When a murmur becomes serious

“The nurses and all the staff at RWJUH Rahway and NBI were fantastic”

As a commercial paralegal at a busy law firm, Linda Kurak is always on the go. “I help attorneys coordinate closings, review title obligations and prepare documents to make sure everything runs smoothly,” she says.

Early last year, however, the 73-year-old Iselin resident began to feel tired. She didn’t sleep well and sometimes had trouble climbing the stairs leading to her home.

She attributed the cause to a heart murmur she had lived with all her life. “I was struggling to get through each day, and when I went to bed, I could hear my own murmur,” she says.

Howard L. Levitt, M.D.

But Linda put off seeking treatment. Then, on April 1, 2023, she felt chest pain that radiated to her left arm. She went to an urgent care clinic near her home. “They did an EKG and told me I needed to go to the emergency room right away,” Linda says. She went to Robert Wood Johnson University Hospital (RWJUH) Rahway right away.

Breakthrough treatment

In the RWJUH Rahway emergency room, doctors rushed to stabilize Linda and treat her symptoms. Cardiologist Howard Levitt, MD, worked to find the cause of her problem. “Her murmur was consistent with a condition called aortic stenosis,” says Dr. Levitt, director of cardiology at RWJUH Rahway.

Aortic stenosis occurs when the aortic valve—the largest of the heart’s four valves—begins to narrow, restricting blood flow to the rest of the body. “The degree of stenosis can be mild, moderate, severe, or critical,” says Dr. Levitt. Linda’s stenosis had reached critical levels.

In the past, open-heart surgery was the only way to treat severe aortic stenosis. Today, patients like Linda can benefit from a newer, less invasive approach called transcatheter aortic valve replacement (TAVR).

During a TAVR procedure—performed in a cardiac catheterization lab—an interventional cardiologist inserts a catheter into an artery, usually in the groin, and then threads a replacement valve through the catheter into the heart. Once the new valve is in place, the doctor uses the catheter to open it, restoring normal blood flow.

“TAVR was initially used only for patients who were too high a risk for open-heart surgery, but over time it has proven to be effective for people who are intermediate and low risk,” says Dr. Levitt. “In Linda’s case, I knew TAVR would get her back on her feet and recover quickly.”

Sergio Waxman, MD, MBA

Coordinated care

As a patient at RWJUH Rahway, Linda had seamless and convenient access to the highly specialized TAVR procedure at Newark Beth Israel Medical Center (NBI). Both hospitals are part of the RWJBarnabas Health system, which also meant Linda could return to RWJUH Rahway and receive coordinated follow-up care locally.

“We operate as one Cardiology Department operating in two locations,” says Dr. Levitt.

As soon as Linda was cleared for TAVR, Dr. Levitt and his team arranged for an ambulance to transport her to NBI. “We were there in just 12 minutes,” Linda says. Interventional cardiologist Sergio Waxman, MD, MBA, chief of the Division of Cardiology at NBI, performed Linda’s TAVR. She went home the next day.

“The nurses and everyone at RWJUH Rahway and NBI were fantastic,” Linda says. “Everyone was so nice. And Dr. Levitt took really good care of me. He’s very laid-back and outgoing. He addressed all my concerns and made me feel comfortable.” Just two weeks after her TAVR procedure, Linda returned to work. In the months that followed, she faithfully attended follow-up appointments at RWJUH Rahway’s outpatient cardiology clinic, which offers both scheduled and walk-in visits.

She’s also made some lifestyle changes to help keep her heart healthy in the long run. “I no longer eat fried foods or fat, and I eat a low-sodium diet,” she says. “I also limit sweets.”

Linda’s experience taught her a valuable lesson she now shares with others. “When your body tells you something, listen,” she says. “I should have sought help for my heart murmur sooner. I’m lucky things turned out the way they did.”

Aortic Stenosis: A Subtle Disease

Although aortic stenosis is the most common form of heart valve disease, it often causes only mild or moderate symptoms and can be difficult to diagnose. “It tends to come on gradually as you get older,” says Howard Levitt, MD, director of cardiology at Robert Wood Johnson University Hospital Rahway.

Common symptoms, in addition to a heart murmur, include shortness of breath, fatigue, and dizziness. “The problem is that most people who experience these symptoms attribute them to aging or poor health, so they don’t seek help,” says Dr. Levitt. “That means they may not get care unless it’s an emergency.”

If you experience any of the symptoms of aortic stenosis or hear a heart murmur, seek help from a cardiologist.

Learn more about transcatheter aortic valve replacement at RWJBarnabas.