Selected Podcast
Cardiology Services Including a 24 hour Cardiac Cath Lab
Dr. Boulware talks about the cardiology services including a 24-hour cardiac cath lab at Gerald Champion Regional Medical Center. Dr. Boulware explains the purpose of the 24-hour cath lab, the services that it provides, and how it helps the patients of the Alamogordo area.
Featured Speaker:
Terry Boulware, MD, FACC, FSCAI
Terry Boulware, MD, FACC, FSCAI, Medical Director of GCRMC Cath Lab, received his MD at the University of Missouri, Kansas City, MO, and completed his residency at John Hopkins Hospital, Baltimore, MD. He is board certified by the American Board of Internal Medicine in Cardiovascular Disease. Dr. Boulware’s Southwest Heart, P.C. in Las Cruces has partnered with GCRMC Alamogordo. Transcription:
Cardiology Services Including a 24 hour Cardiac Cath Lab
Prakash Chandran (Host): Gerald Champion Regional Medical Center Cardiology Services extend life-saving treatments to patients daily. The Cath Lab extends 24-hour cardiac services to Alamo Gordo. And in fact recently saw it's thousanth patient since opening in 2015. It was a man named Robert Vasquez who actually helped build the center and was able to quickly recover from his heart attack in the very same building he helped build. Here to talk to us more about GCRMC Cardiac Services and the Cath Lab is Dr. Terry Boulware. He's the Medical Director of Gerald Champion Regional Medical Center Cardiology and Cath Lab. Welcome to the Champions For Wellness podcast brought to you by Gerald Champion Regional Medical Center.
We believe knowledge is the key that opens the door to a healthy life. I'm your host Prakash Chandran. So Dr. Boulware, thank you so much for joining us today. I really appreciate your time. I'd love to get started by you telling us a little bit more about what daily life looks like at the cath lab. And tell us about some of your primary services.
Terry Boulware, MD, FACC, FSCAI (Guest): So daily life at the cardiac cath lab, can start as early as in the middle of the night, when there's an acute myocardial infarction or a patient flown in from somewhere around the region, who's suffering an acute myocardial infarction, which is closure and thrombosus of an artery, in which case the cath lab is activated, the team comes in and within 30 minutes, we're trying to open and unocclude an artery and prevent damage to the heart muscle.
That is not an uncommon occurrence here. Following completion of that, we then would start in the cath lab around 6:00 AM and we'll typically do anywhere from about five to eight cases. And following completion of the cardiac catheterization procedures, we generally run a very busy cardiology clinic and see patients actively in consultation and follow up in the clinic.
Host: And Dr. Boulware, this may seem like a more basic question, but, you know, just for my own edification, what exactly is the purpose of a 24-hour cardiac cath lab?
Dr. Boulware: Well, unfortunately, heart disease doesn't rear its ugly head between the hours of say nine and five. So, having the availability of an entire team and the cardiologists to perform cardiac catheterization and coronary intervention is something that is needed around the clock. Many heart attacks occur in the middle of the morning hours any time from 12 midnight to 4:00 AM when we see, unfortunately the majority of them. They can also occur at 12 noon or late in the afternoon. So, there's always a team available and a cardiologist available to deal with these emergencies. Many of these patients are very unstable and they require immediate treatment and intervention, many times in order to save their life.
Host: Yeah. You know, I think it's extraordinary that you provide 24-hour cardiology services at the cath lab. You mentioned a couple already, but could you talk about ones that you just wish more patients knew about, ones that you want the general audience that's listening to this to be aware of?
Dr. Boulware: Sure. So, services at the cardiac catheterization laboratory consist of diagnostic cardiac catheterization performing the equivalence of a radiologic procedure to look and define the coronary anatomy and whether there are any blockages in major coronary arteries. We also can do coronary intervention where we put in stents into blocked arteries.
You also have the ability to actually define the severity of any narrowing by using intravascular ultrasound inside of the coronary arteries or measuring flow with a flow catheter. In addition to cardiology and coronary work, we also have the ability to diagnose valve problems. Many patients today who are older, have aortic stenosis or an obstruction of the main aortic valve.
And we're able to diagnose those and prepare them to go on to what's called transcutaneous aortic valve replacement, which is another catheterization procedure. We do not perform that here, but we send those cases to many major medical centers so they can have their aortic valves fixed. We also study heart failure patients and figure out the hemodynamics of their heart failure.
In addition, the cath lab performs a large number of permanent pacemakers and cardiac defibrillators and what are called bi-ventricular AICDs or defibrillators for the treatment and prevention of sudden death and heart failure. In addition to those procedures, the cath lab also performs a significant number of peripheral arterial and venous procedures.
Our colleagues in interventional radiology do many of the venous and the other diagnostic procedures that may even move over into the realm of oncology and cancer treatment, utilizing interventional procedures to treat some of these different diseases that the oncologists may encounter. So it provides a broad spectrum of different services with the major emphasis being in cardiac work, but also a growing and large number of interventional radiology procedures.
Host: Yeah, that sounds incredible. So I wanted to ask what type of patient is best served going to the cath lab? You know, I imagine that when someone is having a cardiac event or shortly after then they should come in, but maybe you can talk a little bit about the right type of patient that can get the most out of the cath lab.
Dr. Boulware: Well, optimally, you would try to make a diagnosis of a coronary issue before it becomes an acute event, or can significantly affect morbidity and mortality. And so stress testing in the office, nuclear stress testing, stress echo, things that can define whether or not there may be a problem. Many of the patients have presented to the office, complaining of either chest pain or shortness of breath and doing a proper workup on those patients may then delineate that they have a problem. And then from there, undergo elective, cardiac catheterization before they're having an acute event. And those are the optimal patients where they have not incurred in the injury, had an acute event, and they're simply undergoing a diagnostic procedure to see if there is blockage involving any major artery and if so, then they're treated appropriately at that time.
Host: So I know that Gerald Champion Regional Medical Center has been offering cardiology services for a while, but the cath lab, is it relatively new to be open 24 hours?
Dr. Boulware: Well, the cardiac cath lab has been an existence, I believe for about six or seven years now. And from the get-go after, I would say the first six months or so, we moved to a availability of the catheterization laboratory, the entire team to be available 24-7. And that was again, primarily designed to deal with and treat patients who are having acute heart attacks, unstable angina, unstable symptoms. Prior to the cardiac catheterization laboratory here, this institution was sending out about 800 helicopter flights to different hospitals in the region that had cardiac programs. And the problem with that was that one, there was taking a considerable amount of time to get those patients to another center. Sometimes those centers would not have bed availability or a catheterization facility available.
And the problem was the mortality or the death rates were significant. The delays were creating problems in terms of getting optimal outcomes and care and the cost to patients and their families could run around $40,000 for a LifeFlight to that might only travel 70 miles to another major medical center.
Host: Yeah. Yeah. I mean, that sounds absolutely incredible. And I can't believe you were sending out those 800 helicopter flights. I know that this is a huge boon and improvement for the community. I'm curious locally, are there other options for this type of heart care in Alamo Gordo?
Dr. Boulware: There are not, this is the only regional hospital in the area it serves a very large county and surrounding counties which also don't have sort of high-end specialty hospitals.
Host: So just before we close here Dr. Boulware, is there anything else that you'd like to share with our audience just regarding cardiology services, including the 24-hour cardiac cath lab?
Dr. Boulware: Just that we've recently had the the pleasure of adding Dr. Greg Peloson. He is former chief of cardiology at Mercy Health in Grand Rapids, Michigan. He comes to us with some amazing training from some of the best in the nation and acute infarct intervention and cardiology training.
We also have the addition of four different nurse practitioners who are all masters or doctorate of nurse practice. And all they do is concentrate on cardiology. And then we have another colleague Dr. Massoud, who's been here for a number of years in the community, who's a noninvasive cardiologist. So we have full line of services and capabilities to see a significant number of patients and meet the needs of the surrounding community at home.
Host: Well, Dr. Boulware, it's been really awesome to learn about the multidisciplinary experienced team that you have and the resources that are available 24-hours a day to the community. So thank you so much for your time.
Dr. Boulware: Thank you so much. And thank you for providing the service for us.
Host: That was Dr. Terry Boulware, Medical Director of Gerald Champion Regional Medical Center Cardiology and Cath Lab. Thank you for listening to Champions For Wellness, local caregivers, educating our community. If you've missed one of our podcasts, you can go to gcrmc.org/podcast. For more information or to make a convenient appointment, you can call 575-446-5600.
My name is Prakash Chandran and thank you so much for listening and we'll talk again soon.
Cardiology Services Including a 24 hour Cardiac Cath Lab
Prakash Chandran (Host): Gerald Champion Regional Medical Center Cardiology Services extend life-saving treatments to patients daily. The Cath Lab extends 24-hour cardiac services to Alamo Gordo. And in fact recently saw it's thousanth patient since opening in 2015. It was a man named Robert Vasquez who actually helped build the center and was able to quickly recover from his heart attack in the very same building he helped build. Here to talk to us more about GCRMC Cardiac Services and the Cath Lab is Dr. Terry Boulware. He's the Medical Director of Gerald Champion Regional Medical Center Cardiology and Cath Lab. Welcome to the Champions For Wellness podcast brought to you by Gerald Champion Regional Medical Center.
We believe knowledge is the key that opens the door to a healthy life. I'm your host Prakash Chandran. So Dr. Boulware, thank you so much for joining us today. I really appreciate your time. I'd love to get started by you telling us a little bit more about what daily life looks like at the cath lab. And tell us about some of your primary services.
Terry Boulware, MD, FACC, FSCAI (Guest): So daily life at the cardiac cath lab, can start as early as in the middle of the night, when there's an acute myocardial infarction or a patient flown in from somewhere around the region, who's suffering an acute myocardial infarction, which is closure and thrombosus of an artery, in which case the cath lab is activated, the team comes in and within 30 minutes, we're trying to open and unocclude an artery and prevent damage to the heart muscle.
That is not an uncommon occurrence here. Following completion of that, we then would start in the cath lab around 6:00 AM and we'll typically do anywhere from about five to eight cases. And following completion of the cardiac catheterization procedures, we generally run a very busy cardiology clinic and see patients actively in consultation and follow up in the clinic.
Host: And Dr. Boulware, this may seem like a more basic question, but, you know, just for my own edification, what exactly is the purpose of a 24-hour cardiac cath lab?
Dr. Boulware: Well, unfortunately, heart disease doesn't rear its ugly head between the hours of say nine and five. So, having the availability of an entire team and the cardiologists to perform cardiac catheterization and coronary intervention is something that is needed around the clock. Many heart attacks occur in the middle of the morning hours any time from 12 midnight to 4:00 AM when we see, unfortunately the majority of them. They can also occur at 12 noon or late in the afternoon. So, there's always a team available and a cardiologist available to deal with these emergencies. Many of these patients are very unstable and they require immediate treatment and intervention, many times in order to save their life.
Host: Yeah. You know, I think it's extraordinary that you provide 24-hour cardiology services at the cath lab. You mentioned a couple already, but could you talk about ones that you just wish more patients knew about, ones that you want the general audience that's listening to this to be aware of?
Dr. Boulware: Sure. So, services at the cardiac catheterization laboratory consist of diagnostic cardiac catheterization performing the equivalence of a radiologic procedure to look and define the coronary anatomy and whether there are any blockages in major coronary arteries. We also can do coronary intervention where we put in stents into blocked arteries.
You also have the ability to actually define the severity of any narrowing by using intravascular ultrasound inside of the coronary arteries or measuring flow with a flow catheter. In addition to cardiology and coronary work, we also have the ability to diagnose valve problems. Many patients today who are older, have aortic stenosis or an obstruction of the main aortic valve.
And we're able to diagnose those and prepare them to go on to what's called transcutaneous aortic valve replacement, which is another catheterization procedure. We do not perform that here, but we send those cases to many major medical centers so they can have their aortic valves fixed. We also study heart failure patients and figure out the hemodynamics of their heart failure.
In addition, the cath lab performs a large number of permanent pacemakers and cardiac defibrillators and what are called bi-ventricular AICDs or defibrillators for the treatment and prevention of sudden death and heart failure. In addition to those procedures, the cath lab also performs a significant number of peripheral arterial and venous procedures.
Our colleagues in interventional radiology do many of the venous and the other diagnostic procedures that may even move over into the realm of oncology and cancer treatment, utilizing interventional procedures to treat some of these different diseases that the oncologists may encounter. So it provides a broad spectrum of different services with the major emphasis being in cardiac work, but also a growing and large number of interventional radiology procedures.
Host: Yeah, that sounds incredible. So I wanted to ask what type of patient is best served going to the cath lab? You know, I imagine that when someone is having a cardiac event or shortly after then they should come in, but maybe you can talk a little bit about the right type of patient that can get the most out of the cath lab.
Dr. Boulware: Well, optimally, you would try to make a diagnosis of a coronary issue before it becomes an acute event, or can significantly affect morbidity and mortality. And so stress testing in the office, nuclear stress testing, stress echo, things that can define whether or not there may be a problem. Many of the patients have presented to the office, complaining of either chest pain or shortness of breath and doing a proper workup on those patients may then delineate that they have a problem. And then from there, undergo elective, cardiac catheterization before they're having an acute event. And those are the optimal patients where they have not incurred in the injury, had an acute event, and they're simply undergoing a diagnostic procedure to see if there is blockage involving any major artery and if so, then they're treated appropriately at that time.
Host: So I know that Gerald Champion Regional Medical Center has been offering cardiology services for a while, but the cath lab, is it relatively new to be open 24 hours?
Dr. Boulware: Well, the cardiac cath lab has been an existence, I believe for about six or seven years now. And from the get-go after, I would say the first six months or so, we moved to a availability of the catheterization laboratory, the entire team to be available 24-7. And that was again, primarily designed to deal with and treat patients who are having acute heart attacks, unstable angina, unstable symptoms. Prior to the cardiac catheterization laboratory here, this institution was sending out about 800 helicopter flights to different hospitals in the region that had cardiac programs. And the problem with that was that one, there was taking a considerable amount of time to get those patients to another center. Sometimes those centers would not have bed availability or a catheterization facility available.
And the problem was the mortality or the death rates were significant. The delays were creating problems in terms of getting optimal outcomes and care and the cost to patients and their families could run around $40,000 for a LifeFlight to that might only travel 70 miles to another major medical center.
Host: Yeah. Yeah. I mean, that sounds absolutely incredible. And I can't believe you were sending out those 800 helicopter flights. I know that this is a huge boon and improvement for the community. I'm curious locally, are there other options for this type of heart care in Alamo Gordo?
Dr. Boulware: There are not, this is the only regional hospital in the area it serves a very large county and surrounding counties which also don't have sort of high-end specialty hospitals.
Host: So just before we close here Dr. Boulware, is there anything else that you'd like to share with our audience just regarding cardiology services, including the 24-hour cardiac cath lab?
Dr. Boulware: Just that we've recently had the the pleasure of adding Dr. Greg Peloson. He is former chief of cardiology at Mercy Health in Grand Rapids, Michigan. He comes to us with some amazing training from some of the best in the nation and acute infarct intervention and cardiology training.
We also have the addition of four different nurse practitioners who are all masters or doctorate of nurse practice. And all they do is concentrate on cardiology. And then we have another colleague Dr. Massoud, who's been here for a number of years in the community, who's a noninvasive cardiologist. So we have full line of services and capabilities to see a significant number of patients and meet the needs of the surrounding community at home.
Host: Well, Dr. Boulware, it's been really awesome to learn about the multidisciplinary experienced team that you have and the resources that are available 24-hours a day to the community. So thank you so much for your time.
Dr. Boulware: Thank you so much. And thank you for providing the service for us.
Host: That was Dr. Terry Boulware, Medical Director of Gerald Champion Regional Medical Center Cardiology and Cath Lab. Thank you for listening to Champions For Wellness, local caregivers, educating our community. If you've missed one of our podcasts, you can go to gcrmc.org/podcast. For more information or to make a convenient appointment, you can call 575-446-5600.
My name is Prakash Chandran and thank you so much for listening and we'll talk again soon.