next few weeks, I thought if I held back on the intensity of my running and just relaxed, the pain would go away, but it actually got worse,” he recalls. “Eventually I even felt the pain when I was walking to work and had to walk up a hill. It wasn’t as bad as it felt when I was running, but it still happened.

Virginia Mason has two cardiac catheterization labs where, with the most recent technology available, 2,400 procedures are performed each year, including 600 interventional studies.

“The final push that got me to seek treatment, happened when I came back from a friend’s bachelor party in Montreal,” David recalls. “Walking from the plane to baggage claim at SeaTac I got so winded I told my friend I needed to sit down. That had never happened before. Now I was convinced I had a problem.”

The next day he went to the Virginia Mason Emergency Department in Seattle. “They admitted me and ran tests that verified there was definitely a problem.”

An echo stress test was performed that revealed high risk findings, predicting a severe interruption of blood flow to the majority of his heart. This led to the recommendation of definitive coronary angiography (heart catheterization), to pinpoint precisely the culprit problem and allow for optimal management.

Heart Institute Cardiologist and Director of the Cardiac Catheterization Laboratory, Wayne Hwang, MD, FACC, performed the cath procedure and discovered the problem, a critical 95 percent blockage of the origin of the left anterior descending artery, a lesion commonly referred to as the ‘widowmaker lesion’.

There was no doubt about the need for intervention for this type of a blockage, but the nature and location of it allowed for options of either coronary artery bypass surgery or stenting. “It is important to integrate all of the information and clinical findings at hand, from the patient’s detailed history, to the stress test predictions, the coronary anatomy itself, and of course the patient’s personal preferences after a careful discussion of all options available,” Dr. Hwang says.

David’s findings were presented at the weekly ‘heart team’ conference for multidisciplinary review, with both cardiac surgery and interventional cardiology opinions. The consensus recommendation was to offer stenting, which was happily agreed to by David. Soon afterwards on the Tuesday before Thanksgiving, the stenting procedure was performed by Dr. Hwang with an excellent result.
 
“The procedure went smoothly,” David says. A week later he ran two miles to test for pain. “At the mile mark I didn’t feel any pain so I knew I was fine.” Along with medication to help his body adjust to the stent, David continues to maintain a healthy diet and to enjoy running and racing.


Heart Institute Award

In 2019, Virginia Mason received the American College of Cardiology’s NCDR Chest Pain — MI Registry Platinum Performance Achievement Award.

The award recognizes Virginia Mason’s success in implementing a higher standard of care for heart attack patients and affirms it has reached an aggressive treatment goal recommended by the American College of Cardiology/American Heart Association clinical guidelines. The Heart Institute demonstrated sustained achievement in the Chest Pain — MI Registry for eight consecutive quarters and is one of only 225 hospitals in the nation to receive the award.

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