Exceptional Cardiac Care
Our comprehensive cardiac services provide the collaboration of a team of experts focusing on the early detection, diagnosis and treatment of all types of cardiac conditions.
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Lancaster Regional Medical Center Recognized for Quality in Cardiac Care
Lancaster Regional Medical Center Recognized fo...
Heart Failure Patients Wind Up in ER Too Often: Study
Finding illustrates need for better outpatient care, researchers say
Pigs' Hearts Beat for a Year in Baboons' Abdomens
Studies may one day lead to use of animal organs for human transplantation
Potassium Supplements May Help Some Heart Failure Patients
Study finds they seem to improve survival for people taking 'water pill' diuretics
Hot Dogs, Salami May Raise Men's Heart Failure Risk, Study Suggests
But unprocessed red meat was not implicated in this research
Many With Heart Failure Aren't Told About End-of-Life Care: Study
Survey found nearly a third of health-care providers lacked confidence to discuss the topic with patients
Resources and Support
Get trusted information about how your heart works, the different types of conditions that can affect your heart, and the types of procedures that you may be facing.
Browse our Heart Health Library
Extra special comfort - with love
A few very generous Lancaster County volunteers hand knit beautiful shawls and one-of-a-kind heart-shaped pillows for Lancaster Regional patients facing cancer and cardiac issues. Dedicated Lancaster Regional volunteers personally deliver the gifts to patients.
Beyond the Physical: Support for your Well Being
Dealing with and recovering from a cardiac procedure, is not limited to physical healing. Many people draw encouragement, strength and motivation from support groups and/or others facing similar challenges. Lancaster Regional has partnered with local organizations such as the American Heart Association to provide a vast network of support options, and educational resources at no charge to ensure your overall wellness during and after what can be a very stressful time in life.
With the American Heart Association, for example, patients have access to:
- The AHA website offers a great deal of educational and support information. You can also sign up for a free heart health e-newsletters (cholesterol, high blood pressure, heart failure, caregiver support, arrhythmia, etc.)
- Visit the AHA’s Cardiac Rehab Health Center – a free online resource to support your recovery, whether or not you’re in Lancaster Regional’s rehab program.
- Mended Hearts is a nationwide patient support organization for people with heart disease, their families, medical professionals and other interested people. To learn about this wonderful support group log on to mendedhearts.org.
If you suspected a heart attack and went to the emergency room right away, chances are you received the first-line treatment: percutaneous (below the skin) coronary intervention or angioplasty. Angioplasty is a procedure to remove the clot and restore blood flow to the heart. It’s likely you will be placed on a lifetime regimen of medication after having a heart attack. Categories of medication include the following types of drugs:
- Anticoagulants — are commonly called blood thinners, which retard the clotting mechanism so blood flows smoothly through arteries.
- Antiplatelet agents — are drugs that keep blood cells from clumping and forming artery-blocking clots.
- ACE inhibitors (angiotensin-converting enzyme) - angiotensin is a small particle—a peptide—that starts a process that causes blood vessels to narrow. Narrowed blood vessels cause high blood pressure because the heart works harder to push blood volume through the vessels. This class of drugs controls blood pressure.
- Angiotensin II receptor inhibitors — represents another group of drugs used to control hypertension (high blood pressure). They block the action of angiotensin II, which causes blood vessels to narrow, and lower blood pressure. These drugs are similar to ACE inhibitors because they both lower blood pressure, but the way they affect angiotensin production differs. Since the drugs work differently to achieve similar results, it’s up to your physician to determine which class of medication is right for you.
- Beta blockers — are also called beta-adrenergic blocking agents and beta-blocking agents. They work by altering the effects of adrenaline on the body’s beta receptors that, in turn, slows the nerve impulses that travel to the heart. These drugs are used to treat high blood pressure and arrhythmias (irregular heartbeat), relieve angina (chest pain), and can help prevent another heart attack once one has already occurred.
- Calcium channel blockers — work by blocking calcium from the heart and blood vessels, which relaxes blood vessels and increases the supply of blood and oxygen into the heart. Calcium channel blockers reduce blood pressure and may be used to treat chest pain (angina).
- Diuretic — is a class of medication that helps you body eliminate excess fluid, which helps lower your blood pressure.
- Vasodilators — are drugs that enlarge the blood vessels (arteries). The goal is to open arteries so blood flow is unimpeded.
- Digitalis — strengthens heart muscle contractions, slows the heart rate, and helps eliminate excess fluid from the body.
- Statins — reduce the level of low-density lipoproteins (LDL), sometimes called bad cholesterol, by inhibiting cholesterol production. Statins also help the liver remove LDL that is already in the blood, which lowers total cholesterol.
*For more information about your heart medications, please consult with your doctor or pharmacist.
From the dear friend of an Lancaster Regional Medical Center patient...
“On a Sunday in August, 2010, a dear friend was playing tennis. He suffered a sudden cardiac death event and was transferred by first responders to Lancaster Regional. Pam, the Emergency Room nurse, dealt with a patient in a life threatening situation, not knowing emergency contact information or past medical history; along with an accompanying friend who was hysterical. I arrived at about 5pm to find her diligent in her care and empathetic to the family and friends who gathered in shock in the emergency waiting room. As I evaluated the accuracy of her assessments and the nursing interventions (I am also a nurse), I found her to be an expert care giver, giving me confidence that my friend was in the best hands possible. Her demeanor of calm and respect, allowed the family to “wrap their arms around what happened” and get ready for the long few days that would lie ahead.
We were given permission by the family to have medical information relayed to us upon our visits. The next morning, after a long night without sleep, my husband and I arrived at the ICU unit hesitant about the condition of our friend. We were greeted by Ken, who sensed our anxiety. It seemed to me that he identified my needs as a fellow nurse and, although it was not official visiting hours, allowed us to visit for a brief time. He approached us with empathy and immediate information. I was thrilled to see that a hypothermia blanket had been initiated on our friend. He was quick to explain that it was evidenced based practice with the goal of reducing oxygen and metabolism needs. His actions allowed my husband and I to settle our minds, and leave the hospital for our work positions with confidence that our friend’s condition was in the hands of confident and expert care givers.
Keri cared for our friend on Monday afternoon, when I stopped by for an afternoon visit. Keri was direct and caring. I noted that a feeding had been started, and commented that I was glad to see that nutrition was being included in the game plan. Keri was excellent in explaining again that it was an important component in healing. I left the room feeling great comfort that the team was hoping for a full recovery and utilizing all current literature.
Monday evening when we returned, Brad was assigned. Brad engaged me in conversation and learned that I was a registered nurse. As I watched Brad, he was impressive in his assessments and clearly had our friend’s comfort as a high priority. He explained the results of his neurological assessment and explained the game plan for the next 24 hours, while always keeping his focus on the patient.
We returned on Tuesday morning, a big day for our friend. It was time to be awakened from sedation and weaned from the respirator. Ken was assigned to our friend, and I breathed a sigh of relief knowing that the care would be excellent.
As I sit here on Tuesday morning, our friend is alert and oriented. He is successfully being removed from ventilation. The chances of him returning to a quality of life similar to Sunday are good. Some would say that it is a miracle and I believe that too. However, miracles need to have caring hands to carry out the science and art that allow them to occur. It became clear to me that the Lancaster Regional nurses perform miracles for patients each day. These nurse staff members and their team carried out this miracle for our friend.
I am sharing my heartfelt thanks to your nursing staff. It would be impossible to give them a commendation equivalent to the gift their nursing care gave to my friend, his family and me. However, may I ask you to please extend to them the highest level of commendation? Your nursing staff changed my perception and I will forever remember them for their heart, hands and minds.”
Coronary Artery Disease - It’s Not Just for Men
Paul Brown, MD, FACS, FACC, Cardiothoracic & Vascular Surgeons of Lancaster (717) 735-3920
Each year in February the American Heart Association (AHA) focuses on women and cardiovascular disease encouraging women to seek earlier treatments for cardiovascular disease to prolong and improve their quality of life. The AHA reminds women that coronary artery disease is not a just disease affecting an overwhelming number of men. In fact, just the opposite is true.
Here are some startling statistics for you:
- Heart disease kills 32% of American women and is the leading cause of death in American women. An additional 11% die from strokes, which have the same risk factors.
- Eight million American women, 10% percent of women under the age 65 and 25% of women over age 65, live with the disease.
- 13% of women over age 45 have had a heart attack. That equates to 435,000 American women having heart attacks each year, with 83,000 under age 65 and 9,000 under age 45. In total, 267,000 women are dying from heart attacks each year, which is six times the risk as from breast cancer.
Contrary to popular belief, coronary artery disease is not just a disease of old age. It is a disease of uncontrolled risk factors such as hypertension, elevated cholesterol, diabetes, obesity, sedentary life- style and ongoing tobacco abuse. For example:
- African American women ages 55-64 are twice as likely as white women to have a heart attack and 35% more likely to suffer from coronary artery disease.
- Women who smoke risk having a heart attack 19 years earlier than non-smoking women.
- Women with diabetes are two to three times more likely to have a heart attack.
- High blood pressure is more common in women taking oral contraceptives, especially in obese women.
- 38% of women, and 25% of men, will die within one year of a first recognized heart attack, and 35% of female and 18% of male heart attack survivors will have another heart attack within six years. 46% of female and 22% of male heart attack survivors will be disabled with heart failure within six years as well.
- More women than men die of heart disease each year, yet women receive only 33-36% of angioplasties and open-heart surgeries. Women comprise only 25% of participants in all heart related research studies and 31,000 of women die each year of chronic heart failure, which is 1.6 times the rate as men.
There are no "pills" that can reverse the disease, but there are many options to help prevent the blockages from getting worse. These options center round controlling risk. It is rarely too late to reduce one’s risk factors. For example, those with high cholesterol who engage in exercise three times per week cut their risk of death in half, from 15 times normal to 7 times normal. Taking cholesterol lowering medications may reduce the risk of death from a heart attack by 50% as well.
If you are concerned you might be at risk, or because you are already having chest pains or shortness of breath with exertion, a visit to your internist or family physician or cardiologist is in order. The oldest and most reliable test to look for disease is probably the ECG, which shows if you have ever had a heart attack in the past or if you are actively having any problems. The next test is a physiologic test of heart function, the most common of which is an exercise treadmill test. One’s pulse, blood pressure and ECG are monitored while exercising. Nuclear imaging of the heart is usually done at the same time to show changes in blood flow to different areas of the heart with rest and exertion. For those unable to exercise, various medications are administered to cause the heart to pump vigorously to simulate exertion.
Depending on risk factors and symptoms, your cardiologist may then recommend an elective cardiac catherization. This is the gold standard test that allows one to correlate the physiologic abnormalities of heart function with actual blockages in the coronary arteries. A cardiologist can then actually open up blockages or recommend that the patient be seen by a cardiothoracic surgeon who specializes in the surgical treatment of the heart. These treatments may include bypass grafting or valve repairs and replacements.
The best news is that people who would have died just 50 years ago of coronary artery disease can now often go home in a few days after treatment. However, the real focus and best approach is the prevention of heart disease in the first place. The old adage of "an ounce of prevention is worth more than a pound of cure" has never been more applicable than to patients with coronary artery disease.
The Mediterranean Diet: A Succinct Overview
Nehal D. Patel, MD, Red Rose Cardiology (717) 735-8150
It’s the type of diet which has received plenty of attention in the media during the last several years. Recent research articles have also been published in prestigious medical journals extolling its benefits. So, what exactly is the “Mediterranean diet”? Is it a dietary plan where the serving size is strictly calibrated and the cuisine is so toned down that it’s virtually flavorless and insipid? No, there’s more to this diet than one may expect at first. Let’s take a look at the history behind this diet so its full perspective becomes evident.
The Mediterranean diet first gained attention back in the 1950s and 1960s when a research team led by Ancel Keys, PhD, found that inhabitants of Greece, Crete, southern Italy, Spain, southern France, and regions of the Middle East seemed to experience much lower rates of cardiovascular disease than their counterparts in North America and northern Europe. At that time, it was found that people residing in this Mediterranean basin consumed more produce and higher levels of monounsaturated fat (predominantly in the form of olive oil). Moreover, they also engaged in a greater degree of physical activity. In addition, the diet also existed in a specific cultural context: the people in the Mediterranean region seemed to foster strong social and family bonds around the dining experience. Eating meals was not done in a solitary and rushed fashion as is sometimes the case in the more fast-paced, industrialized nations. As Dr. Andrew Weil would remark when studying this diet, “eating together and taking pleasure in food” appeared to be central tenets in these healthy societies. What are some basic principles involved with the Mediterranean diet? Here are some guidelines to get started and also to whet your appetite.
- Use olive oil as the primary cooking fat. The monounsaturated fat in olive oil seems to be the key element to many of the benefits of the Mediterranean diet. Extra-virgin olive oil is a worthwhile investment since it contains more antioxidant activity. Use olive oils in sprinkling salad, sautéed with vegetables, tossed with pasta, or as a dip for crusty bread.
- Experiment with whole, unrefined grains. This category includes various types of pasta as well as rice, couscous, barley, bulgur, and polenta (cornmeal).
- Incorporate beans. Legumes such as cannelloni, kidney, fava, and lima beans; chickpeas; and lentils will provide protein and texture to different dishes. They also provide a good source of vitamins, minerals, phytochemicals, and fiber.
- Enjoy produce during each meal. Consuming a rainbow array of fruits and vegetables will provide a good source of protective phytochemicals. Fresh, locally grown produce is preferred but even using canned fruits and vegetables during the colder months is a healthy alternative. Commencing lunch and dinner with salad is also a good technique. It will also promote satiety so you consume less calories.
- Cultured dairy products can be used. Historically, refrigeration was expensive for many inhabitants of the Mediterranean region. The cuisines included more cheeses and yogurt as opposed to milk. As a result, these were used as seasonings and flavorings rather than as a basis for a meal. Grating small amounts of cheese over pasta or soup is a healthy idea.
- Meat intake can be adjusted. Most of the protein in the Mediterranean diet derives from beans and fish. If you enjoy red meat, it can be used occasionally as a seasoning in soups and sauces. In this manner, it can add flavor to a meal as opposed to becoming a focus of the meal.
- “Going nuts” about the diet. Nuts historically have been abundant in the Mediterranean basin. They provide fiber, protein, folic acid, as well as vitamin E. Interestingly, omega-3 fatty acids are found in good amounts within walnuts. Munching on a handful of nuts is more healthy than eating other more processed snacks
- Transforming meals into a social event. Enjoy mealtime in the company of others. Eliminate distractions such as watching television and enjoy the time set aside for the meal.
With practice, you will also learn to savor the various ingredients and elements comprising the meal. A sense of gratitude will also arise with such mindful eating in the company of loved ones and friends. These guidelines can help you to get acquainted with the general outline of the Mediterranean diet. For inspiration in being creative gastronomically, various cookbooks can be consulted. The New Mediterranean Diet Cookbook, by Nancy Harmon Jenkins, is a suggestion. Another good volume is The Mediterranean Diet, by Marissa Cloutier and Eve Adamson. This latter book also includes a good section on the historical context as well as objective research findings supporting the benefits of the Mediterranean diet.
When implementing changes to your diet, it’s best to begin gradually and to experiment with a couple of the suggestions delineated above. Be creative and bon appétit.
Surya R. Kumar, MD, FACS, Cardiothoracic & Vascular Surgeons of Lancaster (717) 735-3920
An aneurysm is defined as a permanent, localized dilatation of an artery, having at least a 50% increase in diameter when compared to the diameter of a normal artery. Arterial aneurysms have been recognized since ancient Greek and Roman times and the term aneurysm is derived from the Greek word aneurysma, meaning “a widening”.
In the last fifty years, tremendous strides have been made in the management of aneurysmal diseases of the arteries. People who would have died many years ago can now go back home after just a few days in the hospital! The greatest risk of aneurysm has always been sudden rupture and prevention of rupture is the key in management of this condition.
Aneurysms occur due to a degenerative process in the architecture of the arterial wall and are classified according to their location, size, shape and etiology. Risk factors include family history, smoking, COPD, disorders of cholesterol metabolism and male gender.
Rupture of an aneurysm is due to rise in wall tension. This causes severe bleeding and is mostly fatal. Aneurysms can also present in other ways. Clots that form within arteries can break away and be carried into the bloodstream, obstructing arteries elsewhere. This can restrict blood supply and cause gangrene and tissue loss. They can also press upon other adjoining structures or rupture into them.
The most common site for degenerative aneurysms is the abdominal aorta, called abdominal aortic aneurysm (AAA). In the United States, ruptured AAAs are the 15th leading cause of death overall and the 10th leading cause of death in men older than age 55. Most AAAs are asymptomatic, which often leads to difficulty in their detection. Most AAAs that become symptomatic do so because of rupture or acute expansion. Rupture has a mortality rate of more than 75%, so early diagnosis via ultrasound, CT or MRI and subsequent treatment are vital.
The incidence of AAA in hospitalized patients in the United States is approximately 50 per 100,000. Non-aortic aneurysms are much less common - three per 100,000 for iliac aneurysms and 4 per 100,000 for femoropopliteal aneurysms. Popliteal aneurysms account for 70% of all peripheral aneurysms. Thoracic aortic aneurysms (TAA) are also lower in incidence in comparison to AAA. But the incidence of TAA has increased gradually and is estimated to be 10.4 cases per 100,000. Most TAAs are discovered incidentally in asymptomatic patients. Visceral and renal artery aneurysms are rare.
For aneurysm treatment, the choice between regular observation and surgical repair and is decided by several factors. Surgical techniques can include open repair or minimally invasive stent graft techniques.
If you have a family history of aneurysmal disease or are concerned that you may have an aneurysm of the abdominal aorta, a visit to your internist or family physician is in order ASAP! He or she may order an ultrasound of your abdomen. If an aneurysm is detected, he or she may refer you to a thoracic or vascular surgeon for follow up, which can include regular observation or repair to prevent rupture. Rest assured that the physicians associated with Lancaster Regional can provide expert, timely and compassionate diagnosis and treatment.