Serious artery blockages kept active 88 year old from enjoying life

Wanda Stovall had been living an active, energetic life for most of her 88 years.

A resident of Fort Worth, she earned her college degree in speech pathology, then changed careers and owned a car upholstery supply company for 10 years. Then, she owned an aircraft repair business for another 20 years. For decades, she volunteered as a docent at the Kimball Art Museum.

But about five years ago, Stovall began feeling unwell. She received a diagnosis of atrial fibrillation, an abnormal heart rhythm that causes the chambers of the heart to beat irregularly and rapidly.

"I had to go to the hospital several times for my shortness of breath, and they gave me several ablations in the hope of getting my heart back to normal rhythm, but it only had short-term effects," Stovall said. "They ended up diagnosing me with congestive heart failure and putting in a pacemaker, but I still hadn't been feeling well. It corrected my heart rhythm, but I was always tired. They treated me with medication and watched me carefully, but I was so tired all the time, I couldn't do much of anything and almost gave up. I hardly ever left my house anymore."

She spent her days sitting on the sofa with no energy to complete any of her usual activities and going to bed at 8 p.m. because she was just too tired to stay up any later.

"This wasn't how I used to be, but I thought, this is just the way it is going to be from now on," she said.

Her husband David, a certified public accountant, knew of a cardiologist at the University of Texas Medical Branch through one of his friends and clients, and insisted that she make an appointment with him.

"We went to see Dr. Hani Jneid at UTMB and it was the best thing we could have possibly done," she said.

Jneid is a Professor of Medicine and Chief of the Division of Cardiovascular Medicine at UTMB, where he also serves as the Medical Director of the Cardiovascular Line and the John Seay and the John Sealy Distinguished Centennial Chair in Cardiology. Jneid took over Stovall's care and discovered several serious blockages in the coronary arteries surrounding her heart. She said he inserted stents in two major arteries to repair the damage from the blockages. She started feeling stronger day by day.

"Her presentation was not the most typical anginal symptoms you would expect to see in younger patients," Jneid said. "Hers was a progressive loss of functional capacity with more shortness of breath and tiredness. We started with a non-invasive cardiac workup, including a stress test. The results suggested the blockages, so we went to cardiac catheterization, angioplasty and stenting procedures, which are invasive procedures. The challenges were in her high-risk status, driven not only by her age and difficult coronary anatomy, but also by her co-morbidities, including weak heart, advanced kidney disease and poor blood pressure control."

Then, Jneid said Stovall endured high-risk procedures to fix all her blocked arteries, including a widow-maker artery supplying the front wall of the heart, but this was complemented by medical treatments and follow-ups for her heart failure, kidney disease and hypertension.

"It was all serious," he said. "We went after her blockages, and we worked with her as an outpatient to improve her heart function and prevent kidney damage before and after the procedure. We fixed her arteries, and she's now in cardiac rehab, feeling much better and increasing her physical activity."

Wanda said she is now able to walk on the treadmill several times a day and gaining back progressively her energy and physical activity.

"I think sometimes doctors are reluctant to do certain things with patients who are a certain age," she said. "But Dr. Jneid was very careful with me. I was tested several times and was very thorough. I was examined extensively, and I think he realized that otherwise I was in good overall health for being 88 and went ahead with the procedure. It has restored me."

Jneid said that sometimes doctors underestimate symptoms of patients, especially older ones, in order to avoid the risks involved in completing necessary workups or performing certain needed procedures.

"As long as there are competent cardiologists and proceduralists who can do these advanced procedures safely and have the right skills and knowledge, there should be no hesitation whatsoever to treat older patients," Jneid said.

"Older patients often benefit more than younger ones, and they should be able to undergo procedures safely and effectively in the right hands and the right setting," he continued. "Medications must also be fine-tuned and it's really an approach of shared decision-making with the family along with continuous meticulous follow-up."

Good medical management, including diligent follow-ups, were critical, Jneid added.

"At UTMB, we practice in an academic setting," Jneid said "We do research, embrace innovation, and provide cutting-edge clinical care, informing clinical care through research, and training the future generation of cardiologists."

Stovalls' grandson Blake Schooler, who lives close to his grandparents, said he's observed a major transformation in her.

"Now, she wants to do things as before, like go out to lunch, go to sporting events, and get her nails done. She hadn't been able to do any of these things for the last two years," he said. "She'd been such an active person. She'd been involved in all kinds of clubs and social events in Fort Worth and had given it all up. She's completely changed now."

The Stovalls are now looking forward to returning to their favorite activity-boating on the East Coast.

"We are going to get a clean bill of health and go back to boating in Newport, Rhode Island," said David Stovall. "She's a completely different person now. It's really a miracle, what's happened."