Beating Expectations

Comprehensive Local Resource for Heart Care Tied to OHSU

As Dr. David Guarraia recounts the story of one recent patient, it quickly becomes apparent how important a resource the MCMC Cardiology clinic has become for Gorge-area residents with heart-related conditions.

Recently, after reading the results of a stress echocardiography test given to a local patient complaining of chest pains, Dr. Guarraia’s partner, Dr. Kevin Wei, referred the patient for a diagnostic angiogram. The result of that test led physicians at Oregon Health & Science University to schedule immediate, and what may have been lifesaving, bypass surgery.

“In less than a week, that patient went from experiencing chest pain to being home starting his rehabilitation after open-heart surgery,” Dr. Guarraia says. “That kind of turnaround is rare even in big cities.”

That said, it is also an example of the kind of comprehensive, responsive system of heart care that Dr. Guarraia envisioned when he signed on with MCMC after the hospital and OHSU agreed to collaborate on a local cardiology clinic.

That was only five years ago, but seems much longer considering all the growth that has occurred at MCMC Cardiology in that time.

“When we opened it was just an RN, an administrative assistant and me. We were located in an office up by the hospital, and we were seeing about four or five patients a day,” says Dr. Guarraia, who came to The Dalles immediately after completing a three-year cardiology fellowship at OHSU.

At the time, Dr. Guarraia had said that, in addition to his love of the Gorge, he chose this opportunity because “I like the idea of building something in this community that hasn’t existed before.”

Five years later, that mission has been accomplished. Only two years after the clinic opened, Dr. Kevin Wei, an echocardiography specialist, came on board to help Dr. Guarraia take care of the dramatically growing number of patients seeking local heart expertise. Today, the MCMC Cardiology staff has grown to include a nurse practitioner, an RN, three medical assistants, an echocardiography technologist and various other team members.

The clinic’s diagnostic capabilities and facilities have grown significantly as well. MCMC Cardiology is now located at Water’s Edge in The Dalles but also has offices in Goldendale and Heppner, and both Drs. Guarraia and Wei maintain their faculty appointments at OHSU.

While patients with a wide range of heart-related issues now rely on MCMC Cardiology for their care, they typically have one of four underlying conditions, Dr. Guarraia says.

“The predominant issues we see are related to high cholesterol, high blood pressure, coronary artery disease and atrial fibrillation, or abnormal heart rhythm,” he says.

Most patients can be treated locally, but anyone requiring open-heart surgery or more highly specialized care is assured of experiencing seamless coordination of care because of the clinic’s close relationship with OHSU.

In another example of the benefits of that collaboration, in 2012 OHSU became the first hospital on the West Coast to successfully use a procedure to replace a patient’s heart valve without requiring open-heart surgery. That patient was a Goldendale resident, who was first seen at the MCMC clinic before being referred to OHSU.

“It’s really a luxury for people in a region this size to have access to the level of specialty and sub-specialty care that is now available locally and through our relationship with OHSU,” Dr. Guarraia says.

It’s also a luxury residents of the region can get used to, he adds. “Dr. Wei and I both love the Gorge; we’re not going anywhere.”

Ask your primary care provider if an appointment with an MCMC heart specialist is appropriate for you.