by Barbara Curtis
There are many ways to describe Tom Krause – avid cyclist, traveler, poet, project manager and IT professional. On June 9, 2015, he would add another to the list that few have lived to tell: sudden cardiac arrest survivor.
That month, Krause was looking forward to a two-week bicycle ride where he and other members of the White Clay Bicycle Club would cycle roughly 1,000 miles from Cornog, Pennsylvania to Niagara Falls. He trained regularly, cycling 50 to 60 miles per ride, but just days prior to the event, he experienced sudden cardiac arrest while at work.
Nearly a decade before his cardiac event, Krause was having chest pain and visited Rita Falcone, MD, a noninvasive cardiologist with Chester County Cardiology Associates. A stress echocardiogram showed he had a blockage in his left anterior descending artery (LAD). Dr. Falcone referred him to Timothy Boyek, MD, Catheterization Laboratory Director at Chester County Hospital, who inserted a medicated stent in Krause during an interventional cardiac catheterization. For 10 years, Krause experienced no chest pain and remained an avid cyclist.
The morning of his 2015 cardiac arrest, Krause went to work like any other day. As he wrapped up an afternoon meeting, he walked back to his desk to write an email to his colleague Josh Bricks. Another peer sitting directly across from him, Dan Gerber, jokingly asked Krause if he was sleeping. Overhearing, Bricks ran to see Krause slouched over and immediately saw the signs of a cardiac episode. He quickly began performing CPR while another colleague dialed 9-1-1.
Fortunately for Krause, his employer had hosted a CPR demonstration several years earlier, which gave Bricks and his colleagues the confidence to make swift decisions. Combined with the assistance of 9-1-1, they were able to keep his heart pumping while waiting for help.
Once the police arrived, an Automated External Defibrillator (AED) was placed on Krause and a shock was delivered. CPR was continued and approximately one minute later, he regained a pulse. Paramedics transported him to Chester County Hospital but on the way, Krause experienced two more episodes where he went into cardiac arrest and required additional CPR and defibrillation.
When he arrived at the Emergency Department, Krause was quickly admitted for an emergency catheterization, where Dr. Boyek would discover a new blockage beyond the original stent in his LAD. Dr. Boyek successfully treated the new blockage with two medicated stents. Two days later, Richard Hui, MD, Medical Director of Electrophysiology, implanted a dual-chamber Implantable Cardioverter-Defibrillator (ICD) to treat the possibility of a recurrent cardiac arrest.
Krause recovered from surgery and returned to his active lifestyle. A year later, he was riding his bicycle uphill and noticed chest pain. He thought the pain may have been the beginning of a cold so he brushed it off. A week later, he rode that same hill and felt chest pain a second time. This time he decided to call his doctor.
He immediately scheduled a visit with Dr. Falcone, who detected a third new blockage in the same artery, upstream of all his previous stented sites. This new blockage could not be treated safely with additional stents so Krause was recommended for bypass surgery. He was referred to Steven Weiss, MD, Chief of Cardiac Surgery.
“There were two things I really liked about Tom,” said Dr. Weiss. “One, that he returned to an active lifestyle that likely allowed him to detect his new blockage sooner than a sedentary person. Second, that he recognized his chest pain as cardiac-related the moment he biked up that same hill and then he quickly acted upon it.”
Dr. Weiss performed a Minimally Invasive Direct Coronary Artery Bypass (MIDCAB) in Krause’s LAD. Since he only needed one bypass, Dr. Weiss was able to perform the surgery through a small two to three-inch incision under his left breast. By performing a minimally invasive operation, Krause was able to recover and return to work and recreational activity much sooner.
“Even though Tom watched his diet, took all of his appropriate medications, and exercised regularly through cycling, he continued to develop new disease consistent with a high risk and strong genetic code to develop blockages that could be life-threatening. This is a rare case of progressive and aggressive coronary artery disease but clearly, his story had a happy ending,” added Dr. Boyek.
Today, Krause is back to writing poems, training for his next long-distance cycling event and telling stories of his latest travel experience in Alaska. After his sudden cardiac arrest, he wrote a poem about a key component of why he is still alive today, “I have asked many of people what they would do – sadly CPR would be done by a very few. It is important to know CPR; hands-only is fine – but it is no good if you don’t use it in time. Due to my friends, I am back on my bike and driving my car. Do your loved ones a favor and learn CPR.”
Timothy Boyek, MD and Richard Hui, MD are also Cardiologists at Chester County Cardiology Associates.