Penn Patient Stories: How Josh is Living Healthily with Lipid Disorder

"I thought I was young and indestructible. It took a doctor from Penn Medicine to set me straight about my condition."

– Josh Smargiassi, 33 and proud father of three

Living with Lipid Disorder

When I was 17, I went in for a normal checkup and found out that I had high cholesterol. I was young and very active playing sports, so they said it was hereditary. I figured I'd just treat it with diet and exercise and I followed that regimen through college, always maintaining numbers around 300—high for someone my age, but I didn't want to treat it with drugs. I worried about side effects, plus I was young and felt indestructible.

Josh, a Penn Medicine patient, was diagnosed with
a genetic cholesterol disorder.

After college I got married. My wife, who works in the medical field, wanted me to get more aggressive with my treatment, so we saw a local cardiologist who put me on statins. They worked, but I kept feeling that at my age, I'd rather get off the drugs and switch to natural therapy.

Problem was, when I did that, my numbers shot up close to dangerously high levels of 500. My doctor said they couldn't do anything more for me and told me to go to a specialist in familial hypercholesterolemia. They recommended Penn Medicine.

Read more patient stories, explore your options with a Penn cardiovascular specialist and and get the facts:  
Go With Your Heart

Why Penn Medicine?

I'm from Philly, so I already knew Penn Medicine was the best. Also, their heart and vascular program is ranked number 1 in the region, so I went. I saw Dr. Soffer of the Penn Medicine Preventive Cardiovascular program. Dr. Soffer was very nice and compassionate, but also very strict and stern at the same time.

He told me that, with two small boys and another baby coming, I really had to take care of this or it could end my life at a young age. I still didn't believe it, because I felt fine, but Dr. Soffer didn't give up.

He said he cared about me and wanted me to take full advantage of the best treatments available. I finally decided to get on board and started treatments that included statins, niacin and several other things. Through this, my cholesterol came down to 194, but Dr. Soffer still wanted better results for me. He told me I was eligible for a clinical trial and I enrolled to get my numbers down even further.

Moving Forward with Clinical Trials

Throughout all this, the cardiologists at Penn's Preventive Cardiovascular Medicine program were the first to explain my cholesterol problem in ways I could understand, not just with numbers. They drew it all out clearly. Finally I understood how serious my condition was.

The trial I am on now is for the newest treatment. It processes cholesterol in addition to statins. I won't know the overall result for another year, but I am an eternal optimist.

As a dad and husband, I'm so thankful that Dr. Soffer didn't let up on me or let me accept anything less than the most advanced treatment for my care. It's great that I'm in an area with excellent doctors and good support and I'm doing everything I can. I'm doing the right things, under the right guidance, finally!

Penn Medicine Hosts International Electrophysiologists

Left to right: Chandrasekaran Kolandaisamy, Frank Marchlinski, Po-ching Chi, Chan Chao-Shun

International specialists and fellows in the treatment of cardiac arrhythmias visited the Hospital of the University of Pennsylvania (HUP) this week. The guests from Japan, India, Taiwan and Australia visited the hospital following the annual Heart Rhythm Society meeting in Denver, Colorado.

Related: Download a Free Guide to Atrial Fibrillation

Po-Ching Chi, MD, and Chan Chao-Shun, MD, clinical research fellows from the National Yang Ming University in Taiwan were among the many visitors. “Dr. Marchlinski's group is well-known as the best ventricular tachycardia (VT) ablation center with the highest volume of patients and the most advanced VT ablation skills,” says Po-Ching Chi. “It was an opportunity that we could not miss to be clinical observers here.”

Frank Marchlinksi, MD, director of the cardiac electrophysiology program at HUP, says, “At the heart of science and medicine is the open exchange of new ideas and techniques. It is an honor to host these international experts and fellows in the electrophysiology community and to share and learn from them.”

The electrophysiology program at the Hospital of the University of Pennsylvania is a leading center in the nation for the treatment and research of cardiac arrhythmias. Each year, hundreds of the world’s leading electrophysiologists attend events hosted by the group to learn about the latest advances in the science and treatment of cardiac arrhythmias.

Related: 8^th Annual International Symposium on Ventricular Arrhythmias

Penn Heart and Vascular Celebrates Nurses Week

It’s National Nurses Week and, at Penn Heart & Vascular, our nurses are an integral part of making our care extraordinary.

Read more from just one of our extraordinary nurses, Amy B. Marzolf, MSN, CRNP, a Heart Failure Coordinator at the Penn Heart & Vascular Center. Amy talks a bit about the importance of outpatient nursing, care provided to patients who are not physically in the hospital, as just one of the critical pieces of the care cardiovascular patients receive at Penn Medicine.

From an outpatient perspective the nursing care patients receive is critical. We triage urgent calls, recognize early symptoms, follow up on plans of care, and monitor patients often over the phone for disease progression. In reality the outpatient nurses have a dynamic group of highly skilled, highly trained providers who are unbelievably talented at caring for patients when not even being able to physically see them on a daily basis. Having a team that is not only working hard when the patients are admitted, but dedicated to quality outpatient care is the key to reducing readmissions, preventing disease progression, advancing treatments, and fostering overall improved health and a better quality of life for the patients. Working with heart failure patients we understand the complexity of living with a chronic illness. It requires daily work that does not end when the patient leaves the hospital. It only just begins. As a heart failure nurse and now nurse practitioner I am able to support my patients throughout the spectrum of their illness.

At Penn Medicine, we are exceptionally proud of the nursing team at our three hospitals, and within our network. And in fact, the nursing care is recognized not only by our own teams, but also on a national level. The Hospital of the University of Pennsylvania (HUP) has achieved Magnet status – the highest institutional honor awarded for nursing excellence – from the American Nurses Credentialing Center (ANCC). Being recognized as a Magnet hospital is one of the highest achievements an organization can obtain in the world of professional nursing.

To all of our Heart & Vascular nurses - Thank you for everything you do, for your work as educators, researchers and care givers.

Penn Patient Stories: How Patricia Overcame Heart Failure

"A seriously incorrect diagnosis at another hospital led me to Penn...and a great surgeon who returns emails."

– Patricia Brough, 68 and proud grandmother of five

About 11 years ago, I was getting totally out of breath just walking to my car after work. I figured I was 57 at the time, and I told myself I'm just getting old, you know. Then one night I woke up totally unable to breathe and I went to the emergency room at my local hospital in New Jersey.

Their diagnosis? Asthma. No problem, go home, they said.

The next day I spoke to my son and he suggested I get a second opinion since I had never had asthma before. We decided to go to Penn because my dad always used to say, 'why go to the foot soldiers in NJ when you can go over the bridge to the generals at Penn?'

So I looked on the Internet and found Dr. Acker, a heart surgeon at Penn Medicine. I emailed him that day and within an hour, he personally emailed me back and referred me to a Penn cardiologist, Dr. Mariell Jessup. I called Dr. Jessup and she got me in right away, ran all kinds of tests and diagnosed me with heart failure. Basically, I needed a mitral valve replacement almost immediately – it wasn't asthma at all.

Thankfully, within the week, I had that surgery at Penn, and all was fine for years.

Then, in 2010, I suddenly got this terrible toothache and went to the hospital. To my surprise, it was a symptom of a heart attack. Once again, I had a pacemaker and defibrillator put in at Penn. Since then, I'm feeling great. I've been horseback riding and parasailing. I do everything I used to do, and more. I've gotten to see three of my grandchildren being born. I walk two miles a day. All because over a decade ago, Dr. Acker—someone who didn't even know me—answered my email. Penn saved my life.

Read more patient stories, explore your options with a Penn cardiovascular specialist and and get the facts:  
Go With Your Heart

Treating Adult Congenital Heart Disease

Today, babies born with a heart defect have their best chance in history of surviving. But what happens when they grow up? 

Ali Gorman R.N., 6 ABC's Action News Health & Medical reporter, speaks with Dr. Yuli Kim, Director of Penn Medicine's Adult Congenital Heart Disease Center, and Amy Verstappen of the Adult Congenital Heart Association. 

In this feature story about congenital heart disease, Amy Verstappen tells 6 ABC that when she was born, doctors knew right away there was a problem.  She had a congenital heart defect and like many, she was treated and then told all is well. As an adult, she continued to be told that there was no longer a problem with her heart.  But shortly after giving birth, her heart started to fail.

A report from the Journal of the American Medical Association shows she's not alone.  The report reads: "The frequency of hospitalizations for adults with congenital heart disease has grown at a rate more than twice that of children." That's why Amy started the Adult Congenital Heart Association.

Dr. Yuli Kim of Penn Medicine is one of only about 100 doctors nationwide formally trained to treat adult congenital heart disease.

Congenital heart conditions are different in adults than in children. Likewise, patients with congenital heart disease (CHD) experience cardiac problems differently than adults with acquired heart disease. That is why Penn Medicine and The Children's Hospital of Philadelphia (CHOP) joined forces to create the Adult Congenital Heart Disease Program.The program offers a team specially trained in the complex anatomy and heart function of adults with CHD, as well as the broad array of services and education necessary to manage their long-term complications.

Watch the video interview and read more on Action News.

Learn more about congenital heart disease and the Penn/CHOP Adult Congenital Heart Disease Program.

A Runner's Heart Healed

Penn patient completes a 12k after open-heart surgery

In April 2009, Elliot Gordon was training for the Boston Marathon, what would have been his 43rd such race. But on the morning of April 5, out of the blue, the usually healthy Gordon started to feel dizzy at his home in Princeton Junction, NJ. Within moments, he passed out.

Elliot was suffering from an aortic dissection. This serious heart condition results from a small tear in the inner wall of the aorta, causing blood to flow between the layers of the wall of the aorta and force the layers apart. If the dissection tears the aorta completely open (through all three layers), immense and rapid blood loss occurs.

Emergency Heart Surgery

After being rushed to a local hospital, it was determined that he needed emergency heart surgery. He was transferred to the Hospital of the University of Pennsylvania (HUP).

At HUP, Joseph Bavaria, MD, vice chief, Division of Cardiovascular Surgery and director, Thoracic Aortic Surgery Program, performed an open-heart procedure to have Gordon’s torn aorta removed and replaced with a synthetic graft.

"He needed an urgent intervention and the surgery itself is high risk," says Dr. Bavaria. "Half of patients suffering from an aortic dissection die before they even reach the hospital."

Thankfully for Gordon, Dr. Bavaria and the HUP OR team have extensive experience in complex aortic surgeries, with outcomes ranking among the best in the nation. After being rushed from the emergency transport, he was taken directly to the OR, where Dr. Bavaria and his team were able to accurately assess the situation and begin the operation.

His heart was in good hands

Despite the grim odds, after several hours in surgery, he was transferred to the Heart & Vascular Intensive Care Unit to recover.

“The surgeons said I survived because my body was in such good shape. Had I not been training for Boston, I would have died.”

Gordon was not out of the woods yet. His recovery was difficult; he was on dialysis for about six months. Fortunately for Gordon, he was being cared for by a highly skilled, multidisciplinary team lead by cardiovascular surgery anesthesia intensivists, and received around-the-clock comprehensive care.

After a month and a half in the hospital, he was released in May 2009. He was 25 pounds lighter and because he was already so lean from decades of running, there wasn’t much fat to lose in the first place. The loss was all muscle -- he couldn’t get out of bed, couldn’t stand, couldn’t walk.

Heart Healthy and Running Again

He was given the okay to try light running again after six months, but it took over a year before he was finally able to jog slowly. In his first attempts back on a treadmill, he had many difficulties. But he was determined to get back to the sport he so loved and had dedicated decades of his life to.

On November 20, 2010 he ran his first “return” 8k since the operation. A year later, on November 12, 2011, he ran a 12k race. And in November 2012, Elliot signed up for the Philadelphia Marathon to run the half marathon. “Not very many people could, or would even attempt, to run a half marathon after this type of procedure,” says Dr. Bavaria. “His surgery went so well that it enabled him to keep going with his running. He really is a miracle man.”

February is Heart Month: Reduce your Risk for Heart Disease

Every 34 seconds, someone in the United States has a heart attack, and each minute someone dies from a heart-disease related event.

To combat cardiovascular disease and educate the public about how to decrease their risk, Congress and the American Heart Association have proclaimed February to be American Heart Month.

There are many risk factors for heart disease, but the following are holding steady or even increasing.

Heart Disease Risk Factors:

Obesity

The percentage of overweight individuals, both adults and children, has been rising for several decades:

• 33.3 percent of adults are overweight
• 35.7 percent of adults are obese
• 17 percent of children and adolescents ages 2 to 19 are obese
• 12.1 percent of children ages 2 through 5 are overweight

Smoking

Raises the risk of coronary heart disease, and it remains highly prevalent:

• Smokers are 2-4 times more likely to develop heart disease
• More than 46 million U.S. adults are daily smokers
• About 4,000 people ages 12 to 17 begin smoking every day

Diabetes

It is projected that the prevalence of diabetes will continue to rise:

• 1.9 million new cases of diabetes were diagnosed in people 20 years or older in 2010
• 79 million people have prediabetes, which greatly increases the risk of diabetes

If you are concerned about your heart health, Penn Medicine has advanced, personalized cardiovascular risk assessments, which include:

• Atherosclerosis imaging
• Genetic testing
• Advanced lipid testing
• 24-hour blood pressure monitoring

Learn about Penn Medicine's
personalized cardiovascular risk assessments