Man Takes Steps to Manage Heart Condition
When it comes to heart disease, sometimes there are no second chances. Fred Van Serke of Hubertus lost his two brothers to HCM, a heart rhythm disorder often shared in families. Fred had a device implanted in his chest to help save his life, and he shares his story to urge others to do all they can to minimize their risk.
Growing up on a farm, the Van Serke brothers – Fred Jr., Taylor and Logan – shared a love of the outdoors. They also shared a heart condition called hypertrophic cardiomyopathy, or HCM. Fred, now 28 and living in Hubertus, was diagnosed while he was in high school after having a typical sports physical. HCM causes the heart muscle to thicken and restrict blood flow. The brothers had very minimal symptoms, and were told they had only mild disease.
HCM can take decades to progress, and many people never experience problems. But it can also progress quickly. One day in August 2011, Taylor died suddenly at age 25. HCM was ultimately determined as the cause of death.
HCM is caused by a gene mutation and is most often inherited. It affects 1 in 500 people of all ages, with symptoms appearing in both children and adults. HCM occurs when the muscle mass of the lower left chamber of the heart is thicker than normal, or the wall between the two lower chambers of the heart, becomes enlarged, and it obstructs the blood flow. A heart murmur may be heard. HCM can cause heart valve problems, chest pain, dizziness and shortness of breath.
Even though Fred did not have symptoms, he sought help from the Froedtert & the Medical College of Wisconsin Cardiology Clinic at North Hills Health Center in Menomonee Falls. There, he saw cardiologist Alexei Agapitov, MD.
“Fred did not have any symptoms, but features in his echocardiogram and his family history put him at risk for sudden death,” Dr. Agapitov said. He recommended Fred see an electrophysiologist at the hospital.
“With HCM, the heart has more muscle tissue than normal, and it is disorganized,” explained Jason Rubenstein, MD, Medical College of Wisconsin cardiologist who practices at the Froedtert & the Medical College of Wisconsin Electrophysiology Clinic at Community Memorial Hospital. “This disorganized muscle tissue can cause very fast heartbeats or erratic beating known as ventricular fibrillation. Ventricular fibrillation can lead to cardiac arrest.”
There is no cure for hypertrophic cardiomyopathy. Instead, treatment concentrates on minimizing symptoms and reducing the risk of sudden cardiac death. According to Dr. Rubenstein, less severe HCM can be managed with lifestyle changes. Surgery can also be an option for some patients. For higher-risk patients, the only protection is an implantable cardioverter defibrillator or ICD.
An ICD is a computerized battery-operated device that is surgically implanted under the skin of a patient’s chest. Wires from the implant are attached to the heart. If the ICD detects a chaotic heartbeat or fast rhythm, it delivers an electric charge to defibrillate the heart, essentially stopping the heart and letting the normal rhythm return.
Together, Fred and Dr. Rubenstein decided an ICD would be the best solution for Fred. Two weeks after Fred’s surgery to implant the ICD, tragedy struck again. Fred’s other brother, Logan, died in his sleep. He was 23 years old.
Amid the family’s grief, new questions emerged as to who else in the family was at risk. Hoping to find answers, Fred was referred for cardiac genetic counseling at Froedtert & the Medical College of Wisconsin.
“There are many genes that can cause HCM,” said Jenny Geurts, MS, certified genetic counselor. “If you can identify the gene that is responsible, you can identify other family members who might be at risk.”
According to Geurts, genetic evaluation can be important for families with a history of unexplained deaths. In Fred’s case, he and his family pursued testing to help determine which side of the family is at risk, so they can be screened appropriately.
Fred encourages other people who may have an inherited heart disorder to get the care they need.
“When it comes to heart disease, sometimes there are no second chances,” he said. “Don’t put things off. See a doctor, take their advice and go with it.”
The Froedtert & the Medical College of Wisconsin Cardiology Clinic at North Hills Health Center offers a full range of diagnostic and therapeutic options for patients with cardiovascular disease. The Froedtert & the Medical College of Wisconsin Electrophysiology Clinic at Community Memorial Hospital offers an array of treatment options for patients with heart rhythm disorders.