This is an encore episode as I believe we cannot stress the significance enough for this type of testing to confirm the effects of a myocardial bridge on the patient. The more that's known, the more likely it is that the proper course of treatment can be taken. If you missed it the first time, don't miss it this time. This is a must listen episode.

Unlock the secrets of properly understanding and diagnosing myocardial bridges with insight from Dr. Jeffrey Fowler, a leading interventional cardiologist at University of Pittsburgh Medical Center. Our conversation promises to illuminate the often perplexing process of diagnosing these cardiac anomalies and their impact on heart function. Through the lens of minimally invasive procedures and advanced imaging techniques like coronary CT angiograms, Dr. Fowler demystifies why myocardial bridges are not always the main culprits behind chest pain and the definitive testing now being done to ascertain the significance of the myocardial bridge.

We're going to explore the intricate world of invasive testing, as we detail the provocative testing process used to evaluate myocardial bridges, their severity and their contribution to angina, or chest pain. Dr. Fowler explains how starting with an empiric trial of medications can lead to more invasive procedures like heart catheterization if necessary. Learn about the steps of the provocative test and the role of acetylcholine in testing for endothelial dysfunction and vasospasm, with reassurances about the safety and reversibility of these tests. This episode is our first on the detail and best practice for diagnosis of the bridge through the provocative test we've heard so much about. It's meant for the education and knowledge for both patients and professionals, enhancing understanding of the nuanced approaches in relatively rare process of diagnosis.

Celebrate the spirit of collaboration among cardiology experts as Dr. Fowler shares the necessity of communication and advice. He's consulted with many others along the way including Dr. Shaw at Yale and Dr. Tremmell at Stanford, highlighting real-world case studies like that of patient David Vollmer. Join me in this compelling narrative of breakthroughs and dedication in the realm of cardiac care, and discover how ongoing advancements promise a brighter future for patients everywhere.

You can email Dr. Fowler directly at: fowlerja@upmc.edu

To reach Dr. Fowler call 412-647-6000 and ask for him specifically. Or you can visit the hospital website HERE

You can learn more about the Microvascular Network in the link HERE

Chapter Summaries:

(00:00) Understanding Myocardial Bridge Diagnosis Process

Interventional cardiologist explains use of coronary CT angiogram to detect and manage myocardial bridges in chest pain cases.

(10:04) Invasive Testing for Heart Conditions

Diagnosing and treating myocardial bridges through coronary CTA and provocative testing, including an empiric trial of medications and invasive procedures.

(22:05) Collaboration in Myocardial Bridge Diagnosis

Leading cardiologists collaborate to refine best practices for treating myocardial bridges, using personalized approaches and expert insights.

(27:47) Imaging and Diagnosis of Myocardial Bridge

Acetylcholine, dobutamine, cold saline, and adenosine are used to assess endothelial and microvascular function in chest pain and exertional symptoms.

(37:07) Complex Testing and Treatment Options

Evaluating myocardial bridges using diagnostic tests to guide surgical interventions, while balancing personal wellness in a high-stakes medical career.

(49:16) Cardiac Surgeon Discusses Myocardial Bridges

Dr. Bonnati's unroofing procedure for David at UPMC, with insights from Dr. Fowler and upcoming perspectives from Dr. Bonatti, enriched by David's journey.

What if facing a serious heart condition could be your turning point towards a more empowered life? Join us as we uncover the extraordinary journey of Teresa Raisanen, a woman who transformed challenges into triumphs. From the mysterious chest pain in 2012 to the life-changing diagnosis of a myocardial bridge in 2024, Teresa's story is one of courage, persistence, and the relentless pursuit of clarity in the face of daunting medical challenges. Discover how her determination and self-advocacy paved the way to finding the right specialists who would ultimately guide her to recovery.

Embark on Teresa's incredible path as she navigates the labyrinth of healthcare systems, insurance hurdles, and the pressing urgency of her condition. With the compassionate expertise of Dr. Blair and the logistical support from her husband's airline benefits, Teresa's journey to Houston to meet with Dr. Danny Ramzy for specialized care, is a testament to the power of informed decision-making and resilience. The episode paints a vivid picture of the emotional and physical trials faced by patients seeking timely and effective treatment, spotlighting the critical importance of proactive advocacy in healthcare.

As Teresa emerges from surgery, her journey doesn't end—it evolves. This episode highlights the profound impact of support systems, from family and friends to fellow patients like Gabby, illustrating the healing power of community. Teresa's recovery underscores the unique challenges and triumphs post-surgery, emphasizing the necessity of effective pain management and enduring patience. Her story is a beacon of hope, inspiring listeners to prioritize their health and embrace the possibility of recovery, no matter how formidable the journey may appear.

If you would like to purchase the book, Imperfect Heart, click HERE

Chapter Summaries

(00:00) Heart Condition Diagnosis and Advocacy

Teresa Raisanen's journey with a complex heart condition, diagnosis of myocardial bridge, self-advocacy, and finding a suitable doctor for treatment.

(09:21) Medical Journey With Life-Changing Diagnosis

Dr. Blair's expertise aids in identifying severe cardiac issues, while logistical challenges arise in scheduling consultations and tests.

(22:21) Recovery and Support After Surgery

Self-advocacy and caregiver support are crucial during medical procedures and recovery, along with effective pain management and shared experiences with fellow patients.

(36:29) Navigating Cardiology Referrals and Treatment

Proactive advocacy and knowledge are crucial in navigating cardiac care, including seeking out specialists and understanding conditions like endothelial dysfunction and myocardial bridging.

(41:43) Road to Recovery and Inspiration

Recovery from endothelial dysfunction takes patience and medication, as shown by Teresa's inspiring journey of healing and prioritizing quality of life.

This episode needs little description. Thanks to Kelly and Tank Sears for their candid and sometimes raw emotion in this conversation as they share the reality of the strain a myocardial bridge can put on a relationship, a marriage, a family. Yes, we'll cover the health portion of the surgery and Kelly's amazing recovery after a less than vacation like visit to Greece to see Dr. Kofidis, but it's the perseverance and trust that both she and her husband demonstrated in getting not only the appropriate health care but how they held it together as spouses in a truly challenging time. And that's not to mention the kids in the mix too. The strength of their love was challenged and the good news... there's a happy ending.

Chapter Summaries

(00:00) Uncovering a Myocardial Bridge and More

Kelly shares her heart health journey during COVID-19, navigating medical uncertainties and challenges with her husband Tank.

(08:22) The Battle for a Diagnosis

A patient's struggle with persistent symptoms dismissed by medical professionals, leading to independent research and emotional toll.

(21:23) Navigating Medical Challenges With Family

Family's challenges with loved one's health, frustrations with American healthcare, seeking treatment abroad, and finding hope in a doctor's potential solution.

(28:20) Family Support Through Medical Challenges

Family decisions during a health crisis, logistics of overseas medical trip, emotional toll, importance of new experiences, involving children, and realization of decisive action.

(41:24) Navigating Medical Challenges and Marriage

Perseverance and communication are crucial in maintaining a strong relationship through medical challenges, as shown by a couple's experience with treatment abroad.

(48:55) Shared Stories Finding Validation

Shared experiences and storytelling on the podcast validate and connect listeners, bridging understanding and offering support.

This intro requires few words. We have a friend with a huge podcast and radio audience. 170 stations strong and he gave us the courtesy of interviewing me to help us get our stories told and raise the awareness for the MB condition. Dr. Ronald Hoffman, the longest running physician hosted radio show in syndication on 170 radio stations had no idea what a Myocardial Bridge was. He wanted to know and he wanted his audience to know once he took a look at the book. He gets it and he understood it well enough that he wanted to help us share it to his audience. He saw the value to both his listeners as well as the doctors that listen to his Intelligent Medicine radio show and podcast. With the deepest gratitude, I cannot thank him enough. We're making noise, we're getting traction and we're saving lives in our collective effort to continue to keep getting the word out. Thank you Dr. Hoffman for your interest to host me on "Intelligent Medicine Podcast"!

The interview on his podcast is in this link: https://drhoffman.com/rethinking-heart-health-uncovering-myocardial-bridges/

You can find out more about Dr. Ronald Hoffman by visiting his website https://drhoffman.com/

Navigating the intricate journey of living with a myocardial bridge is no small feat. This episode, I open up about the emotional rollercoaster of coping with myocardial bridges and stress the undeniable importance of patience, understanding, and self-advocacy. Heart procedures are anything but predictable, and while some, like the recently unroofed, find hope in successful outcomes, each person's path is uniquely challenging.

Let's continue to build a supportive network for those affected by myocardial bridges, underscoring the power of shared stories and experiences. No one should feel isolated on this path, and I encourage you to join the community of those who have shared their stories on the podcast. If you're aware of doctors that might make a great guest, please share their contact information with me as well. I'll connect with them. Strengthening our collective resolve through awareness, positivity, and gratitude we'll continue to push the pace of getting this disease recognized as symptomatic and life threatening. Together we can foster hope and understanding in our community.

You can email me directly at jeff@hearmenowstudio.com

You can find the interview with Dr. Ronald Hoffman on the "Intelligent Medicine" website HERE

Could you be one of the tens of thousands of people unknowingly living with a myocardial bridge? Or worse yet, knowingly living with the condition and not having it recognized as a potentially symptomatic, even life threatening, condition? My guest today is another local acquaintance. A friend of a friend. An unbelievably close association to yet another myocardial bridge patient. Janie Desmond Ison and I are going to unpack the startling statistic that while a quarter of the population may have myocardial bridges, only a small fraction are diagnosed as symptomatic. This episode challenges prevalent misconceptions, shares the journey of symptoms often dismissed, and highlights the power of awareness in seeking proper medical attention. Through her story, we aim to connect with those who might feel alone in their struggle and encourage them to pursue the support they need, knowing this is yet another example of the condition that may be similar to what you're facing.

Join us as we follow an individual's incredible journey from experiencing mild symptoms like shortness of breath and palpitations to receiving a life-changing diagnosis of a myocardial bridge and an uncommon solution. We discuss managing this condition amidst complications like low blood pressure and fatigue due to treatments from beta blockers. The narrative sheds light on navigating unexpected health issues and the emotional and physical challenges of making complex medical decisions. We emphasize the vital importance of trust in healthcare professionals and explore the paths available for effective management and recovery.

Our conversation also offers a hopeful glimpse into life after heart surgery, focusing on recovery's emotional and physical hurdles. The critical role of cardiac rehabilitation, peer support, and the need to reassess life priorities post-surgery are discussed. We celebrate advancements in surgical techniques and the necessity of advocating for one's heart health by staying vigilant about symptoms. By sharing these stories of resilience and recovery, we hope to inspire and reassure listeners facing similar challenges, highlighting the strength found in community and support networks.

For more information and details visit the website HERE

To purchase the book, "My Imperfect Heart: Stories of Myocardial Bridges" find it at Amazon.com or in this link.

Chapter Summaries

(00:00) Myocardial Bridge Awareness and Discussion

Myocardial bridges are often undiagnosed, causing frustration and symptoms like shortness of breath and heart attack-like sensations.

(04:57) Journey With Myocardial Bridge Diagnosis

Personal journey of health challenges, diagnosis of myocardial bridge, managing condition with low blood pressure and fatigue.

(19:58) Navigating Post-Surgery Complications and Recovery

A heart surgery journey highlights the importance of clear communication, informed decision-making, and navigating post-operative challenges.

(35:02) Navigating Life After Heart Surgery

Emotional and physical challenges of heart surgery, importance of support and rehabilitation, and need for proactive health management.

(42:10) Advocating for Your Heart Health

Exploring heart surgery complexities, including myocardial bridges and evolving treatment options, and the importance of awareness and research.

(50:47) Sharing Stories of Heart Health

Acknowledging and addressing heart health issues, sharing personal experiences, and emphasizing the importance of being proactive.

Can myocardial bridges be more than just incidental findings in cardiac diagnostics? Join us as we unravel this complex topic with Dr. Khaled Ziada from the Cleveland Clinic. You'll gain a deep understanding of how myocardial bridges, often dismissed as non-significant, can impact blood flow, especially when factors like endothelial dysfunction and coronary spasms are involved. Listen in to discover the pivotal role of provocative testing in determining when surgical intervention is truly necessary.

We discuss the complex techniques utilized in identifying and evaluating myocardial bridges. From CT scans to angiograms and intravascular ultrasounds, Dr. Ziada walks us through the tools that help pinpoint these bridges with a degree of precision. He also elaborates on the use of dobutamine provocation to assess arterial compression and simulate stress conditions, which can reveal underlying ischemic issues. This comprehensive diagnostic approach is crucial for tailoring surgical and medical treatment strategies to the unique needs of each patient.

Finally, we explore the often-underestimated challenges of treating endothelial dysfunction and microvascular disease post-surgery. Dr. Ziada emphasizes the importance of personalized medical therapies and lifestyle interventions in managing these conditions effectively. We also get a glimpse of the exceptional care model at Cleveland Clinic, where patients receive tailored support, whether through virtual or in-person consultations. Collaboration is vital between patients and physicians to enhance quality of life and stability in managing these intricate cardiac conditions and I found Dr. Ziada to have wonderful sense of concern for the well-being of those he works with.

You can learn more about the Cleveland clinic HERE.

You can email Dr. Ziada directly at ziadaK@ccf.org

Chapters

(00:00) Myocardial Bridges and Surgery Considerations

(06:36) Identification and Evaluation of Myocardial Bridges

(16:35) Endothelial Dysfunction and Medical Treatment

(28:33) Microvascular Dysfunction and Treatment Options

(35:02) Microvascular Dysfunction and Patient Care

What if the symptoms of heart disease are present, but the usual suspects aren't to blame? This intriguing question sets the stage for my conversation with Dr. Samit Shah, as we dive into the complex world of ischemia with non-obstructive coronary arteries (INOCA). Dr. Shah shares his groundbreaking work on invasive coronary function testing, a crucial development in the past decade that helps us understand symptoms like chest pain and shortness of breath without coronary blockages. DISCOVER ANOCA program is creating standardized protocols for provocative testing, ensuring that patients receive precise diagnoses and effective care.

Our discussion takes a closer look at the nuanced challenges of diagnosing and treating myocardial bridging, vasospasm, and microvascular dysfunction. With a compelling case study, we illustrate how provocative testing can identify the root causes of symptoms, leading to non-surgical treatment paths. Dr. Shah introduces the Discover Inoka study, which standardizes the use of intravascular imaging for myocardial bridges. By establishing these testing protocols, the medical community is better equipped to treat such conditions with newfound enthusiasm.

As we wrap the conversation, we confront the ongoing challenges and future opportunities in making provocative testing widely accessible. The importance of understanding conditions before major interventions and the role of the Microvascular Network in connecting patients to specialized care are emphasized. We also spotlight advancements in studying myocardial bridging, where surgical unroofing is now tracked in clinical trials, offering unprecedented insights into patient outcomes and enhancing cardiac care. Dr. Shah's insights are driving forward a crucial conversation on improving diagnoses and offering hope to patients with challenging cardiac conditions.

CHAPTER TIMESTAMPS

(00:00) Discover ANOCA Clinical Trial Overview

(08:41) Advance in Diagnosis and Treatment

(14:07) Improving Access to Provocative Testing

(27:24) Myocardial Bridging Clinical Trial Outcomes

Discover INOCA clinical trials application and information is available HERE.

For more information about myocardial bridging and microvascular testing, visit the microvascular network, HERE

White paper on chest pain. American Heart Assoc

https://www.ahajournals.org/doi/10.1161/CIR.0000000000001029

https://www.microvascularnetwork.com/

https://www.jscai.org/article/S2772-9303(24)01512-6/fulltext

https://www.jscai.org/article/S2772-9303(25)01048-8/fulltext