ILWACO - For seven years, Ocean Beach Hospital's cardio and pulmonary rehabilitation department has helped area residents bounce back from heart transplants, heart valve replacements, coronary disease and more. Now, a new service at OBH may generate thoughts of comic books and movies - advanced diagnostic procedures using nuclear medicine.
Producing remarkable images of organs with help from radioactive isotopes, OBH's nuclear medicine department is overseen by Dr. Albert Fabiano, who specializes in internal medicine.
Established in 2003, the cardio and pulmonary rehabilitation programs are run by Dan Burns, a respiratory therapist, cardiovascular technician and certified pulmonary function technician.
When a patient complains of chest pains, their primary physician will examine them, possibly perform an EKG, and, if necessary, refer them to Burns and Fabiano for a stress test.
Up until last fall, the hospital could only offer the traditional treadmill stress tests. But with the nuclear medicine department picking up speed since around November, doctors can now send their patients to OBH to undergo a nuclear stress test, which is ideal for patients who do not have the strength or stamina required for the traditional treadmill stress test.
If the patient cannot undergo the treadmill stress test, doctors can induce the same results by injecting the patient with an isotope called Lexiscan, which dilates the blood vessels.
First, using a special machine, they take images of the patient's heart at a resting state. Then they inject the radioactive Lexiscan. Once the blood vessels are dilated, doctors take a second set of pictures. By comparing the resting and stressed images of the heart, doctors can see how much blood is reaching the heart and if there are areas that may not have adequate blood supply.
"It looks like a CT scan, but it shows the different planes of the heart," Fabiano explains. "It shows blood distribution in the arteries, which helps pinpoint where the problem lies."
Burns says injections like Lexiscan are a great tool because it's a non-invasive way to evaluate someone's cardiac condition, and the patient doesn't have to drive out of the area to have it done.
"They'll receive the same quality evaluation here as they would in a bigger facility in Portland or Seattle," Burns adds.
Fabiano says another benefit of Lexiscan is that it dissipates quickly - within minutes - so it has very negligible side effects.
If the images show an abnormality in the heart, the patient can be treated at OBH. And if a more thorough cardiology study is necessary, the doctors can refer the patient to another facility.
Fabiano says sometimes chest pains can be caused by a digestion reflux issue, but doctors like to rule out heart disease and similar concerns first because of the severity.
"We acknowledge the problem, evaluate the problem and take the next steps to treat it," he says.
"Not all cardiac issues can be evaluated without cardiologists," Burns explains. "This program can determine if a patient needs a cardiologist, or if they can stay [at OBH]."
Nuclear medicine imaging has been used to diagnose early stages of disease and conditions throughout the body, but currently OBH is only using it for stress tests.
In addition to the nuclear stress tests, the hospital's cardiac rehabilitation services consist of state of the art equipment, telemetry, treadmills, bicycles, education programs for patients and their families, and professional monitoring for people who have had a heart attack, open heart surgery, or cardiac procedures such as an angioplasty or coronary atherectomy. The benefits of the pulmonary rehabilitation program include increased endurance, improved exercise performance, reduced dyspnea and other breathing difficulties, and correcting poor nutrition.