Jeffrey Metz has always enjoyed bicycling and taking long walks near his home in downtown Milwaukee. But about two years ago, he began to feel off.

“I started to have these sensations — nothing intense, but a little shortness of breath and a little tightness in my chest,” said Jeffrey, now 64. Even when not exercising, he had an overall sense of physical and mental fatigue.

Jeffrey’s primary care physician referred him to the Froedtert & MCW cardiology team. Based on his symptoms and a family history of heart disease, he was sent for a stress test. He had the test in May, and it indicated a likely blockage in his right coronary artery.

In June, Jeffrey had a catheterization procedure with Jorge Saucedo, MD, MBA, interventional cardiologist and MCW faculty member. The results were more than Jeffrey expected. His artery was not just partially blocked, but totally blocked — what specialists call a chronic total occlusion, or CTO.

Higher Level of Care

Jeffrey was quickly referred a Froedtert & MCW interventional cardiology team who specializes in caring for heart patients who are at higher risk due to the complexity of their disease, the complexity of the treatment or the presence of other health problems.

While CTOs are fairly common, patients with CTOs and other complex heart problems are often not offered treatment precisely because they are high risk and/or complex.

Froedtert & MCW providers in the Complete Revascularization in High Risk Indicated Patients (CHIP) Program want to change that. They see patients with complex coronary artery disease in this multispecialty clinic. This approach allows for team-based treatment recommendations that can improve both heart function and quality of life for patients with complex disease.

When Jeffrey met with the team, they carefully explained several treatment options. One option was to perform an advanced, minimally invasive procedure using multiple catheters to open the blockage and reestablish blood flow to Jeffrey’s heart.

“The choice for me was pretty clear,” Jeffrey said. “I elected to move ahead with the minimally invasive option.”

The procedure took place in August at Froedtert Hospital, part of the Froedtert & MCW health network. For Jeffrey, the results were immediate.

Jeffrey experienced a rapid return of not only his physical energy, but also his mental acuity. “I didn’t realize how compromised I was until after I had the procedure,” he said. “Within three days, it was like getting my battery recharged.”

Know the Signs, Know the Options

Jeffrey’s case shows that chest pain is not the only symptom to watch for.

Coronary artery disease symptoms can include chest pressure or tightness, shortness of breath or just lightheadedness. Additionally, the symptoms may be very different in women with coronary artery disease, who may experience nausea or fatigue.”

Not every total blockage requires procedural care. In most cases, a patient with a CTO can do very well on medication alone.

However, if you have a CTO or another challenging cardiac disease, it’s recommended you talk to someone who performs these advanced procedures regularly.

The CHIP team at Froedtert Hospital is a resource for both patients and their cardiologists.

Listen to Your Body

Following his recovery, Jeffrey began 12 weeks of intensive cardiac rehabilitation at Froedtert Hospital. This comprehensive approach to cardiac rehabilitation is not widely available and includes both monitored exercise and education sessions on topics such as eating well and reducing stress.

“The facility is very nice, and the people there do a great job,” he said. “I do rehabilitation three times a week, and on my days off, I am back to my walking and bike riding.”

Jeffrey is also back to enjoying life with Debra, his wife of 38 years. The couple has two adult children, and they recently welcomed their first grandchild.

For people concerned about their heart health, Jeffrey’s advice is to be aware of the signals your body is sending you.

“You don’t have to be in terrible physical condition to have a heart problem,” he said. “In my case, it wasn’t like I was dropping over. I just didn’t feel good. You really have to listen to what your body is telling you, and then be proactive in getting yourself checked out.”

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