“I would have periodic episodes of a very rapid heart rate, and I discounted them for about six months,” shares Courtney Ammons, a Wake County high school chemistry teacher.
Because she had hyperthyroidism, she experienced rapid heart beats occasionally, so she assumed this was an unwanted side effect of her condition.
After an eventful day with her students, on June 1, 2023, around 8:30 pm, she was having an episode, and it was registering on her smart watch at around 160 beats per minute.
“I knew it should not be that high while sitting and doing nothing. I called my primary care doctor after hours and and got the PA who was on call. She suggested I go to the emergency department. I went to WakeMed North Hospital Emergency Department.”
Comprehensive Care and a Startling Diagnosis at WakeMed North Hospital Emergency Department
They immediately took her back, performed an electrocardiogram (EKG) and sent her to the waiting room to be processed in the patient queue. In time, she was admitted to a patient room, where the care team connected her to a monitor, so they could identify any irregular heart symptoms. Courtney also received a chest X-Ray, a computed tomography (CT) scan and blood work.
The nurse noticed an unusual pattern, so Dr. Kathryn Cox, the emergency medicine physician for the evening, reviewed the nurse’s findings and determined that it could possibly be atrial fibrillation (AFib). She called WakeMed cardiologist Tapan Godiwala, MD, RPVI.
Dr. Godiwala suggested the team start Courtney on a calcium-channel blocker to slow her heart rate. The team then continued monitoring Courtney and decided it was best to keep her overnight. She saw Dr. Godiwala the next morning, June 2.
AFib Explained
AFib is the most common heart rhythm disorder (cardiac arrhythmia). It is the cause of 15 percent of preventable strokes among Americans, and approximately 2 million Americans have it. It is an irregular, rapid and quivering heartbeat.
Although AFib often progressively worsens in most people, it is treatable, particularly when patients seek help early — when they first begin having symptoms or when their doctor first suspects it.
Understanding the basics of AFib is the first step in preventing harmful complications, including stroke and heart failure.
Next Steps with WakeMed Heart & Vascular Cardiology and Atrial Fibrillation Center
Dr. Godiwala asked Courtney several questions and ordered an EKG and echocardiogram. He wanted to ensure Courtney’s heart was strong enough to handle AFib medications. During this time of testing, Courtney’s heart finally converted, and she was referred to WakeMed’s Atrial Fibrillation Center for AFib as well as to WakeMed Heart & Vascular Cardiology where she would continue seeing Dr. Godiwala for general heart care. With these next steps in order, Courtney was discharged from the hospital on Friday, June 2, with a follow-up appointment at the Atrial Fibrillation Center on Monday, June 5, with Michelle Deans, PA.
Deans ordered an EKG and began information gathering. She determined that Courtney could treat her AFib in two ways: medication and an ablation. Ashish Patel, MD, MPH, FACC, collaborated with Deans to confirm that Courtney had both an atrial flutter and AFib and that these two treatments were the best course of action.
With her diagnosis certain, Deans referred Courtney to nurse navigator Barry in the WakeMed Atrial Fibrillation Center, so she could easily access information and answers regarding her care.
A Fight for the Right Medication
Courtney had a follow-up appointment on Friday, June 9, for another EKG. Gratefully, it was normal, so Deans ordered medication. Yet, Courtney’s insurance would not approve the medication because of the high cost, so Deans fought for the approval. She felt strongly that other available medications were not best over time and at Courtney’s young age.
Courtney recalls, “Deans said, ‘I don’t want you on that because you’re too young to be on that medication for the rest of your life since it has unfortunate side effects.’ While haggling with insurance, Deans secured a discount card for me to receive a one month free supply. Nurse navigator Barry walked me down to the pharmacy at Raleigh Campus to obtain it. Meanwhile, Deans continued jumping through hoops with the insurance company because my insurance denied the request twice. On the third try, they approved it. I was in awe of their dedication to helping me and the very personal steps they took to make sure I would receive quality care.”
Since AFib often goes hand-in-hand with sleep apnea — a potentially dangerous sleep disorder, Courtney then followed up with my general cardiologist Dr. Godiwala on June 11, and he ordered a sleep study. She completed it on June 14 with follow-up with Dr. Ashish Patel on June 29.
Ablation at the WakeMed Heart Center
A battery of tests completed, Dr. Patel determined that Courtney was a good candidate for an outpatient ablation, which he performed on September 1 at 8:30 in the morning at the WakeMed Heart Center.
“I was very, very nervous going into it,” explains Courtney. “I have had about five surgeries during my lifetime and none really affected me like this one did. There was something about it being a heart procedure that made me very nervous.”
Despite her misgivings, Courtney’s procedure went smoothly. The team prepped her for surgery and from start to finish, she was under for the nearly two-and-a-half hour procedure.
“I felt pretty good upon waking. I wasn’t in any real pain and just felt a little groggy from the anesthesia.”
Courtney was discharged home shortly after waking and rested for the next several days, with orders to take it easy for at least two weeks.
“I feel I have the stamina to head back to work and am happy that I will continue my medication for three months to develop scar tissue, which is what I need for my heart to stop misfiring. I’m thankful to the entire team who helped me get through the process from diagnosis to surgery and aftercare. They offered me top quality care.”
About WakeMed Atrial Fibrillation Center
If you have a new diagnosis of Atrial Fibrillation (AFib) or an existing diagnosis of AFib and need additional support, WakeMed Heart & Vascular’s Atrial Fibrillation Center is here for you.
Patients with AFib often have multiple complications related to their heart that further increases their chance of having a stroke or developing heart failure. Our AFib Center brings together a multidisciplinary team to provide the care and resources you need to help you understand and manage your condition.
We offer:
- Individualized, comprehensive care for those with a new diagnosis of or existing AFib where additional support is needed
- Symptom, rate and rhythm control management
- Guidance on further interventions, clinical trial participation or medication management following appropriate guidelines and protocols
- Specialists for all aspects of your care delivered in a coordinated way
- An in-person assessment with our AFib Center team who provides you and your family the additional education and support needed about your AFib condition
The goal in providing this care is to reduce return visits to the hospital because of your AFib, improve your overall health and provide a better quality of life.
About WakeMed Heart & Vascular
WakeMed Heart & Vascular physicians bring together expert cardiovascular, thoracic and vascular surgeons who are dedicated to delivering the highest level of cardiovascular care in Raleigh, Apex, Cary, Fuquay-Varina, Garner and Clayton, N.C. For decades, these physicians have chosen to bring their talent and expertise to WakeMed for its reputation for excellence in cardiovascular care and commitment to providing the most exceptional patient experience.
About the WakeMed Heart Center
When it comes to matters of the heart, there’s nothing like experience. Wake County’s first open heart surgery was performed at WakeMed in 1968, and we continue to be a leader in innovative cardiovascular care delivered by highly trained, board-certified physicians and staff who take a team approach to patient care. At WakeMed, patients always come first.
Whether it’s having a cardiac intervention team ready and waiting for you in a time of emergency, managing your high cholesterol or high blood pressure levels or helping you regain strength with our dedicated cardiac rehab program, WakeMed’s Heart & Vascular services, physicians and staff are here for you.
About WakeMed North Hospital
Located in North Raleigh, the Emergency Department at WakeMed North Hospital is available 24 hours a day to provide full-service emergency care to patients of all ages. Our doctors, nurses and specialists are backed by WakeMed Children’s and Wake County’s only Level I Trauma Center.
WakeMed North Emergency Department Features:
- Private Treatment Rooms
- Private Triage Rooms
- A Minor Emergency Care Area for patients requiring less urgent care
- Board Certified Emergency Medicine Physicians
- Onsite Laboratory and Radiology support
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