A North Texas couple is bringing attention to a rare, but known heart complication of pregnancy.

When Karieana Karhu was born in late December, her mother’s heart filled with pride and love. Two weeks later, Suzanne Karhu’s heart very nearly stopped.

“I received a distressed phone call from my wife,” Chris Karhu said. “She was very panicked, and all she could say was, ‘Help me, help me!’”

At the hospital, doctors diagnosed the 39-year-old mom with a coronary dissection, meaning one of the main arteries to her heart had ripped.

“It actually only took the first picture,” said cardiologist Dr. Mordecai Klein after viewing an X-ray. “I was shaking for two hours… that’s how close she was to death.”

Some symptoms of pregnancy-related heart problems include:

• fatigue
• feeling of racing heart or skipping beats
• increased nighttime urination
• shortness of breath
• swelling

Expectant or new mothers with those signs should tell their doctors right away.

Experts suspect hormones or the stress of childbirth may weaken heart muscle.

In Suzanne Karhu’s case, a coronary dissection is even more rare and usually isn’t diagnosed until after death.

She and her husband returned to Medical Center of Plano to thank the doctors, nurses, and paramedics who saved her life.

“I never knew so many people were involved,” said Suzanne, who was unconscious for much of the ordeal.

The Karhus credit the emergency and medical team with with working a miracle to save little Karieana’s mother.

“She’s going to make a full recovery, live a long life, and take care of our daughter,” Chris Karhu said with a smile “Thank you guys very much.”

Heart disease is a rare, but known complication of pregnancy. It happens in one about 4,000 cases.

According to a report published in the July 2008 issue of the Journal of the American College of Cardiology, becoming pregnant can double or triple a woman’s risk for heart attack, even though heart attack in child-bearing years is considered rare.

E-mail jstjames@wfaa.com

Tracy Kornet
PLANO (CBS 11 / TXA21)CBS News

When someone has a heart attack the first thing medical professionals do is fight to save the heart. But that’s only half the battle.

Now a North Texas doctor has created a new system that is giving patients a better chance at regaining their normal lives after nearly losing them.

Looking at 41-year-old Julie Krumnow of Plano, it’s hard to tell she has a life-threatening condition. Just over two months ago, even she didn’t know. “Coming up to this, I had no issues whatsoever with my heart or my health at all.”

But on December 12, during a routine trip to the grocery store her entire life changed in an instant. “I lost consciousness and just fell down.”

Krumnow suffered a massive heart attack right there in the store. “They said that I stopped breathing at that point.”

Paramedics rushed to her side and were able to revive her, but they were concerned her lack of oxygen might have caused brain damage.

Dr. Mordecai Klein, a cardiologist at the Medical Center of Plano, teamed up with the Plano Fire Department five months ago to introduce a new procedure to help save cardiac patients like Krumnow. “The goal is to initiate the therapy as soon as possible.”

Before they get to the hospital, paramedics force the patient into hypothermia, chilling the body to 93 degrees. It’s all in an effort to prevent brain damage “If we can intervene with the low temperature then this interrupts that process.”

Battalion Chief Marty Wade says his paramedics use IV saline that is chilled to 33 degrees to start the process. It slows the metabolism and everything else down so the body is in kind of a less stress environment.

They add ice packs to the groin and underneath the armpit and administer a drug that prevents the body from shivering. “Their brain won’t need as much oxygen if their core temperatures are lowered.”

Once at the hospital and the heart attack is stopped the patient will remain in monitored hypothermia for two more days before being warmed back up.

“The more we can do, the more people we can bring back to their families. She has two sons in this case, the more good we can do.”

The induced hypothermia worked for Julie Krumnow. She remembers everything except the day of her heart attack. “I have my memories, I have everything, and I’m very grateful.”

She says she now owes her life and memories to Dr. Klein. “I think the quick action of everyone around me, the fact that the paramedics got to the store so quickly and they knew what to do and how to do it.”

Plano is the first city in North Texas doing induced hypothermia in the field on cardiac calls. The hope is that more fire departments will begin training soon.

For more information on Dr. Klein, click here.

Mordecai N. Klein, MD

A cardiologist is a doctor who specializes in preventing, diagnosing and treating disorders of the heart.

The training required to become a cardiologist is quite rigorous. Students are required to complete four years of undergraduate school, four years of medical school, three years of residency,three years of a fellowship and two additional years if one wants to become an interventional cardiologist. In total, it takes fourteen to sixteen years to become a certified and board-approved cardiologist. After completing the necessary education and training, students are required to complete a difficult exam given by the American Board of Medicine that is taken over two days.

Dr. Mordecai Noah Klein, recently voted Cardiologist of the Year by the hospital staff at The Medical Center of Plano, began practicing cardiology in 1991 and is a Fellow of the American College of Cardiology.

What qualifications are needed to become a cardiologist?

It takes a special type of person to become a cardiologist – one who is hard-working and dedicated to helping others. This profession requires working long hours, often under stress, so the ability to remain calm under pressure is very helpful.

What, exactly, does a cardiologist do?

Texans with heart problems may be referred to a top cardiologist in Plano by their primary care physician. Cardiologists will review a patient’s health history, conduct physical exams and may perform various tests, including echocardiograms, EKGs, exercise tests and cardiac catheterizations, among others.

A description of these tests follows:

Echocardiogram: Uses sound waves to look at the heart.
EKG: Detects abnormal heart rhythms and other changes that may suggest heart attack or lack of blood flow to the muscle.
Exercise test: Measures how the heart responds to physical activity.
Cardiac catheterization: Takes pictures of the heart. This procedure requires that a tube be inserted into the heart. It can also be used to repair or remove blockages from the heart.

What is the F.A.C.C. and how does a cardiologist become a member of it?

The F.A.C.C. stands for Fellow of the American College of Cardiology. This is a professional organization for cardiologists. Once a cardiologist becomes a member of this prestigious organization, he or she pledges to adhere to a set of guidelines established by the F.A.C.C., placing patient health and medical advancement as their highest goals. Dr. Mordecai Noah Klein is a Fellow of the American College of Cardiology and is currently practicing in Plano TX, a suburb of Dallas, Texas.

Despite advances in technology and pharmaceuticals, the prevalence of cardiovascular disease (CVD) in the United States continues to rise. With current conditions, it is expected to continue to rise for years.  The cost of addressing cardiovascular disease  alone (including coronary disease, hypertension, stroke and congestive heart failure) runs into the hundreds of billions of dollars annually.

It is important to know that CVD is PREVENTABLE. By participating in one’s own care, one may prevent CVD. So, people “know thy numbers.”

Number 1:  Know Thy Blood Pressure

Number 2: Know thy LDL (bad cholesterol) level

Number 3: Know thy Triglyceride levels

Number 4: Know thy HDL level

Number 5: Know thy Fasting Glucose level

Number 6: Know thy Waist Circumference/weight

Number 7: Know thy Ejection Fraction (ability of the heart to pump blood

Know your numbers so you can act upon them:

The Metabolic Syndrome is a group of risk factors that if found in a person may increase the risk of developing CVD.   Abdominal obesity, high triglyceride/low HDL/high LDL, elevated blood pressure, insulin resistance/glucose intolerance, increased clotting activity of the blood, and evidence of inflammation(e.g. elevated C-reactive protein) are all components of the Metabolic Syndrome. The presence of three or more of these entities in a given individual may constitute the diagnosis of the Metabolic Syndrome.

Know thy waist circumference/weight!

A waist circumference of greater than 40 inches in men and 35 inches in women is part of the Metabolic Syndrome. The fat cells that accumulate in the waist are not benign. They are living cells that manufacture different types of hormones and growth factors that may adversely affect one’s health. The higher the weight, as measured by the Body Mass Index (BMI), the higher the likelihood of Hypertension, Diabetes Mellitus and CVD.  The fat must go!  It is not an easy task. There are several published diets that, if followed, can start the progress.  Increasing fruit and vegetable intake and reducing fat and cholesterol intake is a good start. If you are searching for guidance consult your doctor.

Know thy LDL/HDL and Triglycerides!

Lowering the bad cholesterol and raising the good cholesterol is essential especially if one has other risk factors for CVD. In most cases aim for an LDL less than 100. Aim for less than 70 if there multiple risks for or documented CVD. Triglycerides should be lowered as well. Medications and diet are available to address these problems. While some of the medications possibly have unwanted side effects, the beneficial effects far outweigh any risks of complications. If you want to take control of your lipid status, consult your physician.

Know thy glucose!

Again, obesity leads to diabetes. Knowing that dangerous sugar levels are present may move one to lose weight and change dietary habits.  Exercise is also an integral component of controlling sugar and weight. Moderate exercise for 30 minutes a day, at least 5 days a week, is indicated. For more information, consult your physician.

Know thy blood pressure!

A risk factor for CVD, blood pressure could also be the sign of other potentially life-threatening medical problems. A normal blood pressure is less than 120 millimeters of mercury systolic (top number) and 80 millimeters of mercury diastolic (bottom number).  By reducing weight, eating a reduced-fat diet rich in fruits and vegetables, restricting salt intake, exercising regularly (30 minutes daily most days of the week) and limiting alcohol intake one can lower blood pressure.  A weight loss of 10 kilograms (22 pounds) may lead to a 5-10 millimeter of mercury reduction of blood pressure. Medical therapy is also available to help lower the pressure. For more assistance contact your physician.

Know thy Ejection Fraction!

Ejection fraction is the percentage of the blood that returns to the heart from the lungs that gets pumped to the body. It can easily be determined by doing an ultrasound of the heart (echocardiogram).  Normal Ejection Fraction is 50%-60%. Low Ejection fraction may be caused by active coronary artery disease, long-standing hypertension, viral infections and valvular disease most commonly. If the function is too poor there is risk of congestive heart failure and dangerous arrhythmias. Medications or implantation of an AICD (defibrillator) may be protective. So know thy Ejection Fraction.
It is hoped that people will start taking responsibility for their own health. Together with the physician, good cardiac health can be maintained. To do this, Know Thy Numbers.

The Dual Source “128-Slice” CT machine can assess not only the aorta, carotid arteries and peripheral (leg) arteries but now gives your physician or cardiologist the ability to perform a noninvasive angiogram of the coronary arteries with 3D images of the wall and channel of the blood vessels.  In the past this was only possible with an invasive cardiac catheterization and even then you could only see the channel of the blood vessels.

Who should have a CT Angiogram?  Current Medicare guidelines say the test is indicated for patients with low to moderate risk of CAD (coronary artery disease) and symptoms suggestive of CAD who in pre-CT Angiography days would need a catheterization.  So, if you have had persistent “classical” anginal chest pain with a negative or indeterminate stress test or if you have known CAD with new symptoms that would otherwise have you hospitalized, you would be considered for CTA of the coronaries.  Someone with coronary risk factors would also qualify for evaluation of the coronary arteries before a major non-cardiac surgery.

However, if you are between the ages of 40 and 75 and have one or more cardiac risk factors then you are a great candidate.   These risk factors include:

 Abnormal Cholesterol – high LDL (above 130), low HDL (below 40 in men and below 50 in women), and high triglycerides (over 150)

 History of tobacco use

 High blood pressure

 Overweight

 Sedentary lifestyles

 Family history of premature heart disease

 Diabetes

Most people do not realize that conventional stress testing only detects severe artery blockage.  In fact, you may have what is considered a “normal” nuclear stress test or stress echocardiogram with less than 70% blockage.  The bad news is that statistics show that most heart attacks occur in patients with less than 50% blockage of the blood vessels.

CT Angiography of the abdomen, carotid arteries, renal arteries and lower limb arteries is also very useful for finding aneurysms, blockages and congenital anomalies.

If you have an interest in learning more or if you or your physician feel that you may need such testing feel free to contact me at my office

Most people are familiar with the signs  and symptoms of heart disease. Heart disease’s less-known sibling, Peripheral Artery Disease (PAD) is hardening of the arteries which supply blood to the arms, legs, intestines, kidneys, etc.  Sometimes the vessels are so affected that blockages (obstruction to blood flow) occur and cause symptoms such as pain, cramping, ulceration, infection, and even death.  Frequently, legs severely  affected by PAD, if neglected, end up being amputated.

Even today, with the advent of new tests to detect PAD and new treatments that can salvage limbs affected by PAD, many amputations are still being done.  A simple test, the Ankle/Brachial Index (ABI), measures the blood pressure in the arm versus blood pressure in the legs.  If one has low ABI’s and symptoms, further testing, such as CT Angiography (similar to CTA for the heart) or angiography should be done next.  At  the same time, one’s physician should start medical therapy with aspirin, lipid-lowering medications, etc.  A completely blocked leg artery, even with ulcers and gangrene in the affected limb, can often be fixed and saved with lasers, balloons, stents or even, in extreme cases, bypass surgery.  Amputation should be  a last resort only!  So, if you have diabetes, hypertension, high cholesterol and/or symptoms of leg pain or skin ulcers/infection, please see your physician for further evaluation and care. Get a leg up on PAD!

Now the American Heart Association has come out with new recommendations for EP, or Endocarditis Prophylaxis (prevention of infections in the heart). While there may be an increased risk of infection with certain procedures (dental work, GI endoscopy or urologic procedures), the risk is still very small and is outweighed by the risk of the emergence of antibiotic-resistant bacteria and reactions to the antibiotics (such as allergic reactions and/or the development of inflammation of the colon).

If you have Mitral Valve Prolapse and other valvular abnormalities, such as Aortic Stenosis or Aortic Regurgitation, you no longer have to toil to find antibiotics before the trip to the dentist. This makes life much easier! Some people will need to continue EP with antibiotics. For instance, individuals with prosthetic heart valves and individuals who have had previous infection in the heart (Infectious Endocarditis) will require EP. If one has had a heart transplant and the valves of the transplanted heart are deteriorating, that person will need EP. Finally, congenital heart disease that remains surgically uncorrected or repaired with artificial materials will require that the individual have EP. Repaired congenital heart defects with residual defects near the site of an artificial patch or device will also require the protection of EP. We hope this short discussion keeps you up to date.

If you have questions or if you are one of the aforementioned individuals who has been using preprocedural antibiotics, feel free to discuss this with your physician

Varicose veins are swollen, twisted, and sometimes painful veins that have filled with an abnormal collection of blood. Symptoms include fullness, heaviness, aching, and sometimes pain in the legs.

Watch the video by Diane Sawyer on Good Morning America to learn more about this new procedure to remove varicose veins. Then call Harmony Heart Group to schedule your appointment for the procedure.

You can read more about our Varicose Veins services here.