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Fall 2013 - Patient Profile: Luck of the Irish

Prompt, Knowlegable Attention to Minor Chest Pains Averts Disaster

H2H Fall 2013 Luck Irish

Brian Sean McNeely was born on St. Patrick’s Day and has always joked that he’s a leprechaun with a happy-go-lucky demeanor. He certainly had the luck of the Irish on his side on January 27. McNeely experienced an aortic dissection, a rare and serious condition that comes on suddenly, often with no previous risk factors or history of heart disease.

Dr. Bryon Boulton, a cardiovascular surgeon with Carolina Cardiovascular Surgical Associates explains, “The wall of an artery has three layers – an aortic dissection occurs when a tear in the inner two layers forces the layers apart and allows blood to flow within the vessel’s walls. It’s a major, life-threatening emergency. Approximately 60 to 70 percent of patients won’t survive without immediate surgical intervention depending on the location of the dissection.”

“I woke up and just didn’t feel right, but the pain was so unremarkable that I almost went back to sleep.” McNeely describes the “pain” as a toothpick running through the center of his chest and back through his shoulder blades. It was so minor, he almost wouldn’t describe it as pain. In fact, he drove himself to the WakeMed Brier Creek Healthplex Emergency Department where he was promptly evaluated with no sign of heart attack.

Per protocol, McNeely was transferred to the WakeMed Raleigh Campus Chest Pain Unit for further evaluation. Initial testing pointed to a simple infection of the lining around the heart, but to confirm the diagnosis, cardiologist Dr. Charles Mangano of Raleigh Cardiology ordered a CT scan and an echocardiogram and instead found an aortic dissection.

“This is not a common condition, so it’s often misdiagnosed,” explains Dr. Mangano. “We often call it the Great Masquerader, because it can present as chest, shoulder or back pain and can mimic a heart attack, a blood clot in the lung, pericarditis, or even a pulled muscle. Early diagnosis and treatment are the keys to survival.”

“Once my results came back, things got very quiet and started moving quickly,” Mc- Neely recalls. “The next thing I knew, I had a heart surgeon in front of me saying, ‘We need to talk.’ Dr. Boulton told me I had experienced something called an aortic dissection, and I immediately remembered John Ritter. I looked at Dr. Boulton with disbelief and said, ‘Like John Ritter?! But, he died!’ That was when I realized the seriousness of my condition, and I was off to surgery before I knew it.”

The surgery required removing part of McNeely’s aorta and replacing it with a synthetic graft. It lasted nearly 13 hours.

H2H Fall 2013 Luck Irish doctors

Dr. Boulton explains, “While this condition affects less than one percent of the total population, it is seen on a fairly routine basis at WakeMed, and we have teams in place 24/7 to diagnose and treat emergencies. In this case, it was 8 p.m. on a Sunday night, and our team was immediately ready, prepping for surgery.”

“I was in the right place at the right time,” explains McNeely. “There aren’t many places with a top-notch cardiothoracic surgeon like Dr. Boulton and such a phenomenal and thorough cardiologist as Dr. Mangano. I feel very blessed that I chose WakeMed that day. I have never been this passionate about any organization, any group of doctors, nurses and support staff as I am about WakeMed.”

Today, McNeely is back to work and living his life with a renewed sense of enthusiasm. He has lost over 75 pounds and says he’ll continue to lose weight by eating less and taking care of himself. He takes medication to keep his blood pressure below the normal minimum because high blood pressure is a risk factor for aortic dissection.

“I just hope my experience can serve as a lesson to others to LISTEN to your body,” concludes McNeely. “If I had gone back to sleep and ignored what seemed like pretty unremarkable symptoms, I probably wouldn’t be here today.”

As a single dad with four young children – two sets of twins, ages 9 and 12, he doesn’t have much downtime. “I’m convinced part of the reason I’m still here is to care for my kids. They need me and I need them.”