A skipped heartbeat reveals a silent and serious heart risk

Jeff Shultz was putting his new exercise machine to good use, staying on top of his fitness routine. The 71-year-old Lancaster County business owner, already active with his work as a custom interior painter, spent his days climbing ladders and scaffolding. In his free time, he enjoyed cycling and tackling yard work. He kept a close eye on his blood pressure, helping ensure his health was in check. Overall, the Armstrong World Industries retiree was feeling great.  

That’s why Shultz was both surprised and alarmed when one day while working out, he checked his pulse and noticed his heart was skipping a beat. 

He immediately reached out to his primary care provider who detected a heart murmur, ordered a series of tests, and referred him to Robert J. Rokowski, MD, FACP, a cardiologist with The Heart Group of Lancaster General Health. Upon reviewing his chart, Rokowski noted Shultz was a candidate for early surgery and encouraged him to see Mark Epler, MD, chief of cardiac surgery at Penn Medicine Lancaster General Health. 

An unexpected diagnosis: thoracic aortic aneurysm 

Shultz’s tests revealed a thoracic aortic aneurysm—an abnormal expansion of the main blood vessel in the chest. Because thoracic aortic aneurysms may grow silently without causing symptoms, people like Shultz with this condition are often unaware they are at risk of a life-threatening rupture.  

The testing also showed Shultz also had a bicuspid aortic valve (BAV), rather than the normal tri, or three-leaflet aortic valve. BAV is a congenital heart condition—one that people have from birth, increasing their risk of developing a thoracic aortic aneurysm. Epler stressed that in order to avoid a major cardiac event, Shultz would need open-heart surgery to fix the bicuspid aortic valve and the aneurysm. 

Shultz admitted this news was jarring but recalled the peace of mind his doctors offered. Epler reassured him of the surgery’s excellent outcomes that would not only save his life but also improve it.  

“Dr. Epler said my heart would be stronger with a new valve, I would have a better quality of life, and the surgery would give me many more years,” he recalled.  

In addition, because Lancaster General Hospital is the only hospital in Lancaster County that offers cardiothoracic surgery, Shultz was grateful he could receive this advanced care close to his home.  

While he waited for his surgery date and prepared for the journey ahead, Shultz followed doctors’ orders, avoiding heavy lifting and strenuous activity. He knew to call 911 immediately if he developed any intense chest pain.  

Aortic aneurysm and valve replacement surgery  

Shultz’s surgery involved both replacing his ascending aortic aneurysm along with his diseased bicuspid aortic valve. Cardiothoracic surgeons at Lancaster General Hospital perform this open-heart surgery more than 80 times each year with excellent success rates. Shultz’s experience was no exception.  

After a week of recovery in the hospital and seven at home, he began to feel like himself again. Twelve weeks later he was back to his interior painting work.  

Reflection and gratitude  

While Shultz’s physical recovery had some challenges, the exceptional care he received during his hospital stay left a lasting impression. 

“Everyone who treated me gave the best care. The staff were incredible, offering support and kindness every step of the way,” he said.   

As he looked back on the early days of his diagnosis, Shultz admitted he still couldn’t quite believe how quickly everything changed.   

“This came out of the blue,” he said of his heart issues. “Before I was diagnosed, I was scooping mulch and really working out.” Open-heart surgery was the furthest thing from his mind, and he is grateful he was surrounded by the team at Penn Medicine Lancaster General Health.  

He praises Epler and Rokowski not only for their medical expertise, but for the time and care they took to thoroughly explain his condition and recovery process. Their efforts and expertise gave him the reassurance he needed. Thanks to the exceptional care of the entire team, Shultz said he is back to normal and feels as though his heart issues never even took place.