As a doctor, I knew I was probably going to die.
It’s said that when you suffer a near-death experience, your whole life flashes before your eyes.
But for a local physician who recently suffered a massive heart attack, the flashbacks that came before he underwent lifesaving treatment at Monmouth Medical Center dated back just 13 years — to the birth of his son.
Heart attacks are the leading cause of death for both men and women all over the world, and for Michael Disciglio, M.D., an internist in practice for more than 25 years, the electrocardiogram (EKG) performed minutes after he arrived in Monmouth’s Emergency Department showed him that he was suffering the very massive and rapidly fatal acute myocardial infarction (AMI) that is often referred to as the "widow maker."
“When I saw the EKG, I thought back to when I was a resident,” said Dr. Disciglio, who completed training in internal medicine at Monmouth Medical Center in 1987. “Back then, if we read an EKG like that, we knew the patient was not going to survive, and all I could think about was my son — that I was going to miss seeing my son grow up.”
But the good news for Dr. Disciglio and 13-year-old Michael Patrick Disciglio is that modern treatment for acute myocardial infarctions — more commonly known as heart attacks — can result in survival and even good outcomes. In Monmouth’s ER, they initiated a “Code STEMI” — the process put in place to treat all heart attack patients within the first 90 minutes of an attack. Back in 2006, Monmouth Medical Center joined the American College of Cardiology in launching a national quality improvement initiative with the goal of ensuring that patients like Dr. Disciglio with ST-segment elevation myocardial infarction (STEMI) undergo emergency angioplasty within 90 minutes. The result was “Code STEMI” and the results have been impressive.
For any patient arriving at Monmouth Medical Center with symptoms of a heart attack, Emergency Department physicians order an electrocardiogram (EKG) within minutes. An EKG can detect signs of poor blood flow, heart muscle damage, abnormal heartbeats and other heart problems. If a heart attack is diagnosed, the Code STEMI is activated, with the on-call interventional cardiologist and the specially trained cardiac catheterization team called in for emergency treatment. The Code STEMI team that cared for Dr. Disciglio, led by interventional cardiologist Rita Watson, M.D., acted quickly, performing a lifesaving emergency angioplasty 79 minutes after his diagnosis. “Dr. Watson did a miraculous job,” Dr. Disciglio said, noting that he had a near total occlusion, or blockage, of the LAD — the left anterior descending coronary artery that feeds the entire front wall of the heart.
An acute myocardial infarction is the interruption of blood supply to part of the heart, causing some heart cells to die. It is most commonly due to the blockage of a coronary artery following the rupture of a vulnerable atherosclerotic plaque, which is an unstable collection of lipids such as cholesterol and white blood cells in the wall of an artery. The resulting restriction in blood supply and oxygen shortage, if left untreated for a sufficient period of time, can cause damage to heart muscle tissue or death. Classical symptoms of an AMI include sudden chest pain. It is estimated that a quarter of all myocardial infarctions are silent, without chest pain or other symptoms.
Dr. Disciglio — a trim nonsmoker with normal blood pressure and cholesterol — notes that he has always had a special interest in cardiology and says that on the night of his heart attack, he had given a lecture on lipids at an area restaurant. When he returned home, he started feeling pressure in his chest, but noting that he had a negative stress test just a month before, he ignored it until the pain grew worse and traveled to his jaws and teeth. That’s when he decided he needed to get to an emergency room.
“I feel extremely fortunate that I lived long enough to get to the hospital and have this procedure performed,” said Dr. Disciglio, who also underwent cardiac rehabilitation at Monmouth’s Joel Opatut Cardiopulmonary Rehabilitation Program as a part of his recovery. “It’s still hard for me to fathom that I was able to survive that heart attack, and yet, the next day, my EKG was completely normal. Looking back to when I was doing my residency, a patient lucky enough to survive a heart attack like that would have been left a cardiac cripple.”
To see where the technology was then and where it is today at Monmouth Medical Center is extraordinary, he says. “I’m still in awe of this place, and that I was lucky enough to survive and get to see my son grow up,” he said of his only child, a middle school student. “My son and I are like bookends — we’re always together — and I am so grateful to Dr. Watson and the team at Monmouth Medical Center for giving me back my life with him.”