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Healthy You

DNA Unravels Heart Health Mystery

Wednesday, September 05, 2018 7:24 AM

Yvette Horne’s examination by a cardiologist three years ago was unplanned, but it ultimately saved her life. Horne had just logged onto NorthShoreConnect to schedule her yearly mammogram online when she noticed information about women’s heart health, including a list of warning signs.

Yvette Honre

“I read through it and thought ‘Hmm, that’s been happening to me the last couple nights,’” she recalled.

Horne quickly went to the NorthShore Skokie Hospital Emergency Department and was seen by Cardiologist Philip Krause, MD. He confirmed the 67-year-old Evanston resident suffered a minor heart attack due to blockages in her coronary arteries. “I was healthy and had no family history of heart issues,” said Horne. “I couldn’t understand why this was happening.”

Lurking Danger
Dr. Krause, Division Head of Cardiology, worked quickly, placing stents in two coronary arteries to open up the blockages and restore normal blood flow. Horne recovered, but at the time she had no idea of a hidden genetic issue—one that would continue to pose a threat to her health.

Horne began experiencing shortness of breath and sluggishness a year later while on a golf trip—the same symptoms she experienced prior to her heart attack. Once home, she made a follow-up appointment with Dr. Krause who performed a series of tests revealing a very rare condition: a narrowing of the stents caused by another dangerous plaque build-up in her coronary arteries.

“To have the build-up return so quickly definitely raised questions about why this was occurring,” Krause said. “Fortunately, we were able to catch it in time and treat it.”

Genetic Intervention
Dr. Krause referred his patient to NorthShore Cardiovascular Institute colleague David Davidson, MD, Director of Preventive Cardiology. In conjunction with the Center for Personalized Medicine, Dr. Davidson focuses on the genetic origins of heart disease and recommended Horne undergo genetic testing. Both physicians hold academic titles at the Pritzker School of Medicine.

DNA testing found that Horne carries a mutation in the Lipoprotein(a) [Lp(a)] gene, which makes her susceptible to plaque build-up in her arteries.

“This was great information to have and it allowed us to develop a much more precise treatment plan for Yvette,” said Dr. Davidson. “It’s critical that her cholesterol levels be kept in check.”

Horne was put on a more intensive cholesterol-lowering statin drug, along with blood pressure medicationand a daily aspirin.

Treating the Whole Person
Dr. Davidson, who also heads the Cardiovascular Institute’s Weight Loss Management Clinic, advises patients on diet, exercise and other lifestyle changes.

“I’ve always been health-conscious, but now I understand the genetic source of my condition and can specifically address it with Dr. Davison,” said Horne. “It’s wonderful to be at a place like NorthShore with this expertise on hand.”

Horne has encouraged her two sons to undergo genetic testing to see if they have the same genetic mutation. “I was just really lucky,” added Horne, “and I don’t want them to get to the same point.”

Dr. Davidson does not want his patients to rely on luck either. “Personalized Medicine is the future,” he noted. “It’s exciting to be able to tap into someone’s genetic information as we did for Yvette, and apply therapies based on their unique profile.”