Proper testing and a quick diagnosis were at the heart of John Azlant’s recovery last year from a potentially life-threatening condition.
After being referred to a specialist at the Cleveland Clinic for a fluid buildup around his heart, Azlant, 67, of Stow, underwent a cardiac MRI and other tests that showed he had inflammation in the sac around his heart, a condition known as pericarditis.
Aggressive treatment with several anti-inflammatories — combined with a medication to reduce water retention and a low-sodium diet — led to a complete recovery.
“The good news is, here I am 14 months later and I’m feeling fine,” he said. “All my tests show the inflammation is gone. I continue to feel real good.”
Five weeks ago, he was able to meet his newborn twin grandchildren.
“Everything came together,” he said. “Someone was watching. Fate landed me in the right place.”
Azlant is a success story, but many other patients with pericardial disease don’t fare as well.
Too often, the condition isn’t diagnosed until patients suffer advanced cases that are more challenging to treat, said Dr. Allan L. Klein, director of the Center for the Diagnosis and Treatment of Pericardial Diseases at Cleveland Clinic.
“Often it’s unrecognized,” Klein said.
The doctor chaired a writing group for recently released guidelines to help determine the proper imaging techniques to diagnose and treat pericardial disease.
The guidelines were published in this month’s edition of the Journal of the American Society of Echocardiography.
Experts from the Society of Cardiovascular Magnetic Resonance and the Society of Cardiovascular Computed Tomography also were involved with creating the consensus statement.
Advances in imaging are making the condition easier to detect and determine proper treatment if the proper tests are used, Klein said.
“The guidelines basically are telling clinicians when to use the tests and what’s appropriate in this era of cost containment,” he said.
These conditions can cause a wide variety of symptoms that result in patients of all ages being seen in ERs, primary-care offices and by specialists, making it challenging to diagnose, according to Klein.
Acute pericarditis can occur spontaneously or be caused by infection, kidney failure, a heart attack, cancer, radiation treatments or trauma, according to the Cleveland Clinic.
In some cases, the condition can be chronic.
For months beginning in May 2012, Azlant didn’t give much thought to his nagging, hacking cough that wouldn’t go away.
When he awoke in the middle of one night that summer unable to catch his breath, he mapped out all the ERs between his home in Stow and his financial consulting job in Stark County that day in case he took a turn for the worse.
“I knew things were not good,” he said. “I felt no energy. I felt tired.”
At the urging of his colleagues, he went to his primary-care doctor, who immediately sent him to a hospital in suburban Cleveland, where he was diagnosed with an infection and sent home.
When he wasn’t feeling better a week later, his doctor sent him to a cardiologist for another opinion.
An echocardiogram (cardiac ultrasound) revealed a buildup of fluid in the sac around his heart, which was treated with a surgical procedure. The cardiologist at Hillcrest Hospital referred him to Klein, who ordered a cardiac MRI that revealed “very, very severe inflammation” according to the doctor.
With aggressive “triple therapy” treatment and follow-up monitoring for a year, the patient was cured, Klein said.
“He was a complete success with a very severe beginning,” Klein said.
Cheryl Powell can be reached at 330-996-3902 or firstname.lastname@example.org. Follow Powell on Twitter at twitter.com/abjcherylpowell.