Departments and Specialties

Cardiac Services

Ronald Graniero participates in a supervised workout at The Joel Opatut Cardiopulmonary Rehabilitation Program at Monmouth Medical Center. The program offers individualized exercise and educational programs for patients with cardiac or pulmonary conditions

Ronald Graniero's story

The morning of December 14, 2006 started out like any other for Ronald Graniero. At his travel agency in Oakhurst, he began the day with some light aerobics in the office when all of a sudden an extreme tightness came over his chest. The events of the next several hours would change his life forever.

The days leading up to December 14 were routine in every way for the Oceanport resident. Admittedly in good health, with low stress, Graniero enjoyed jogging, swimming and tennis. A heart attack was the farthest thing from his mind.

But the when the extreme tightness came upon his chest that morning and he began to sweat, Graniero knew exactly what it was. “When it hit me, I knew I was having a heart attack,” he said.

Generally, symptoms of a heart attack include angina, which is a broad description for pain or discomfort in the middle of the chest also felt as squeezing, pressure, aching, burning or tightness. Other signs of a heart attack include pain or discomfort in the jaw, upper body, arms, shoulder or stomach; sweating, shortness of breath; nausea and/or vomiting, dizziness or extreme weakness.

Fortunately for Graniero, he was educated on the signs of a heart attack and he knew just what to do. He quickly took an aspirin and called 9-1-1. According to the American Heart Association, research has shown that getting an aspirin early in the treatment of a heart attack, along with other treatments an emergency medical technician or emergency physician can provide, can significantly improve a patient’s chances of survival.

When the Oakhurst Paramedic Squad arrived at Graniero’s office, he specifically asked to be taken to Monmouth Medical Center, an affiliate of the Saint Barnabas Health Care System, in Long Branch. It took only 10 minutes to get to the hospital and an emergency team was ready when he arrived.

In 2005, the Society of Chest Pain Centers granted every hospital within the Saint Barnabas Health Care System the designation of Accredited Chest Pain Center. The Saint Barnabas Health Care System was the first and only system in New Jersey to achieve this designation and is among a distinguished group of only 141 hospitals nationwide. This designation sets apart hospital emergency departments with this designation as the place to go for anyone experiencing chest pain.

Jennifer Waxler, D.O., Medical Director of the Emergency at Monmouth Medical Center, said, “This designation is a definite benefit for patients with Acute Coronary Syndromes in terms of earlier aggressive and preventative multidisciplinary treatment plans.”

Heart attacks are the leading cause of death in the United States, with 600,000 people dying annually of heart disease. More than five million Americans visit hospitals each year with chest pain. Dr. Waxler explained that in Monmouth’s Emergency Department, the approach taken with patients experiencing chest pain or a coronary event allows physicians to reduce time to treatment during the critical early stages of a heart attack, when treatments are most effective. “We can more rapidly diagnose and treat them, ensuring that they are properly cared for,” Dr. Waxler added.
Once Graniero arrived at Monmouth Medical Center’s Emergency Department, he was put under the care of emergency physician Elizabeth Gilman, MD. An EKG, or more formally called an electrocardiogram, was performed. This test measures electrical signals created by the heart as it beats and can determine if a patient is having a heart attack. In Graniero’s situation, this in fact was the case. After it was determined he was heart attack, Graniero was sent for cardiac catheterization.

Monmouth Medical Center’s Cardiac Catheterization Laboratory provides invasive cardiac services, offering the most advanced technology for the diagnosis of a wide range of cardiac disorders. Cardiac catheterization is a tool used to determine if the coronary arteries have become blocked or narrowed due to fatty deposits of plaque which can lead to a heart attack. As plaque buildup increases, it becomes difficult for the arteries to supply enough oxygen-rich blood for the heart to work properly. If the artery becomes totally blocked, a heart attack can occur.

During Graniero’s cardiac catheterization, a narrow and flexible tube called a catheter was inserted into a blood vessel and guided towards his heart. The catheterization can show if the arteries are blocked, if the heart is pumping normally and if there are any structural heart problems.
Graniero’s catheterization revealed one of his arteries was blocked and he would require angioplasty with stents. Percutaneous Transluminal Coronary Angioplasty, also known as PTCA, is performed during cardiac catheterization for the purpose of opening a partially blocked blood vessel so that it can flow through more easily. A small balloon was inflated inside the narrowed blood vessel in Graniero’s heart. The balloon helps widen the blood vessel and improve blood flow. A stent, or a tiny mesh tube was put in place in side the artery wall to keep the vessel wide open and strong.

One of the greatest benefits of angioplasty is that the procedure is less invasive and has a shorter recovery time than other types of treatment including bypass surgery. For Graniero, that meant three days in Monmouth Medical Center’s Intensive Care Unit, and then a few more days on the cardiac unit before being discharged home on December 22.

“This was my first time in the hospital and everything went better than I could have expected,” Graniero said. “The staff was so very cooperative. Everyone was just great!”

After recuperating at home, Graniero began cardiac rehabilitation in January. The Joel Opatut Cardiopulmonary Rehabilitation Program at Monmouth Medical Center offers individualized exercise and educational programs for patients with cardiac or pulmonary conditions. Workouts are conducted under the supervision of registered nurses and respiratory care practitioners.

Graniero said, “These nurses are very much involved in my recovery, which has made great strides in a matter of weeks.”

Louise Balligan, RN, manager of the Cardiopulmonary Rehabilitation Center, said, “Our highly specialized staff works closely with physicians to meet our patients’ individualized needs. We monitor a patient’s heart rhythm, rate and blood pressure to measure the body’s response to exercise.”

The 12-week program features state-of-the-art fitness equipment including treadmills, arm ergometers, rowing machines and stationary bicycles. The cardiopulmonary rehabilitation program is open to individuals who have had heart bypass surgery, valve replacement surgery, a heart attack, angioplasty, stents or stable angina. A referral from a physician is required to participate in the program, which is covered by most major medical insurance plans including Medicare, Balligan said.

For Graniero, having a heart attack was not something he anticipated in his life, but like the millions of Americans who have these episodes each year, he is fortunate to be alive today to talk about his experience.

“I am lucky,” Graniero said. “The people at Monmouth Medical Center saved my life.”

For more information on cardiac services available at Monmouth Medical Center, call 1-888-SBHS-123 or call Cardiology Services
(732) 923-5000 extension 31295. If you or a loved one ever experience symptoms of a heart attack, always call 9-1-1 immediately.

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