The Challenge: Blocked Heart Arteries
Euphemia Steffey is an active, independent 94-year-old.
She swims as often as possible, takes classes, and keeps in close touch with her family, including 9 grandchildren and 14 great-grandchildren.
In January 2017, Euphemia arrived at the emergency room at UPMC Shadyside feeling short of breath.
Tests showed signs of a heart attack. They also found her ejection fraction — the amount of blood her heart could pump out — was very low.
She needed a heart catheterization to check for blocked arteries.
The Path to UPMC’s Heart and Vascular Institute for Vessel Disease Care
Krishna Tummalapalli, MD, director of interventional cardiology at the Heart and Vascular Institute at UPMC Shadyside, performed a transradial catheterization. He used the radial artery in her arm — rather than an artery in her leg — to look for blockages.
Dr. Tummalapalli diagnosed Euphemia with triple vessel disease. This type of heart disease involves blockage to three of the main arteries that bring blood to the heart.
In Euphemia’s case, hardened plaque and calcium almost completely blocked the artery at the front wall of her left ventricle.
Her left ventricle — the heart’s main pumping chamber — wasn’t getting enough blood to pump properly. This explained why her ejection fraction was so low.
Euphemia had a few options for treatment, including:
- Surgery
- Another heart cath and stent procedure
- Medicine
Dr. Tummalapalli says:
“When we make a plan for treatment, we take many things into account. These include the patient’s overall health, lifestyle, and wishes — not just their age.
“Euphemia wanted to maintain her independence and ability to be active. We decided that a catheterization and stent procedure was in her best interest.
“Elderly patients are at an increased risk of procedural complications. But, compared to younger patients, they also get the most benefit from invasive procedures like catheterizations when done in the proper instances.”
The Solution: Atherectomy, Stent, and Cardiac Rehabilitation
Dr. Tummalapalli and his team performed an atherectomy. This treatment uses a catheter with a spinning diamond tip to safely scrape away plaque and calcium from inside an artery.
He also placed a drug-coated stent to help hold Euphemia’s artery open and prevent re-blockage.
As Euphemia healed, her care team's effort and skill impressed her.
“Everyone was warm, friendly, and efficient,” she said. “I felt confident in their abilities.”
Two weeks after discharge, Euphemia began cardiac rehab at UPMC Shadyside.
Today, she’s back in the pool, swimming two days a week between her rehab sessions.
Her most recent echocardiogram was normal, with complete recovery of her left ventricle function.
Euphemia remains grateful to Dr. Tummalapalli and his team at UPMC Shadyside.
Euphemia’s treatment and results may not be representative of all similar cases.
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