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Heart Care for a Triathlete - A Story of Threes


Heart Care for a Triathlete: A Story of Threes

For David Watkins, a racing heart wasn’t anything out of the ordinary. A long-time triathlete, he was used to pushing his body to the max.
But what he didn’t know was that while he was training for his three triathlon events — running, swimming and cycling — there was a trifecta going on in his chest.
The problem began in the middle of a race, when his heart beat became irregular, bouncing up to 220 beats a minute and falling as low as 30 a minute. He collapsed.
The medics on the scene ascribed the episode to overexertion and dehydration. When Watkins followed up with a cardiologist, the physician agreed that overexertion was probably to blame, but ordered an echocardiogram, an ultrasound test that shows the heart’s structure and function.
Diagnosis: congenital heart disease
The echocardiogram found that Watkins had a bicuspid aortic valve. This meant the valve that controls the flow of blood from the heart to the aorta had only two leaflets instead of the normal number of three.
Bicuspid valves are a congenital condition, meaning Watkins was born with it. They can cause no symptoms but can become more narrow or leak with time, and if they are sufficiently narrow, can impede the flow of blood into the aorta and make the heart work harder. Some people with bicuspid valves have aortic aneurysms, and abnormal enlargement of the aorta that can be dangerous if the aorta gets too large.
Watkins kept up his running but the episodes of irregular heartbeats and weakness kept returning, sometimes occurring even at rest. “Finally, my doctor looked at me and said, ‘We need to get you to UW Medicine. If anybody can figure out what’s going on with you, it’s them,” recalls Watkins.
Leading edge heart care
There are a number of reasons why Watkins came to the right place, says UW Medicine cardiologist Dr. Karen Stout, a specialist in congenital heart disorders.
Not only does UW Medicine offer the services of a team of specialists all working under one roof, Dr. Stout notes, it is an academic medical center, which means the cardiologists, cardiovascular surgeons and others involved in a patient’s care are actively involved in research, and, as a result, on the leading edge of cardiac care.
“Along with day-to-day patient management, we participate in clinical trials and other scientific efforts to understand what is causing the heart condition and how to best treat it,” says Dr. Stout.
Atrial fibrillation and an aortic aneurysm
What the UW Medicine team found was that Watkins had not one but three serious problems with his heart: He had an irregular heartbeat called atrial fibrillation, which explained the wild fluctuations in his heart rate, the bicuspid aortic valve, and, most worrying, a possibly life-threatening enlargement, or aneurysm, of the aorta where it joined the heart. Watkins recalls that his UW physician who sat down with him and said: “You don’t just need this surgery, you need this surgery now.”
Medical triathlon:
  • Heart valve replacement: bicuspid aortic valve
  • Aneurysm repair: aneurysm of the aortic root
  • Maze procedure: surgery for atrial fibrillation
The UW Medicine team of heart specialists at UW Medical Center went to work. Watkins was taken to the operating room and had his aorta repaired and his bicuspid valve replaced with a pig valve, restoring normal function. In addition, he had a procedure, called a Maze procedure, to treat the atrial fibrillation. When he arrived back in the ICU, he went into ventricular fibrillation and he was successfully resuscitated.
After a week at UW Medical Center, Watkins went home, and a year and one month after his surgery, he competed in and completed a triathlon.
Collaborative care
Such results are possible, says Dr. Stout, because UW Medicine physicians are not only at the top of their field, they work as a team. “Our collaborative environment advances not only cardiac knowledge but also the health and well being of our patients.”
Take control of your heart health and schedule an appointment for a routine physical by calling 855.520.5151. Or, fill out an online form to request an appointment with experts at the UW Medicine Regional Heart Center.
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