Tackling coronary heart disease through advanced approaches to prevention and treatment

David Perkowski, M.D., Medical Director, Cardiac Surgery, Saddleback Memorial Medical Center

Steven Schiff, M.D., Medical Director, Invasive Cardiology, Orange Coast Memorial Medical Center

There’s great hope on the coronary heart disease front with more options for diagnosis, treatment and recovery than ever before. Two-thirds of adults survive the disease — 27 percent higher than a decade ago — and impressive new technologies and techniques show tremendous promise.

Progress is impressive and risk factors well known, yet more Americans continue to die from coronary heart disease than any disease. While hereditary factors play a role, unhealthy lifestyle choices remain a significant culprit.

To learn more, Smart Business turned to Steven Schiff, M.D., prominent cardiologist and medical director of invasive cardiology at Orange Coast Memorial Medical Center; and David Perkowski, M.D., the medical director of cardiac surgery at Saddleback Memorial Medical Center, who pioneered and has performed over 1,500 ‘beating heart’ surgeries.

How do heart attack symptoms vary among men and women?

For women — who die of heart disease more than men — symptoms can be so subtle patients may not suspect they’re in trouble. Symptoms may include nausea, dizziness, uncomfortable pressure, tightness or heaviness in the chest that doesn’t go away quickly; cold sweats or pounding heart; pain radiating up the shoulders or neck or down the arms or back; difficulty breathing; and/or shortness of breath. Because symptoms experienced by women tend to be more variable and less typical, care must be taken to consider the diagnosis of a heart attack or blocked arteries in female patients.

What risk factors are most prevalent?

Smoking, obesity, sedentary lifestyles and heavy consumption of saturated and trans fats are prevalent among many Americans. These negatively impact cholesterol counts and blood pressure levels and can cause dangerous plaque build-up in coronary arteries. Too often, children will mirror their parents’ unhealthy habits. With one in three California children and teens overweight, the elevated number of kids with risk factors for heart disease — high body-mass index, glucose intolerance, elevated blood pressure and high cholesterol — translates into higher risks of coronary heart disease as they become adults, making family fitness essential.

How can health risks be lowered?

Lowering cholesterol and treating high blood pressure can reduce the risk of dying of heart disease, having a non-fatal heart attack or needing heart bypass surgery or angioplasty. Preventive measures include maintaining an appropriate weight as well as eating foods low in cholesterol and fat. Reducing stress, controlling blood pressure and exercising regularly are important, as are regular check-ups, screenings and following a doctor’s advice.

What advances are available locally?

Orange County residents have access to world class heart care. Advanced and innovative diagnostic technologies, treatments and rehabilitation for heart disease are the norm at MemorialCare Heart & Vascular Institutes at our hospitals. These include open heart surgery, angioplasty, stenting and device implantation such as internal defibrillators and pacemakers. In addition, heart and vascular services offer catheter ablation, rehabilitation and centers for cardiac care for women. MemorialCare was the only West Coast health system to be listed among the 25 Best Health Systems for Overall Care and Heart Attack, Heart Failure and Surgical Care in Total Benchmark Solution’s Competition. We
are among just a few designated cardiac paramedic receiving centers in Orange County with emergency treatment times that beat the national average. And our hospitals are recognized for quality cardiac outcomes continually surpassing state and national standards.

Orange Coast Memorial is the area’s first hospital, and only a handful in the U.S., with a Hybrid Cardiovascular Interventional Suite. This advanced approach to heart care allows cardiac specialists to provide interventional treatments and surgery in one suite, reducing procedure time and stress on patients. We also offer angiography, angioplasty, bypass surgery or combinations of these in the Hybrid Suite. Our da Vinci robotic system offers breakthrough minimally invasive capabilities with greater surgical benefits.

Saddleback Memorial is a pioneer in off pump coronary artery bypass surgery, or ‘beating heart’ surgery, that is performed without stopping the heart, resulting in better preservation of heart function, reduced hospital stays and quick recoveries. We received American Heart Association’s Get With The Guidelines Heart Failure Gold Performance Award, honoring our attaining stringent guidelines for treating heart failure. Advances continue with a center that is dedicated to managing heart disease and other chronic conditions.

How can we create a healthier workplace?

A healthy lifestyle is your best defense against many diseases, and the workplace can help everyone achieve better health. MemorialCare offers programs and screenings, which include nutrition education, exercise tips and health activities, like break time walking groups. Ensuring the availability of fruits, vegetables and nutritious foods in vending machines and eating places also helps create healthy choices.

Memorialcare.com offers tools that help evaluate medical risks and health guides outlining heart attack symptoms, heart-healthy eating and women’s wellness. Our hospitals offer prevention programs and heart evaluations at worksites and other convenient locations.

Steven Schiff, M.D., is a cardiologist and medical director of invasive cardiology at Orange Coast Memorial Medical Center. David Perkowski, M.D., is medical director of cardiac surgery at Saddleback Memorial Medical Center. The not-for-profit MemorialCare Health System includes Long Beach Memorial Medical Center, Miller Children’s Hospital Long Beach, Community Hospital Long Beach, Orange Coast Memorial Medical Center in Fountain Valley and Saddleback Memorial Medical Center in Laguna Hills and San Clemente. For additional information on excellence in health care, please visit memorialcare.org.


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