Making a Caring Heart Strong Again

Constance (“Connie”) Mohammed’s mission and job are to help others in the community. For more than 30 years, she has worked for the city of Boston as a community service advocate and currently serves senior citizens in the Mattapan and Hyde Park neighborhoods. A self-described “jack of all trades, master of all,” Connie has a comprehensive knowledge of the programs and services in each neighborhood, and works hard and passionately to ensure the needs—from health to housing—of those she cares for are met. “I do it all,” Connie explains. “If someone is returning home from a hospital stay, I will coordinate all of the components, like meals and a home aide, to make sure that the person can continue to get better.” 

Connie gives the same amount of energy and commitment to herself as she does to the community. Diagnosed with a heart murmur, she has always been diligent with her check-ups at Boston Medical Center, where she sees her primary care physician, Robert Witzburg, MD. Because of her diagnosis, Connie saw Witzburg twice a year so he could closely monitor the murmur. “We focused on a detailed assessment of her functional status—her level of activity—and her cardiac exam,” Witzburg explains.

Due to a slow but steady progression of her condition, Witzburg increased the frequency of her echocardiograms. With each close evaluation, Witzburg found it was still safe for Connie to continue to go about her inherently active lifestyle, which was reassuring to her. However, on the eve of a routine check-up last spring, Connie felt extremely and uncharacteristically anxious. Noting this to Witzburg, he listened to her heart and observed that it sounded different. “Her cardiac exam had changed,” says Witzburg. “This led to an urgent referral to cardiology for additional testing.” Witzburg immediately contacted Gene Valsky, MD, in the Cardiovascular Center at BMC, who listened to her heart shortly thereafter. “They sprang into action,” Connie remembers.

“When I listened to Connie’s heart and read her echocardiogram, I noticed there was a decrease in her heart’s function. Her aortic valve looked tight,” Valsky explains. “I called Dr. Witzburg and said, ‘We need to fix this right away.’” What Valsky found was that Connie had a severe case of aortic valve stenosis. Normally, the aortic valve opens and closes, allowing blood to flow from the heart to the body. For Connie, the three “leaflets” that open and close in the aortic valve had become calcified—the passageway that the blood moved through was much narrower—and her heart had to work a lot harder to pump blood to her body. The only way to repair this was through valve replacement surgery.

Even though it was an unexpected diagnosis—“I was like a walking bomb,” notes Connie—and the idea of needing life-saving surgery can be scary, Connie felt the compassionate care she received from everyone was comforting. “The way everyone worked together as a team—it was just beautifully orchestrated. They took the time to explain things to me, and did so in a way where I could fully understand what was happening,” says Connie. In addition, her medical team also made sure the replacement valve used would fall in line with her religious beliefs, as certain considerations needed to be made regarding animal-derived surgical implants. Out of respect for Connie’s faith, her surgeon opted for a mechanical valve and the surgery was a complete success. “She sailed through the surgery beautifully,” adds Valsky.

On the road to recovery, the next step was to make Connie’s heart strong again through BMC’s Cardiac Rehabilitation program. Certified by the American Association of Cardiovascular and Pulmonary Rehabilitation, the overarching goal of the program is to improve cardiac health and reduce the risk of future cardiac events. Since every patient’s case is different, each rehabilitation plan is tailored to one’s specific needs and priorities. “After a cardiac event, patients tend to feel nervous and anxious about exercising,” says Carol McNally, RN, coordinator of the program. “We make sure that when the patient comes to cardiac rehabilitation, they feel confident and comfortable with what they are doing. That’s our number one priority.”

The program does much more than get patients exercising again—they also provide nutritional, educational and psychosocial support for needs that arise due to their cardiac event. The team accomplishes this by performing an extensive evaluation, including an examination from the Director of Preventive Cardiology and Director of the Cardiac Rehabilitation program, Gary Balady, MD. “That’s what makes this program particularly special. Dr. Balady sees each and every patient before they begin,” McNally explains.

With the help of her team of doctors, nurses and exercise physiologists, Connie is back to living a full and normal life. “Connie is vibrant and active and with this surgery and cardiac rehabilitation, we were able to allow her to keep living that way,” says Valsky. She continues to see Witzburg regularly and Valsky listens to her heart every six months to make sure it is on track for getting stronger.

Connie is back to working full-time, and to say that she was eager to return would be an understatement. “On September 14, I was given the okay to go back to work. On September 15, I was back at work,” says Connie, with a laugh. “I’m going on like I did before,” she concludes. “I feel rejuvenated. I feel happy. Everyone—especially my surgeon, who is so special to me—squeezed life back into my heart.”