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Unusual Diagnosis Leads to Lasting Patient-Doctor Relationship By Dr. Stephen Portz

Unusual Diagnosis Leads to Lasting Patient-Doctor Relationship By Dr. Stephen Portz

Ask Nick Giorgione what he has learned about his heart condition during the past 13 years, and the 26-year-old can get very specific.The Henderson resident knows walking up stairs will leave him winded. He has experienced firsthand that sprinting on a treadmill will trigger a device in his chest to administer internal electric shocks.

Nick is also certain of something else: He has a comprehensive understanding of his hypertrophic cardiomyopathy, a wide-ranging cardiac disease, thanks to cardiologist Dr. David Navratil with HealthCare Partners Cardiology.

Navratil has served as Nick's cardiologist for 13 consecutive years, demonstrating the personalized care that serves as the crux of HealthCare Partners' Total Care Model. "On the list of people most crucial to my life, Dr. Navratil is at the top," Nick says.

Cardiac Issues at a Young Age
At an evening football practice in 2001, Nick noticed he felt strange. The 13-year-old suddenly saw everything suddenly grow fuzzy. He woke up still on the field to paramedics leaning over him with defibrillator paddles. It was the first cardiac arrest of his life. "I just knew I was at football practice and I wasn't supposed to be on the ground," Nick says.

When he was transported to Desert Springs Hospital, Nick's father, Steven Giorgione, sought the expert opinion of Navratil, an old family friend who is board-certified in internal medicine, cardiovascular diseases and cardiac electrophysiology. Navratil quickly diagnosed Nick with hypertrophic cardiomyopathy. The condition involves the heart muscle becoming abnormally thick, making it difficult for the organ to pump blood. Symptoms can range from mild to severe, with some patients at high risk for sudden death.

Within a week, the cardiologist surgically implanted an automatic implantable cardioverter defibrillator (AICD) into the teenager's chest. The device monitors his heart rate and administers shocks to the heart in response to any issues that arise. "I have fewer than a dozen of these cases in my practice, and none of them are as aggressive as Nick's condition," Navratil says.

The Total Care Model
Navratil was the clear choice to remain Nick's cardiologist following his diagnosis, initiating a doctor-patient relationship that has lasted more than a decade. "I trust him because he's seen everything I've gone through," Nick says.

This ongoing continuum of care is an important component of the Total Care Model practiced by HealthCare Partners Nevada, a medical network serving more than 300,000 patients a year. The organization offers 290 primary care providers and more than 1,700 specialists across Southern Nevada.

HealthCare Partners has experienced many successful patient stories like Nick's through the Total Care Model, a unique approach to health care focusing on comprehensive, patient-focused care. Under this approach, primary care providers, specialists and professional staff work as a coordinated team to manage all aspects of patients' care and overall health.

Battling for Control
Nick initially struggled to accept his diagnosis. His case of hypertrophic cardiomyopathy involves high risk of cardiac arrest during physical activity. This was crushing news for Nick to hear at 13 years old, when, at already more than 6-feet tall, competitive sports were his passion.

Navratil offered a broad-minded prognosis, allowing Nick to follow his passion for sports while carefully monitoring his symptoms.

Nick learned the hard way he could never be as active as he wished, experiencing two heart attacks within a month when he tried playing competitive basketball. With Navratil's support, Nick resolved to finding other avenues for success."Navratil gave me the confidence that this condition wasn't going to kill me," Nick says.

Nick always felt free to discuss any questions with his cardiologist. Navratil has continued to meet with him throughout the years to review tests and consult with Nick following any additional incidents. The cardiologist conducted two more surgeries for Nick's AICD. When Nick needed a hand operation at 18 and the doctor on duty casually mentioned turning the AICD off, Navratil responded to Nick's concerns by visiting the hospital and ensuring that the device would stay on during the procedure. "I always know he's the one who can handle anything related to my condition," Nick says.

Looking Forward
Nick has since found many accomplishments outside athletics. He recently graduated from law school at the William S. Boyd School of Law, and he is currently studying for the bar exam. He still sees Navratil at least twice a year, he adds. He hopes one day to apply his personal experiences to support youths facing similar cardiac conditions.

Navratil commends his patient's persistence with managing the condition throughout the years."Nick has done very well living with a disease that can be challenging for many people," Navratil says. "He can still enjoy most things in life." Nick plans to continue doing so, with Navratil's ongoing assistance. "You couldn't pay me to go to a different cardiologist," he says.



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