Double the Expertise in Cardiac Care

When Marc Friedant went for a physical, he didn’t pass. Friedant had been required to undergo the exam as part of a business deal. The 61-year-old Hermosa Beach executive’s financial partner wanted him to have “key man” insurance, a specialized life insurance policy, before they closed a deal to buy a chain of retail stores.

So Friedant’s next step was a visit to his primary care physician, Sunil Adwani, MD. Dr. Adwani told Friedant he was concerned about his dangerously high blood pressure (231/106) and referred him to Nazanin Azadi, MD, an interventional cardiologist at Providence Little Company of Mary, to figure out the underlying cause. Friedant, who regularly walked between five and 15 miles a day, considered himself in good shape and was unaware of his severe hypertension.

Dr. Azadi quickly ordered an echocardiogram, which she found “quite abnormal. The lateral wall of his heart wasn’t squeezing well.” Based on those findings, Dr. Azadi asked Friedant to undergo a nuclear cardiac stress test and then an angiogram. “We discovered he had severe disease in all of his heart’s arteries,” she says. “I think it would only have been a few months before Marc had a catastrophic event. It was a ticking time bomb.”

FAMILY HISTORY

Although Friedant had no idea he had blocked arteries, he wasn’t a stranger to heart disease: His father had undergone sextuple bypass surgery at age 62. “I remember it like it was yesterday,” says Friedant. “I was pretty freaked out seeing him that gray color, with all those machines and wires.” In fact, Friedant’s anxiety about the memory kept him away from doctors as an adult, which is why his condition wasn’t picked up sooner.

After his tests with Dr. Azadi, Friedant recalls, the doctor came in to talk to him. “She has the greatest bedside manner— she’s just a genuinely caring person. I could tell she didn’t want to be telling me what she was going to tell me.”

Dr. Azadi explained that she was referring Friedant to Matthew Powers, MD, a cardiothoracic surgeon with Keck Medicine of USC and an assistant professor of clinical surgery at the Keck School of Medicine of USC. Dr. Powers’s advanced fellowship training was focused on the treatment of complex diseases of the thoracic aorta, so his expertise was needed in Friedant’s case.

Fortunately for Friedant, Providence Little Company of Mary had partnered with Keck Medicine of USC three years earlier to provide expert cardiovascular surgical care. The partnership meant Friedant could get academic-level expertise from Keck USC’s Dr. Powers while recuperating close to home in the South Bay.

Dr. Powers concurred with Dr. Azadi’s prediction that Friedant was close to a crisis, since the weakened heart muscle that had shown up on the echocardiogram was evidence of a heart attack six to 18 months before. “With the amount of disease present, Marc may have had a few more days or a few more weeks. A coronary bypass offered the best long-term option,” says Dr. Powers.

NOT YOUR ‘80S SURGERY

Although it meant open heart surgery for Friedant, Dr. Azadi and Dr. Powers felt that multiple bypasses, where the patient’s own arteries and veins are used to replace the blocked arteries, would be a more effective fix than placing a collection of stents. Although Friedant was worried about what he had witnessed with his father’s surgery, Dr. Powers explains, “the quality of this type of surgery has increased quite dramatically since his father had it done in the ’80s.”

For one thing, surgeons now are more likely to use arteries from the chest for the bypass, as Dr. Powers did, rather than harvesting them from the patient’s legs, as they did 40 years ago. The modern approach means less pain and faster healing. Friedant says he did in fact recover very quickly, partly because he went into the surgery in good shape. “Two to three days after my hospital stay, I started my walking routine again,” he says. “In three or four weeks I was back to 10,000 steps.”

And most important, Friedant says he notices a difference in his cardiovascular performance. “I feel better. There are a few hills in this area, and I’m not winded anymore when I get to the top.” Dr. Powers was able to see the change occur even before Friedant did, while they were still in the operating suite. “Marc’s heart loved the new blood flow,” he recalls. “We saw results immediately. The heart got much stronger.”

Both Dr. Powers and Dr. Azadi commend primary care physician Dr. Adwani for pushing Friedant to pursue the root cause of his hypertension. “Not every patient has classic heart disease symptoms,” says Dr. Powers. “Primary care doctors are really the patient’s safety net.”

For more information on Providence Little Company of Mary hospitals, call 844-925-0942.