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Dennis Schultz felt like a truck running out of gas.
He had no strength to mow the lawn. He couldn't go on walks without running out of breath. He "ran out of air" just trying to take trash to the curbside.
"I knew something wasn't quite right," says the 50-year-old resident of Riverside, Iowa. "I wasn't tired. I could still do my job as a truck driver but that was mostly sitting behind the wheel."
Schultz wisely decided to visit his family physician, Michael Jurgens, MD, at UI Family Care, Southeast Iowa City. Jurgens diagnosed him with exercise-induced dyspnea, a narrowing of the airway in which the mucosal lining becomes irritated.
"In addition, he had several risk factors including elevated cholesterol, smoking, and family history," Jurgens says.
Based on those considerations, Jurgens referred Schultz to Neal Weintraub, MD, a cardiologist with UI Heart and Vascular Center at University of Iowa Hospitals and Clinics.
A graded exercise test showed only subtle signs of heart disease, but they were enough that Weintraub felt a coronary angiogram was justified. This decision was validated when the angiogram showed significant atherosclerosis (blockages in his coronary artery), apparently as the result of mixed hyperlipidemia (see below).
Schultz was then taken to the cardiac catheterization laboratory, where interventional cardiologist Phillip Horwitz, MD, placed two drug-coated stents to open a blockage in the right coronary artery. This treatment, along with medication, addressed Schultz's heart disease.
"Overall, I would say the prognosis is very favorable," Horwitz says.
Jurgens adds that the entire sequence of care demonstrates the best example of cooperation among primary care providers and specialists.
"Everyone worked toward the common goal of not only making the patient well, but keeping the patient well," he says. "This type of working relationship is not always easy to establish, but is well worth the effort as Mr. Schultz's case demonstrates."
Schultz praises the medical care he received and ultimately credits his religious faith with playing a role in his recovery. "God has always taken care of me," he says.
Since undergoing treatment, Schultz has regained his energy. He can once again mow his half-acre yard by hand and more actively help his wife, Daina, care for the couple's 8-year-old son.
"I feel great," Schultz says. "They did everything for me that I needed, and I mean everything. I couldn't have gotten better care, or quicker, treatment. I thank them all."
For more information, patients and families may:
For consultation or referral, physicians should call UI Consult.
—Michael Sondergard
At a glance
Mixed hyperlipidemia (or dyslipidemia) is a common condition characterized by high levels of low-density lipoprotein (LDL) cholesterol, triglycerides (TGs), and non-HDL (high-density lipoprotein) cholesterol, and low levels of HDL cholesterol. This pattern is strongly associated with obesity, diabetes, and the metabolic syndrome. Treatment often involves combination therapy with two or more drugs.
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