December 9, 2019
When someone is in poor cardiac health, they’re said to have a “weak” heart. What looks like weakness, however, often is the opposite.
Just ask Peter Pica of Brick, New Jersey, a longtime cement truck driver whose most recent job was delivering equipment to and from cell tower construction sites across the Northeast. He worked until the age of 79—more than a decade after most men his age had retired—because he’s a workhorse. And so, it would seem, is his Herculean heart, which has survived four heart attacks spanning nearly 20 years.
A History of Heart Attacks
The first one took place when Peter was 62 years old. He was working on a construction site when he began having pains around his neck. He told his foreman he wasn’t feeling well, and the foreman said it was probably something he’d eaten. When Peter got home, however, his wife, Pat, insisted he go to the doctor. When he did, he found out he had suffered a heart attack, the treatment of which was triple-bypass heart surgery.
The circumstances of Peter’s latest heart attack, in 2018, were remarkably similar to those of his first. He was working on a jobsite in Connecticut when he began having pains in his chest. He again told his foreman that he was feeling strange, and his foreman once again blamed his lunch. When he got home that evening, his wife insisted they go to the hospital, just as she’d done years prior. This time, however, Peter’s heart was in far worse shape.
“They told me my heart was only operating at 30 percent,” says Peter, now 80, whose cardiologist subsequently installed an implantable cardioverter-defibrillator (ICD) that would shock his heart into beating normally in the event of another cardiac episode.
An Alternative to Heart Transplant
Unfortunately, things got worse, not better, for Peter, who also had been prescribed inotropic therapy (where medication is delivered through continuous infusion in order to help the heart beat stronger).
“After that, my heart got really bad and they gave me about three months to live,” continues Peter, who was experiencing end-stage heart failure, the typical treatment for which is a heart transplant.
Because of his age, however, Peter was a less-than ideal transplant candidate. Doctors at Jersey Shore University Medical Center’s freshly minted Advanced Heart Failure Center recommended surgery to install a left ventricular assist device (LVAD), a battery-operated mechanical pump that helps the left ventricle (the heart’s main pumping chamber) pump blood to the rest of the body.
“Peter’s heart was failing, so we ended up implanting an artificial heart pump,” explains Sinan Simsir, M.D., the cardio-thoracic transplant surgeon who performed Peter’s LVAD procedure. “He probably would not be alive today if we had not intervened.”
A Candidate for Surgery
Peter’s age made surgery risky. Doctors were willing to move forward, however, due to a number of qualifying factors. “His advanced age was one negative factor, but only one,” Dr. Simsir continues. “When you looked at him, he looked like somebody who had vivacity. He wanted to live for other people, like his family. Also, there was no irreversible damage to his other organs. We made the assessment that once we fixed the output from his heart, his kidneys, lungs and liver would continue to function well. That’s why he ended up being a reasonable candidate.”
“Aside from his heart condition, he was fairly robust,” echoes cardiovascular disease specialist Jesus Almendral, M.D., medical director of the Advanced Heart Failure Center at Jersey Shore, which is one of only six hospitals in New Jersey that offers the LVAD procedure. “He also had very strong family support, which is crucial. Patients need to have somebody who can learn the pump aside from themselves and can be there as a backup in case something happens.”
Life with an LVAD
By way of a small hole in the abdomen, a cable connects the internal pump to a battery-operated external controller. Because the device can’t get wet, bathing requires great care and swimming is off limits entirely. Mostly, though, life with the LVAD is good, says Peter, who finally retired after his last heart attack and now spends his days fishing, crabbing, doing rehab and enjoying time with his family, including his wife, five children and eight grandchildren.
“I’m just enjoying the rest of my life,” says Peter, who praises Dr. Almendral and Dr. Simsir, both of whom have extensive experience implanting LVADs. “I had great doctors and nurses. It’s like they gave me a second chance to live.”
Because he’s survived four heart attacks in all, it’s more like his fifth chance to live—which is why it feels erroneous to call his heart “weak.” Despite its struggles, “strong” is the only fitting word for a ticker as tenacious as his.
Learn more about Hackensack Meridian Health’s state-of-the-art cardiac care, including innovative heart-failure treatments like the LVAD.
To make an appointment at the Advanced Heart Failure Center at Jersey Shore University Medical Center, call 732-776-4196.
The material provided through HealthU is intended to be used as general information only and should not replace the advice of your physician. Always consult your physician for individual care.