A Heartfelt Birthday Gift
24/7 Cardiogenic Shock Program provides lifesaving treatment
March 18, 2025
4 minute read
24/7 Cardiogenic Shock Program provides lifesaving treatment
In December 2023, David Wagner, of Mount Pleasant, felt out of sorts — just vaguely unwell and unable to eat or sleep normally. Certain it was the flu, he went to a walk-in clinic and learned he had atrial fibrillation (AFib), a type of abnormal heart rhythm. He wondered if it might be related to his aortic valve, which he had replaced a decade earlier. The walk-in clinic referred him to a hospital in Racine, where they adjusted his heart medication.
Over the next few weeks, David returned to the hospital’s emergency department and was admitted for a few days as his erratic heart rhythm continued.
“When he was hooked up to the monitors, you could see his heart go from 150 to the 30s,” said David’s wife, Katy. “He seemed to shut down and would pass out.”
In January 2024 — on the eve of David’s 52nd birthday — doctors determined his replacement valve was failing. But by then, David was in a health crisis. At the hospital, he collapsed, saying it was difficult to breathe.
David was in cardiogenic shock — a rare and often deadly condition in which the heart can no longer pump the blood the body needs, and other organs begin to fail. Cardiogenic shock can be brought on by a heart attack or another heart issue, such as a deteriorating valve like David’s.
David’s doctors in Racine called the Froedtert & the Medical College of Wisconsin Cardiogenic Shock Program at Froedtert Hospital, a 24/7 resource for doctors across the region working with patients with acute heart issues. Each year, the Froedtert & MCW cardiovascular team is called to treat or consult on hundreds of cardiogenic shock cases.
“When we get the call, the patient is already in serious condition,” said H. Adam Ubert, MD, cardiothoracic surgeon and MCW faculty member. “These patients are incredibly sick and require vast resources. Many smaller hospitals aren’t equipped for that. We’re sort of like the firefighters — we put out the fires because we have around-the-clock intensive care and interventional cardiology.”
David arrived at Froedtert Hospital in the wee hours of his birthday. The care team treated him with vasopressors, which narrow the blood vessels to improve blood pressure, as well as inotropes to help the heart pump more blood and keep blood and oxygen flowing to his organs.
Dr. Ubert said they typically use extracorporeal membrane oxygenation, or ECMO, commonly known as a heart-lung machine, or a heart pump to treat people in cardiogenic shock.
“Unfortunately, David wasn’t a candidate for those because of his heart valve condition,” Dr. Ubert said. “In the middle of the night, we quickly got an echocardiogram to confirm what we suspected and then did a CT scan so we could proceed with treatment.”
In addition to Dr. Ubert, David’s care team included Saif Anwaruddin, MD, interventional cardiologist, MCW faculty member and medical director of the Structural and Valvular Heart Disease Program; and Mina Iskander, MD, interventional cardiologist and MCW faculty member. They did not think David could tolerate open-heart surgery in his condition. Instead, they opted for a transcatheter aortic valve replacement (TAVR). That allowed them to place a new tissue valve via an artery in David’s leg in a less invasive procedure.
A TAVR procedure is typically not performed in emergency situations, and not every hospital would be prepared to do such a procedure late at night, but the Froedtert & MCW cardiovascular team is always ready. While the new tissue valve is a bridge to further treatment, it quickly reversed David’s heart emergency.
“After the intervention to fix the valve, David turned around almost instantly,” Dr. Anwaruddin said. “If he presented too late or had we not intervened at the appropriate time in the middle of the night, he may have had a different outcome.”
Dr. Ubert praised the critical care anesthesia team that played an integral role in David’s successful outcome. David’s family is also grateful for his care team’s expertise.
“The Froedtert & MCW health network is top notch, and the doctors and nurses are amazing,” David said. “Everyone really knows what they’re doing.”
David and his doctors advise prompt treatment and seeking a second opinion for people feeling a little off.
“Don’t ignore shortness of breath that’s new or doesn’t make sense or new shoulder pain or neck pain,” Dr. Ubert said. “We’d rather see you a little early than a little late.”
Froedtert & MCW cardiovascular experts use a full spectrum of resources to provide innovative, advanced care. For an appointment or second opinion, call 414-777-7700. Learn more at froedtert.com/heart-care.
