June 16—A potentially fatal heart attack that struck an otherwise fit bicyclist last month had a happy ending, thanks to a combination of fortunate circumstances, CPR and Springfield medical expertise.
"I'm a miracle of medicine," said the cyclist, David Burtle, recovering at his Springfield home after the May 16 incident that involved multiple bystanders performing cardiopulmonary resuscitation for more than 20 minutes before emergency medical responders arrived.
"Without them people, I'm gone," said Burtle, who will turn 45 on Sunday and isn't expected to deal with any lasting physical or mental ramifications. "This was a time bomb waiting to happen. It was just the best scenario, with the best people around me."
One of the bystanders, fellow cyclist Dr. Geoffrey Bland, said, "There's no doubt that CPR made all the difference."
Bland was among the cyclists, including several more doctors, who were with Burtle on a 27-mile workout ride through Springfield's west side and sections of rural Sangamon County.
Bland, 62, a Springfield Clinic family medicine specialist who happens to be Burtle's personal physician, performed CPR the longest after Burtle lost consciousness and drove into a grassy ditch along North Lincoln Trail about 10 miles into the ride.
"I think it was pure adrenaline that kept me going," Bland said.
Burtle and Bland were among about 30 adults that day who took part in one of the two weekly, evening rides that have gone on for several years in the spring and summer among moderate- to advanced-level local cyclists.
Springfield Fire Department emergency medical technicians who were dispatched to the rural area along Lincoln Trail, about 5 miles west of Abraham Lincoln Capital Airport, used a defibrillator to shock Burtle's heart into a safer rhythm twice.
Before that happened and Burtle was brought by MedicsFirst ambulance to HSHS St. John's Hospital, Bland and five other people—including three more physicians—worked frantically to keep him alive.
In addition to Bland, those performing CPR included fellow cyclists Steve Schien, 53, and Scott Robinson, 45, as well as Dr. Dustin Stehling, 37, a Springfield Clinic obstetrician-gynecologist who happened to be driving by and stopped to help.
Also at Burtle's side were cyclists Dr. Timothy Van Fleet, 50, an Orthopedic Center of Illinois surgeon who kept Burtle's head and neck stable, and Dr. Nicole Sommer, 46, a plastic surgeon at Southern Illinois University School of Medicine who monitored Burtle's pulse.
Once Burtle was at St. John's, Prairie Cardiovascular cardiologist Dr. Jeffrey Goldstein used a catheter to open a blocked heart artery known as the "widow maker" and inserted a stent to keep the vessel clear.
Burtle, a longtime auto mechanic at S&K Buick and a former U.S. Marine, said he has been interested in cycling most of his life. He also is a weight lifter and overall fitness buff and said he never was diagnosed with any chronic health problems. He and his wife of 20 years, Missie, 45, both used to be personal trainers.
Burtle said his late mother, a smoker, had heart problems apparently related to a bout with scarlet fever as a child. He didn't think he had much risk of heart disease. He added that he has never smoked, his cholesterol level is low, and he eats healthy, though his "big vice" was Dr Pepper soda—about four cans a day.
Burtle, who has taken part in triathlons in the past, is a regular rider at the Tuesday and Thursday workouts. He said he has gotten to know the other riders but tends to talk with them about cycling and not about their careers and backgrounds, though he knows several are doctors.
He said he doesn't remember anything about the day of the heart attack, but Schien, the cyclist riding next to him on May 16, clearly recalled what happened.
Schien and Burtle were leading the pack as they reached a level section at the top of a hill when Burtle, who was to Schien's left, swerved farther to the left and yelled, "Whoa!"
Burtle righted his bike, then veered to the left again, went into the ditch and fell over.
Bland, who was about 100 feet behind the pair, saw Burtle slump down on his bike before going into the ditch. "It was clear to me that he was unconscious before he hit the ground," Bland said.
Burtle, who stands 5 feet, 6 inches tall and weighs about 160 pounds, had no detectable pulse when on the ground. "He was either dead or near death," Bland said.
Bland began CPR within seconds and continued for seven or eight minutes. He then switched off with Robinson, Schien and Stehling, with the group performing CPR for a total of 24 minutes.
Bland said he ended up cracking two of Burtle's ribs during CPR, which Bland said meant the chest compressions were being done correctly.
It was obvious that the CPR was working—by keeping blood circulating—because Sommer began to feel Burtle's pulse, according to Bland. And when the EMTs arrived, they detected a blood oxygen level of 84 percent, which Bland said reflected the benefit of CPR.
This is the first time Bland performed CPR on someone outside a hospital, and he noted that it's rare for people in such situations to survive, even when they get CPR. If Burtle had been riding or exercising alone and had this heart attack, he likely wouldn't have made it, Bland said.
The American Heart Association says effective CPR from bystanders can double or triple a person's chance of survival, but only 32 percent of cardiac-arrest victims get CPR from a bystander and less than 8 percent of people who suffer cardiac arrest outside a hospital survive.
Burtle's cyclist friends learned a few hours after the incident that he was still alive. But he had many ups and downs in the 10 days he spent at St. John's as he went through the cooling treatment and drug-induced coma that ultimately helped him get through the medical crisis, his wife said.
He also spent two days as an inpatient at Memorial Medical Center undergoing physical therapy.
Doctors told Missie Burtle that her husband's good physical condition contributed to his survival and lack of lasting damage. In addition to the broken ribs, he suffered a broken clavicle in the fall and a concussion.
David Burtle is undergoing physical therapy and said he hopes to return to work, even on a limited basis, in the next few weeks. His adopted daughter, Cassie Aldridge, 32, of Springfield, has organized a fundraising event, complete with food and a silent auction, to help offset lost wages and any out-of-pocket medical costs not covered by Burtle's employer-sponsored health insurance.
The fundraiser is scheduled from noon to 5 p.m. Saturday at the Stadium Bar and Grill, 2300 N. Peoria Road.
Missie Burtle, an office worker at S&K, said she is grateful for the local cyclists and medical experts at Springfield hospitals who came to her husband's aid.
She said she and her husband consider themselves "spiritual" but aren't churchgoers. She said something more than luck saved her husband.
"He should not be here," Missie Burtle said. "There's absolutely no way somebody wasn't looking out for him."
Goldstein said it may be frustrating to the general public that Burtle had a heart attack despite his clean living. But Burtle's near-death experience, Goldstein said, underscores the fact that heart disease is the nation's No. 1 killer.
"If it can strike David Burtle, it can strike anybody," he said.
Experts say that half of all heart attacks occur in patients without obvious symptoms of heart disease such as shortness of breath or chest pain.
What apparently happened is that fatty deposits already present in Burtle's arteries broke off for some reason and caused a total or near-total blockage that led to the heart attack, Goldstein said.
One lesson from Burtle's story, Goldstein and Bland said, is that people should pay attention, and talk with their doctors, when it comes to risk factors, especially if they smoke, have diabetes, high blood pressure or other chronic conditions, as well as a family history of heart disease.
A specialized X-ray scan of the heart known as "calcium scoring" might have given some indication of whether Burtle was at risk of a heart attack, Goldstein said. Patients may want to talk with their doctors about the value of such a test, he said.
Schien, an employee of Velo Mine, a local bike shop, said the experience made him more appreciative of life and the compassion of the local cycling community.
Bland said he and the other cyclists finished their ride May 16 after Burtle was driven away. Later that night, after he learned Burtle survived, Bland said he rewarded himself with a long shower and two glasses of wine.
"After much reflection, I can honestly say that we did the best that could have been done under the circumstances," Bland said. "I'm glad it worked out so well—a great team effort."
Robinson, a correctional officer at Logan Correctional Center, said the happy ending for Burtle has given him an emotional lift.
"It's a surreal feeling that you don't want to get over," Robinson said. "We are all glad that we were there so he could pull through and stay around a while longer."
Scientific evidence is unclear when it comes to the overall effectiveness of "calcium scoring" tests, though local doctors say such a test may have helped detect heart disease in David Burtle ahead of his May 16 heart attack.
The test is an X-ray of the heart -- actually a computed tomography (CT) scan -- that measures the presence of calcium deposits in the arteries feeding the heart muscle. Calcium can build up over time when fatty deposits also are present.
The higher the calcium score, the higher the risk a patient may face for having the fatty buildups in vessels that can lead to a heart attack, according to Prairie Cardiovascular cardiologist Dr. Jeffrey Goldstein.
But Goldstein uses results from such a test as just one risk factor to consider when it comes to whether a patient should be recommended for medicine to lower cholesterol levels, an interventional test such as an angiogram or a procedure such as angioplasty.
"It's one of several tools that we have," he said.
The U.S. Preventive Services Task Force, the federal agency that weighs the pros and cons of tests, says there isn't enough evidence to recommend for or against calcium scoring in patients who don't have obvious symptoms of heart disease. Certain tests can lead to false positives or false negatives. They can generate worry and lead to unnecessary or dangerous follow-up tests. So the task force considers whether any unintended consequences are worth the overall benefit.
The finding on calcium scoring came out in 2009, and the task force is looking into updating the recommendation based on the latest research.
Goldstein said patients might want to seek insight from their doctors as to whether they could benefit from calcium scoring.
The test, which often isn't covered by health insurance, is available to patients without the need for a doctor's order at Decatur Memorial Hospital and at Decatur's St. Mary's Hospital, for $39. That price includes a physician's interpretation of the scan, officials from the hospitals said.
Memorial Medical Center in Springfield offers calcium-scoring scans, including the physician interpretation, for $95, but a doctor's order is required. Scans can be scheduled by calling 788-3200.
HSHS St. John's Hospital will offer calcium scoring without a doctor's order beginning July 1 for $99, according to Kristin Doster, executive vice president of Prairie Heart Institute. The scans will come with a call to patients from a cardiologist explaining the results, she said.
Patients can schedule scans at St. Mary's or St. John's by calling Prairie Heart Institute at 788-0706.
Scans at Decatur Memorial can be scheduled by calling 876-1111.
-- Dean Olsen
Want to go?
What: Fundraiser for heart-attack survivor David Burtle of Springfield, father of four adopted children.
When: Noon to 5 p.m. Saturday.
Where: Stadium Bar and Grill, 2300 North Peoria Road
Details: 50/50 raffle, silent auction, $7 per plate of food, live DJ.
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