Bridget Thompson

Heart disease can be elusive

Bridget Thompson is 42 years old. She's in great physical condition, at a healthy weight and does aerobic exercises for 45 minutes, five days per week. Bridget eats a healthy diet and doesn't smoke. She enjoys gardening and landscaping at her home in Antioch, Ill., about 45 minutes north of Chicago. Bridget also does quite well keeping up with her active 12-year-old daughter and 7-year-old son and serves as the school board president at her children's school.

About half of Bridget's thirteen siblings have high cholesterol. Her grandfather died of a heart attack at age 48. As a nurse, Bridget has strong knowledge of health care — and she's notoriously proactive. At a routine physician visit, Bridget requested a blood test to determine if she had high cholesterol and should be taking medication, like many of her brothers and sisters.

Bridget did have an elevated overall blood-cholesterol reading and her doctor recommended some further testing before prescribing medication.

Several days later, when Bridget met with her doctor, she planned to leave with a prescription. Instead, she walked away with a diagnosis of an elusive heart disease and a questionable future. After several more tests and specialist visits in the Chicago area, Bridget was told that there wasn't much that should be done for her "constrictive heart disease."

Once again, Bridget's proactive nature kicked in.

Taking Wing to Mayo Clinic in Rochester

Bridget's husband Saul is a pilot, with his own charter plane business. So, trips from Chicago to Rochester were easy to plan and make. After days of tests and specialist visits, Bridget's diagnosis of constrictive heart disease was confirmed.

"It's called constrictive heart disease because the sac and lining around the heart become inflexible, preventing the heart from filling normally," says Bridget. "Untreated, this condition eventually leads to congestive heart failure."

"It was very unusual to see such severe calcification in someone with no symptoms," says Hartzell V. Schaff, M.D., a cardiovascular surgeon at Mayo Clinic in Rochester. "When I first saw Bridget, I was suspicious that the diagnosis was not accurate."

During a heart catheterization, physicians could see subtle evidence that Bridget's heart was being affected by the calcified pericardium. This presented the dilemma of what to do. Wait until she was outwardly affected or perform complex heart surgery on an asymptomatic patient?

"It's rare to catch this disorder so early," notes Dr. Schaff, "and so we were at a cross-roads."

"For several weeks, it was back and forth between Chicago and Rochester," recalls Bridget. "We decided to leave the kids at home with relatives, to attend school and stay in their routine. But we brought them to Rochester once so they could see where I was being treated." After visiting several areas within the clinic, her daughter, Molly proclaimed "Mom this is the perfect place for you because it's so clean and organized."

Taking Care of Business

Bridget didn't want to wait until she had symptoms and limitations before taking action. "Being proactive was the motivation for seeing my physician in the first place," she recalls, "and waiting until there was possible damage seemed like health roulette to me."

"Years ago, we might not have decided on surgery for Bridget," says Dr. Schaff. "But through our large patient population and research, our treatment philosophy and approach have changed in the past few years."

First, a person in good health with a strong heart can tolerate and recover from surgery much better than a patient whose health is affected by disease. Secondly, waiting until Bridget had limitations could affect her quality of life and other areas of health. "Patients tolerate any kind of surgery, especially heart surgery, when they are strong and functioning at full capacity," says Dr. Schaff.

"Bridget had a pericardiectomy — surgical removal of the pericardium or sac around the heart. We also removed the epicardium — the lining on the surface of the heart. Both were fibrous and calcified, restricting heart function," says Dr. Schaff.

During the operation, specialists use a transesophegeal echocardiagram to guide them. This procedure led to the discovery of an atrial septal defect (ASD) between the upper chambers of Bridget's heart. "This is a condition she was born with, and we also were able to repair it during surgery," notes Dr. Schaff.

"Bridget is cured of her heart disease and she'll have no limitations. There are no adverse implications from living without the pericardium or epicardium. Further, her heart will function better with the ASD repaired. She will however, still need to control her cholesterol to protect against future disease," says Dr. Schaff.

"Mayo Clinic is the model of health care," says Bridget. "It shouldn't be done any other way and that's pretty phenomenal coming from someone who has worked in a health profession. My brother John came to visit me while I was hospitalized. He was so impressed that he's coming back for a physical."

"I'm grateful to have this behind me, with a successful outcome," says Bridget. "Now I can face the future with optimism and confidence."