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Thursday, January 14, 2021

Seamless Production

Posted By: Advancing Care
Irene Nunnari taught literature and theater for nearly 50 years.

Rapid diagnosis, decision-making and coordination of care helped a retired professor get back home for the holidays.

As seen in the February 2021 Issue of Advancing Care.
By Melissa F. Pheterson / Photos by John Halpern

“Irene, you are having a heart attack right now.”

The news was terrifying to hear, recalls Irene Nunnari, but it was delivered in the best possible place: the emergency room at a local hospital where the New Windsor resident had gone for mild chest pain, weakness and shortness of breath. When her bloodwork revealed abnormal levels of heart enzymes, she prepared for an overnight stay, by herself, as COVID-19 visitation restrictions didn’t allow her husband to be at her side.

A Shocking Diagnosis

Ahmad A. Hadid, MD, a doctor of Internal Medicine and Cardiology at Westchester Medical Center was working at that local hospital that day and performed a cardiac catheterization procedure to assess Nunnari’s heart damage and measure the blood flow in her coronary arteries. The results were alarming: In three of Nunnari’s arteries, plaque had built up to the point that they had become dangerously narrowed. The blockages were extensive enough to require life-saving triple-bypass surgery — using other blood vessels in the body to reroute blood flow to the heart around each blockage.

“While we have many locations across our Network in the Hudson Valley, our team operates as one no matter where you go for care. In Irene’s case, the diagnosis, decision and rapid coordination resulted in remarkable continuity of care across our health network. We were able to give her a warm, reassuring greeting with a seamless transfer.” — Ahmad A. Hadid, M.D.

“The good news is that your heart is strong,” Dr. Hadid recalls telling Nunnari. “The bad news is, you have a severe blockage and need bypass surgery.”

“Considering I had no pain and my heart attack wasn’t violent, I was surprised that I needed bypass surgery,” says Nunnari, a retired professor who taught literature and theater at Mount Saint Mary College in Newburgh for 48 years. “However, I am turning 80, and I have a family history of heart disease.”

According to Dr. Hadid, Nunnari had many of the risk factors of coronary artery disease: age, hypertension (high blood pressure), hyperlipidemia (high cholesterol) and a family history of both heart disease and stroke. “We had to quickly organize her care, so she could get the best benefit with the minimum risk.

Nunnari enjoys reading with her granddaughter.

Rapid Coordination and Response

Nunnari needed to be transferred to Westchester Medical Center as soon as possible.

In that time, Dr. Hadid accomplished what Nunnari calls “a small miracle”: making several important phone calls — to her husband and the Cardiac Care team at Westchester Medical Center — and reached every person right away, helping to quickly facilitate her transfer.

“The teamwork at WMCHealth is seamless and committed to excellence. This was an encouraging experience, where I knew everyone was committed to my wellness. They showed compassion, humor, warmth and care as they worked together. We are fortunate to have world-class medical care close to home.”
— Irene Nunnari

“Making those calls was reassuring for her,” says Dr. Hadid, whose office with WMCHealth Physicians is located in New Windsor. “Due to COVID-19, isolation and separation anxiety can be heightened. Connecting with the team at Westchester Medical Center, and presenting her case as she listened, helped put her at ease during a stressful time.”

Compassion, Warmth and Care

Nunnari underwent successful open-heart surgery. From recovery to rehab, she says, the doctors, nurses and therapists provided support and “kept me looking up, not down.” They give coping strategies with such compassion, warmth and care that I felt like I was coming to life again.”

Nunnari chose MidHudson Regional Hospital, a member of WMCHealth, for continued rehab. Thanks to an ambitious therapy schedule, she returned home to celebrate the holidays with her husband. In another twist of fate, the nurses who cared for her at Westchester Medical Center and MidHudson Regional Hospital were graduates of the nursing program at Mount Saint Mary College. Past nursing students had starring roles in the plays she’d produced as a professor there. “I felt as if my career had come full circle,” she says.

Bypass surgery, an open-heart procedure, involves taking healthy blood vessels from elsewhere in the body, then carefully inserting them above and below the blockages in arteries to create new pathways for blood. For Nunnari, the surgeons created a “LIMA to LAD” bypass: carefully removing the left internal mammary artery that runs from the left collarbone to the chest wall, then attaching it to the left anterior descending coronary artery, which is critical in supplying blood to the heart. The goal of bypass surgery is revascularization, the complete restoration of blood supply to the heart muscle, without further blockage or narrowing.

For more information about the WMCHealth Heart and Vascular Institute please visit WMCHealthAPS/heart or call 1.866.962.4327 for an appointment. In an emergency, call 911 or visit the nearest emergency department.