Young patient survives mitral valve prolapse

Josephus “Joey” Rimorin was on a flight to Las Vegas to attend a work party when he started to cough. The coughing continued throughout the three-day trip, but he still managed to have a pleasant time enjoying the food and sights of Las Vegas with his wife and civil engineering coworkers. But after returning home to San Diego, Joey, age 44, had a strange feeling that his cough was something more serious.

“I went to check out a Bonsai exhibit in Balboa Park,” Joey says. “That morning, I kept on coughing — the cough took my breath away. I could not breathe well, and it felt like I would die.”

Joey was taken to the Sharp Chula Vista Medical Center emergency room and shortly after, the unthinkable happened: Joey went into cardiac arrest.

After giving CPR, the medical team was able to resuscitate Joey. But it was clear he was very sick. Joey required high doses of IV drips to maintain his blood pressure. His lungs were also unable to oxygenate his body well, and he required support with a breathing machine called a ventilator.

The intensive care unit (ICU) team worked diligently to diagnose what led to his cardiac arrest.

“When a patient as sick as Joey arrives in the ICU, we first work to stabilize the patient,” says Dr. Nicholas Huynh, medical director of the ICU at Sharp Chula Vista. “In Joey’s case, this included providing CPR and performing additional lifesaving interventions, including initiating prone positioning, to allow Joey's lungs to provide more oxygen to his body.”

Once Joey was stable, the doctors obtained an echocardiogram, or ultrasound of the heart, to further identify the cause of his sudden cardiac arrest. Seeing the results, Dr. Huynh knew immediately what had to be done. “I was able to contact our excellent team of cardiologists and cardiothoracic surgeons for the appropriate intervention plan,” he says.

An unexpected diagnosis

The echocardiogram revealed an acute chord rupture of his mitral valve, which is one of the valves on the left side of the heart. Multiple causes can contribute to this condition, including preexisting valve disease and valve infections.

According to Dr. Kambiz Shetabi, an interventional cardiologist affiliated with Sharp Chula Vista, the team then obtained another ultrasound of the heart. It showed significant leakage through the mitral valve.

“This was a crucial step to figure out what happened to the patient and plan for treatment,” Dr. Shetabi says. “His mitral valve was severely damaged and part of it was ruptured, which was shown on the echocardiogram. Due to this condition, a significant portion of blood was leaking back into the lungs instead of pumping forward into the aorta.”

Joey’s condition rapidly deteriorated as the blood from his heart overwhelmed his lungs and his organ function declined. He was transferred to Sharp Grossmont Hospital’s Burr Heart & Vascular Center, where a surgical team performed heart surgery.

Doctors inserted a temporary Impella® pump in his heart, which is a device to help the heart pump oxygenated blood from the heart to the rest of the body. Joey also underwent a mitral valve replacement.

“This required open heart surgery during which we replaced his mitral valve with an artificial valve,” says Dr. Alexandra Kharazi, a cardiothoracic surgeon affiliated with Sharp Grossmont Hospital and Sharp Chula Vista Medical Center. “The Impella device helped us support him in the perioperative [around the time of surgery] period while he was in shock. He was able to recover well after the valve replacement.”

Positivity, patience and healing

After a stay in the ICU to recover, Joey was discharged. He has plans to transition to outpatient physical therapy once his doctors feel he is ready. In the meantime, he looks forward to returning to work, but understands he still needs to have patience, as his heart is still on the mend.

“I can still feel my chest inside, it is still healing,” says Joey. “My work is stressful, and I am still taking medications for my heart. So I want to make sure that when I do go back to work that I am healthy enough to deal with the stress of my job.”

Along with working with his doctors to strengthen his heart and body, Joey is also more proactive about his lifestyle. He says he is more watchful of what he eats, now calling himself “health conscious.”

“I do miss working — for the most part,” Joey says. “But, I am just trying to keep myself busy with things that are not stressful, like caring for the Bonsai trees I have. I am also just trying to stay positive.”

Gratitude keeps him going

As he reflects on the past few months of treatment and rehabilitation, Joey is grateful for all the doctors, nurses and support staff who cared for him. “I am so thankful for the Sharp HealthCare medical teams, including the cardiovascular medical teams, and Dr. Mehran Mandegar, my pulmonologist, who was there every day checking on my recovery and progress,” he says.

Along with being grateful, Joey is also more aware of the fragility of life. He shares that what happened makes him recognize how precious life is.

“I was not the only one going through this,” Joey says. “It was not just me, it was also my family. And I don’t want them to go through that again.”

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