Howard Bennett was struggling for breath as his wife rushed him to South Miami Hospital.
“The last thing I remember is the dashboard coming up to hit my head,” Bennett recalled. He had a massive heart attack, what doctors call the widow maker because the major coronary artery is blocked.
It would be three days before he regained consciousness. Today he is a different man, running three times a week, eating healthy, and working in a new job as a fire and explosions detective for the state of Florida.
Carol Wilson, now 81, remembers driving herself to the hospital and walking in from the far parking lot before she had her heart attack. Where she had once run seven miles a day and played tennis and golf, after her heart attack, she could barely walk down the hall. For years, she wasn’t even able to heft her golf club, much less walk on the golf course. Today, she regularly plays 18 holes.
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Both people made a common mistake — not calling 911 for an ambulance. And both are living new lives. But their paths to recovery were quite different — one through the best procedures in traditional heart medicine and the other through stem cell therapy.
“EMS, emergency services, can save lives,” said Dr. Jaime Ghitelman, an interventional cardiologist with the Miami Cardiac and Vascular Institute at Baptist Health. “They have all the resources … to shock a patient in case of arrhythmia, they have medications to raise blood pressure if the pressure’s too low, or they can give the first line of therapy.”
“In [Bennett’s] case, he was lucky,” Ghitelman said, “but the story could have been different if he got to the hospital five minutes later.”
Bennett’s heart stopped, and it had to be shocked several tunes: “Basically, he died,” Ghitelman said.
“In this kind of situation, where there’s a lack of any oxygen to the brain, it has been proven with several studies that when you cool down the body and brain, you preserve brain function,” Ghitelman added.
The cardio team at South Miami began the hypothermia protocol, basically wrapping Bennett in a device that lowered his temperature from normal 98.6 degrees down to 93.2 to 89.6 degrees.
They also opened his clogged artery with wires and balloons and inserted a stent and an intra-aortic balloon pump to prevent massive organ failure and take pressure off the heart.
“For 48 hours, we didn’t know: one, if his heart would respond; and two, if his brain would recover from cardiac arrest,” Ghitelman said.
“Most of the time, there is damage to the heart muscles, and that’s when you see patients in heart failure,” Ghitelman said. In Bennett’s case, a later echocardiogram, or ultrasound of the heart, showed his heart had recovered back to normal.
Bennett remembers being awakened and feeling colder than he ever had in his life. He credits the doctor’s skill, the teamwork of the doctors and nurses and perhaps even divine intervention.
After 12 days in the ICU, Bennett went home.
“Getting healthy was a long road,” Bennett recalled. At first, walking to the end of the block was a major feat. Six months later, he made it a mile, even though it took an hour and a half. Now he rises at 5:15 most mornings to do his 40-minute workout or run to a nearby golf course and back before his family wakes.
Bennett, who had quit smoking just before his heart attack, has kicked the habit. He also eschews fried food and eats less red meat and more fish.
“Having goals and trying to meet those goals has kept me healthy,” Bennett said.
Carol Wilson wanted to be active again, too. But after her heart attack, followed a year or two later with a mini-stroke, she could barely do one thing a day, much less any sports.
Then she read an article in the Miami Herald about the stem cell studies Dr. Joshua Hare was doing with heart patients at the University of Miami’s Miller School of Medicine.
“I called up my own doctor, and I pushed and pushed to be in one of the studies,” she said.
Finally, she got accepted. “I went through all these different tests, and they found another blood clot in my heart,” she recalled. She had to wait another six to eight months for that to be resolved before she could participate.
After a heart attack, the “biggest concern and biggest complication is heart failure,” said Hare, a cardiologist and director of the Interdisciplinary Stem Cell Institute at UHealth.
“A new area of medicine right now is the idea that you can actually repair some of the damage that has occurred as a result of a heart attack,” Hare said. The study in which Wilson enrolled injected millions of donor, bone-marrow stem cells into her heart. Stem cells extracted from bone marrow “grow rapidly and help regulate the body to heal itself,” Hare explained.
After a heart attack, an area of the heart that should be beating turns into a scar.
“We inject the stem cells in and around the area of the scar and the cells remove the scar and replace it with new tissue that’s beating muscle. When you replace the scar tissue with beating heart muscle, the [spherical heart] shape goes back to what it ought to be, which is like a football,” Hare said.
The stem cells, Hare said, “do an amazing job of repairing damage. We don’t have any other known strategy in medicine to be able to do that.”
A new study, called the Concert trial, will combine a patient’s bone-marrow stem cells with cardiac stem cells to create what Hare believes is an even more powerful way to repair heart damage.
Hare said it takes about three months for the cells to remove the scar tissue and cause new tissue to grow. He likens stem cells to conductors of an orchestra or to a general contractor who repairs a damaged building by tearing out what’s ruined and replacing it with new construction. UHealth researchers have determined that stem cells injected into the heart can reduce scarring by 35 percent.
“People who were basically sitting in a chair unable to do anything are back playing tennis and having full lives,” Hare said.
Before her stem cell infusion, Wilson got so exhausted that by 4 or 5 p.m. every day she was sleeping.
Said Wilson: “Once I had my stem cells, it really wasn’t too long after that — I would say a couple of months — before I was able to go and do things. I took up golf [again], and I’ve been playing ever since.”
“The most important thing,” Wilson said, “is that we get people to understand the need for stem cells for the heart.”
Post-heart attack tips
Eat healthy foods
‘If it’s fried, I don’t touch it,’ said Howard Bennett, who eats fish three times a week. Carol Wilson eats vegetables, grains, fruit and occasionally red meat for protein. Both have had heart attacks.
Get at least 150 minutes of moderate aerobic activity a week, or 75 minutes of vigorous aerobic activity a week. Bennett does 40-minute workouts three times a week
‘Stay away from people who drain you. You have to protect yourself,’ Wilson says.
Most importantly, says Bennett, no matter how tired or sore you are, ‘Every day is a gift.’
KATHRYN W. FOSTER
STEM CELL STUDY SEEKING PATIENTS
UM's stem cell institute is seeking people ages 21 to 79 who have had a heart attack or heart failure for a study to determine which stem cells are best to treat damaged hearts.
- The Concert trial, the first of its kind, will evaluate heart function in four groups of patients: those treated with their own bone-marrow stem cells; those treated with their own heart-tissue stem cells; those treated with a combination of bone-marrow and heart-tissue stem cells; and those treated with a placebo.
- The University of Miami is one of seven stem cell centers conducting the study.
- Funding comes from the National Heart, Lung and Blood Institute.
- The study needs 144 patients. All patients will be followed for one year.
- To apply, contact Cindy Delgado at UM’s Interdisciplinary Stem Cell Institute: 305-243-7444 or 305-243-1152.