Fainting became commonplace for Brenda in 2021. She and her husband, John, were so accustomed to what they called "blood pressure crashes" that they developed a routine.  

"I would feel dizzy, nauseated and sweaty, and (I would) alert my husband. He would run for a bucket and a cold compress. I would lie on the ground and get my feet up," Brenda shares.  

John would check her blood pressure. Once she stabilized, they would go about their day.  

Brenda, then 53, attributed the episodes to traveling too much for work or not drinking enough water, especially because many occurred on hot days in her home state of Arkansas.  

"I had an excuse every time," she says.  

But in 2023, as she headed out for a run with John — her favorite leisure activity — Brenda fainted and couldn't get back up. John called an ambulance.  

Watch: Dr. Guru Kowlgi explain cardioneural ablation

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After extensive testing at the hospital and a review of Brenda's smartwatch health data, her physician found that the fainting episodes coincided with drops in her heart rate. Brenda received a pacemaker, a device implanted under the skin that sends small electrical impulses to the heart to keep it from beating too slowly or pausing too long.   

But the fainting episodes continued. Brenda also experienced fatigue, brain fog, hair loss and inflammation throughout her body.  

"I'd gone from a person with great energy and vitality to someone who struggled to walk. I was trying every remedy possible," Brenda says.  

She tried cold plunges, gluten-free and dairy-free diets, and intermittent fasting. She took 13 different medications and multiple vitamins, and she stopped air travel. Nothing worked. She lived in constant fear that something was seriously wrong with her heart.  

Brenda continued checkups with her local care team. Despite her symptoms, she kept receiving the same report: "Your heart is fine. Your pacemaker is working. You're good." 

In April 2025, before Brenda left to visit her home country of Ireland, a nurse practitioner who had been part of her care team from the beginning expressed concern about Brenda's condition and advised her to seek care elsewhere. The nurse practitioner referred Brenda to Mayo Clinic, and soon afterward, Brenda and John made the 10-hour drive to Rochester, Minnesota. 

Finding the cause of years of fainting 

In September 2025, after months of extensive evaluations at Mayo Clinic, Brenda met Guru Kowlgi, M.B.B.S., a cardiologist and cardiac electrophysiologist. 

She walked into the appointment with little hope, expecting him to deliver the same message she had heard from other physicians: "You're fine. Keep doing what you're doing."  

Instead, Dr. Kowlgi said, "Brenda, we know exactly what the issue is, and we have a plan to solve it." 

"I couldn't believe it. John and I felt relieved to finally have answers," Brenda says.  

Brenda was diagnosed with vasovagal syncope, a common condition that causes fainting when the vagus nerve triggers a drop in heart rate and blood pressure.   

"A pacemaker is usually the last treatment option for patients like Brenda, but it does not solve all their issues," says Dr. Kowlgi.  

Pacemakers treat slow heart rates, which are the result of vasovagal syncope, but do not address the root cause. Thus, Dr. Kowlgi says patients may continue to have lightheadedness, and even faint, and the condition can significantly affect quality of life.  

For Brenda, Dr. Kowlgi recommended a specialized procedure called cardioneuroablation, also referred to as cardioneural ablation. The procedure uses a catheter to target and ablate, or destroy, areas around the nerve cells in the heart that contribute to the abnormal reflex.   

"It is like a recalibration," explains Dr. Kowlgi. "Since the vagus nerve activity is high, we are trying to blunt it and bring it closer to normal."   

Using cardioneuroablation to target the cause  

Dr. Kowlgi first performed cardioneuroablation at Mayo Clinic in 2022 and has helped advance its use for vasovagal syncope.   

Cardioneuroablation builds on techniques used in cardiac ablation procedures to treat heart rhythm disorders. Dr. Kowlgi is among the physicians using the approach to treat vasovagal syncope, including in patients with pacemakers, such as Brenda. 

In 2024, Dr. Kowlgi performed cardioneuroablation for the first time on a patient with an existing pacemaker. "We started building on that experience. I realized there was an opportunity to not only make patients' symptoms better but to remove pacemakers, which can cause a multitude of issues, especially when implanted in young patients who would otherwise live with them for life."  

Brenda underwent the procedure in October 2025. "When I came off the operating table, I could feel my energy coming back. I was out walking within a week," Brenda says.  

Within two months of the procedure, Brenda went from having her pacemaker provide pacing 40% of the time to no pacing, and her symptoms resolved.  

She spent Christmas in Rochester, skiing with her family for the first time in years. In February 2026, Brenda's pacemaker was removed.  

Returning to running, traveling and family life 

As Dr. Kowlgi continues clinical research on cardioneuroablation and its potential uses, Brenda and John are reclaiming their life together.  

"I thought I'd never be able to run another marathon or plan travel with John to see my mum in Ireland, our sons in New York and Kentucky, and visit the last state on our bucket list," Brenda says. "Now I run 3 to 4 miles a day and am about to go on a cruise to Alaska. It's not just me who got my life back, but my family did too." 

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On June 17, 2026, Kayla Gengler walked through the doors of Mayo Clinic in Rochester, Minnesota, with her husband, AJ, and their youngest daughter, Ida. 

The date carried more than one meaning. It was Ida's first birthday. It was Kayla and AJ's ninth wedding anniversary. And it marked one year since a rare and life-changing obstetric emergency required multiple Mayo Clinic care teams to respond within minutes. 

Watch: Suspected amniotic fluid embolism leads to maternal cardiac arrest and rapid ECMO response at Mayo Clinic

Journalists: Broadcast-quality video (2:28) is in the downloads at the end of this post. Please courtesy: "Mayo Clinic News Network." Read the script.

What happened when Kayla suddenly collapsed at 39 weeks pregnant? 

A year earlier, Kayla, then 33, was 39 weeks pregnant with the couple’s third child. She was at Mayo Clinic receiving care late in her pregnancy when her condition suddenly changed. While being monitored, Kayla reported severe nausea and heart palpitations before losing consciousness.  

Kayla’s care team, including obstetrician Vanessa Torbenson, M.D., immediately called for an emergency cesarean delivery.  

"Moving rapidly was essential. If too much time passed, blood flow to the uterus could have been reduced, putting both mother and baby in danger," says Dr. Torbenson.  

In situations this complex and fast-moving, having obstetrics, anesthesia, and critical care available within minutes can make a crucial difference. Those teams began mobilizing simultaneously as Kayla's condition deteriorated. 

Four minutes later, Ida was born safely as another team continued working to stabilize Kayla.  

Then, Kayla's heart stopped. 

How did Mayo Clinic respond when Kayla went into cardiac arrest? 

When Kayla went into cardiac arrest, Mayo Clinic’s ECMO team was activated immediately.  

Extracorporeal membrane oxygenation, or ECMO, is a form of temporary life support that can assist heart and lung function during critical illness. It requires specialized equipment and a team certified to manage patients whose condition can change rapidly. 

At Mayo Clinic, maternal cardiac arrest triggers immediate consultation with the ECMO team, allowing specialists to assess the need for advanced life support while resuscitation continues. In Kayla's case, ECMO preparation began as other teams worked to restore and stabilize her circulation. 

Troy Seelhammer, M.D., an anesthesiologist, critical care physician and medical director of Mayo Clinic's ECMO Program, was on call that morning. 

"We had a very short window to try to save Kayla’s life," Dr. Seelhammer says.  

 Within minutes, specialists, ECMO equipment and transportation resources were mobilized across Mayo Clinic campuses.  

"Cases like this are incredibly rare," Dr. Seelhammer says. "Survival depends on having experienced, multidisciplinary teams that can quickly come together while remaining coordinated throughout the patient's journey." 

Why did Kayla's emergency require so many specialized teams? 

For Kayla, several urgent needs were developing at once.  

The obstetric team needed to deliver Ida while continuing efforts to stabilize Kayla. While in cardiac arrest, critical care and ECMO specialists were needed to provide advanced life support. Nurses, transport teams and other specialists helped coordinate care, equipment and movement across Mayo Clinic as her condition changed. 

Mayo Clinic's team-based model brought together specialists from across disciplines who routinely work side by side, allowing Kayla's care plan to evolve rapidly as new challenges emerged.

Later, when imaging revealed that Kayla had experienced multiple strokes, neurologic care became part of her treatment.  

What is an amniotic fluid embolism? 

As Kayla stabilized and began recovering in the intensive care unit, specialists from several disciplines worked to understand what had caused her sudden collapse. 

The exact sequence of events remains uncertain. Kayla's care team determined that an amniotic fluid embolism, or AFE, was the most likely explanation. 

AFE is an exceptionally rare obstetric emergency that can occur when amniotic fluid or fetal material enters the mother's bloodstream and triggers a sudden, severe reaction. It can develop during pregnancy, labor or delivery and may rapidly lead to breathing and circulatory failure, abnormal blood clotting and cardiac arrest. 

"There is no single test that can confirm AFE, and it can happen without warning or an obvious cause," Dr. Torbenson says. 

AFE is estimated to occur in about 6 of every 100,000 pregnancies in the U.S. 

Why was Kayla's case so medically complex? 

Surviving the initial cardiac arrest was only the beginning of Kayla's medical course. 

Further imaging revealed that Kayla had experienced multiple strokes. During the evaluation, her care team also discovered a previously undiagnosed opening in her heart, called a patent foramen ovale, or PFO. 

Kayla’s physicians say this opening may have provided a pathway for amniotic fluid in her bloodstream to pass through the heart and reach the brain, potentially contributing to her strokes. 

The combination of suspected AFE, cardiac arrest, ECMO support and multiple strokes made Kayla's case unusually complex. It also meant her care did not end when the immediate emergency passed. 

Recovery would require time, specialized care and continued support. 

What does recovery look like after an obstetric emergency? 

After 31 days in the hospital, including nearly two weeks of inpatient rehabilitation, Kayla was able to return home. 

Recovery was not simple. The strokes left Kayla with lasting effects on her vision, cognition, balance and movement. Vision loss in both eyes meant losing her ability to drive, while weakness and nerve pain in her legs made everyday activities more difficult.  

The emotional recovery has been just as real. 

"At first, I was just so happy to be home with my kids," Kayla says. "Now, I’m learning more about what happened, and there is a bigger emotional piece. I’ve come down from that initial high and am learning to live with a disability." 

As she navigated the physical and emotional challenges of recovery, Kayla leaned on the support of those around her. 

While many memories from the weeks after Ida's birth remain unclear or missing for Kayla, both Kayla and AJ vividly recall the love that surrounded their family from those who stepped in to provide help and encouragement. 

"What I will always remember is the positivity of all the people who sent food and lent a helping hand. There's just so much kindness in the world," says Kayla.

One year later, a return to Mayo Clinic 

One year after the emergency, Kayla, AJ and Ida chose to mark the anniversary by walking through the doors of Mayo Clinic again.  

They came to reunite with some of the physicians and nurses who had cared for them, including Dr. Torbenson and Dr. Seelhammer. 

For Kayla and AJ, the reunion offered a way to reclaim a difficult anniversary. 

"It's so special to be here," Kayla says. "We get to celebrate Ida's first birthday and we get to celebrate all of life's amazing moments." 

For the physicians and nurses, seeing the family together again was a reminder of what coordinated care had made possible. 

"This is what really keeps us going," Dr. Seelhammer says — seeing patients return to their families and their lives after illness. 

Kayla’s recovery continues, and she is still adapting to physical challenges that have changed parts of daily life. But she holds close the ordinary moments with AJ and their children — walks, bedtime routines and watching them grow. 

Those moments are possible because, when a rare obstetric emergency unfolded without warning, specialists from across Mayo Clinic came together within minutes to deliver highly coordinated care. As Kayla's needs evolved from emergency delivery to cardiac resuscitation, ECMO support, neurologic care and rehabilitation, teams across disciplines remained connected at every stage. 

The expertise required to manage each complication was different, but the goal was shared: helping Kayla return to her family. 

No single specialty carried her through the experience. Her care moved seamlessly from one team to the next, with specialists working together to meet each new challenge as it emerged. 

“We drew on years of planning, experience and team training to bring the right resources rapidly to Kayla’s bedside,” says Troy Seelhammer, M.D.. “That preparation allowed teams across Mayo Clinic to respond together when she needed them most."

The post Suspected amniotic fluid embolism leads to maternal cardiac arrest and rapid ECMO response at Mayo Clinic (VIDEO)  appeared first on Mayo Clinic News Network.

After years of testing performed at multiple hospitals that could not explain his intense, and sometimes painful, symptoms, long-distance runner Mike Singh found answers through an athlete-specific approach at Mayo Clinic, helping him adapt his routine and continue running. 

A marathon moment that raised questions 

In November 2018, long-distance runner Mike Singh was competing in a marathon when he suddenly felt that something was not quite right. 

"I was on mile 22 or 23,” Mike remembers. "All of a sudden, I felt sort of out of breath, lightheaded. I thought I was having a heart attack." 

However, as a confident athlete who had completed many races, Mike kept going and finished the race without further incident. 

It would not be a one-time experience, though. The symptoms would often return during Mike's runs, usually when he pushed himself at longer distances. 

More than just exercise 

Running is, and has long been, a central part of Mike's routine. 

"It's not just exercise for me," he says. "Running is a huge part of my life and identity. The thought of losing that was a lot to process." 

Mike runs daily and trains for races throughout the year. So when something did not feel right during that 2018 marathon, it stood out significantly to him. 

Years of tests, no answers 

Early on, Mike sought care at multiple hospitals and medical centers, undergoing extensive testing. 

Despite numerous evaluations, the results always came back the same — no explanations, no real answers. Still, the symptoms continued during Mike's long runs, and so did the uncertainty. 

"I passed all those clinical tests with flying colors," Mike says. "But all that did was leave me with questions, unanswered questions." 

Up to that point (nearly four years into Mike's medical odyssey), no one had been able to re‑create the symptoms he experienced while running. 

Mike decided to visit the Mayo Clinic Sports Cardiology Clinic in Rochester, Minnesota, hoping a different approach could finally explain what others could not. 

Re-creating the run 

At Mayo Clinic, the Sports Cardiology team met Mike and focused on understanding when and how his symptoms occurred. As Mike described the clinical signs, the team immediately identified one key detail: Mike's symptoms typically began several miles into his long-distance runs. 

Instead of relying on standard tests, the team focused on re-creating the exact conditions that triggered his specific symptoms. 

"If symptoms are not reproduced on a stress test, you can't definitively say the test is negative," explains Nadia Elfessi, a physician assistant on Mike's care team in Sports Cardiology. 

"My care team said, 'Let's just do whatever is necessary to re-create those symptoms,'" Mike says. 

 To do that, Mike ran long enough to trigger the exact symptoms he experienced during long-distance races. Then, while those symptoms were still occurring, the Mayo Clinic team moved immediately into testing. 

Because Mike's symptoms had eluded diagnosis for years, the team also developed a customized testing protocol to evaluate whether abnormal vagus nerve activity was contributing to the problem. Drawing on Mayo Clinic's expertise in cardioneural ablation, specialists temporarily blocked vagal activity with medication and had Mike exercise again under carefully monitored conditions. 

For the first time, the team was able to observe changes in Mike's heart rhythm as they happened. While the testing ruled out vagus nerve overactivity as the cause of Mike's symptoms, it revealed an underlying problem with his heart's electrical conduction system, helping the team arrive at a diagnosis and management plan tailored specifically to him. 

Finding the cause 

Now, Mike had an answer.  

"They adapted the protocols to fit my situation," Mike says. 

Dr. Guru Kowlgi, a cardiac electrophysiologist at Mayo Clinic, says the team's approach focused on recreating the exact conditions that triggered Mike's symptoms — something that had not happened during years of previous testing. 

Once the symptoms were reproduced, the team identified a disruption in the electrical communication between the heart's upper and lower chambers that occurred only during intense exertion. The findings led to a diagnosis of exercise-induced chronotropic incompetence, a rare condition in which the heart cannot appropriately increase its rate during physical activity. 

"It took a level of creativity and time that went beyond a standard evaluation," Dr. Kowlgi says. 

Why it was difficult to detect 

Exertion made the difference. 

"High-level athletes, like Mike, may only experience symptoms when they're pushing themselves at nine-tenths or even ten-tenths of maximal performance," says Dr. Darrell Newman, a cardiologist and director of Mayo's Sports Cardiology Clinic. 

Choosing a path forward 

With a diagnosis in hand, Mike's medical odyssey was over. He now had options. He now had hope that he could possibly pursue his love of running throughout the rest of his life. 

One option was a pacemaker to help regulate Mike's heart rhythm, but it was unclear whether it would improve his symptoms enough to return him to his desired level of performance. Rather than pursue a pacemaker, Mike chose a personalized management plan focused on adjusting his training and monitoring his symptoms during exercise. As part of that approach, he uses wearable technology to track his heart rhythm and capture electrocardiogram (ECG or EKG) recordings that he can share with his Mayo Clinic care team. 

Still running — with a different approach 

Today, Mike still runs regularly, but his approach has changed. 

"It's a little bit of an inversion," he says. "Instead of my heart adjusting to my level of effort, I have to do the opposite and adjust my level of effort to my heart rate." 

"I can take that ECG, send it to the Mayo team and get pretty quick feedback," he says. 

Today, Mike continues to run (and compete), adjusting his effort but not giving up. 

"I'm still able to do it," Mike says. "Working with the experts at Mayo Clinic, I am able to continue living my lifestyle. I just enjoy running so much. It is a huge part of my life, and the Mayo care team was able to give that back to me."  

A new understanding 

For Mike, having answers made the difference. 

"It wasn't a simple answer, and not having any answers after so many years of searching can be defeating and also disheartening," Mike says. "But having this team of experts at Mayo just take time with me, work with me and find the information changed everything. In a manner of speaking, they saved my life, and they've allowed me to continue living that life." 

Today, Mike continues to run (a lot), adjusting his effort but not giving up the part of his life that matters so much to him. 

The post Racing to find answers: Yearslong search lands Mike Singh at Mayo Clinic  appeared first on Mayo Clinic News Network.

A simple 10-second heart test with the aid of artificial intelligence is helping physicians detect a serious, often-overlooked disease.

For Rochester businessman Mike Busch, that technology proved life-changing. After months of unexplained symptoms, an AI-enhanced ECG helped doctors at Mayo Clinic quickly uncover a diagnosis that might otherwise have been missed.

Watch: AI-ECG helps physicians detect hidden heart condition

Journalists: Broadcast-quality video (2:31) is in the downloads at the end of this post. Please courtesy: "Mayo Clinic News Network." Read the script.

At the age of 77, Mike Busch says he has no plans for retirement.

"I still work full time," he says.

Spending time with Carol, his wife of 51 years, running his business and promoting youth wrestling in the region means Mike is always on the go.

But in 2023, his health became a concern.

"I wasn't feeling well for a few months, felt like somebody was sitting on my chest," Mike says. "I kind of lost my balance and kind of fell a little bit. I knew I had to probably go in and see somebody. I had been putting it off too long, and went into Mayo."

His doctor ordered an electrocardiogram, or ECG. It's a simple 10-second test that records the heart's electrical signals. Unbeknownst to Mike, he had developed a heart condition called cardiac amyloidosis.

"Cardiac amyloid is a condition where abnormal proteins deposit in the heart. It makes the heart stiff and causes problems with heart failure," says Dr. Martha Grogan, a cardiologist and director of the Cardiac Amyloidosis Clinic at Mayo Clinic in Rochester, Minnesota.

"I kind of suspected something, but I didn't think it was that serious," Mike says.

His doctors were able to quickly diagnose him, thanks in large part to AI.

"Artificial intelligence, isn't it? I think," Mike says. "I'm not sure."

"The algorithm that we have to detect amyloid was strongly positive. Our scale goes from zero to 100, and he ranked a 98," says Dr. Grogan.

"It begins to learn what the patterns are, and then when it's all done, we can give it an unknown ECG and say, 'Is the pattern that suggests amyloid heart disease present, yes or no?' And it's a very powerful classifier. It can see signals that are hidden to humans," says Dr. Paul Friedman, a cardiologist and Norman Blane and Billie Jean Harty Chair, Mayo Clinic Department of Cardiovascular Medicine Honoring Robert L. Frye, M.D., at Mayo Clinic in Rochester, Minnesota.

That's vital for patients with cardiac amyloidosis, which is often misdiagnosed as other types of heart problems, delaying important treatment.

"I couldn't believe it, put it that way," Mike says.

This AI-ECG tool was developed at Mayo seven years ago and recently received FDA clearance.

"Since the introduction of the AI-ECG at Mayo Clinic, it's now been used over a million times by clinicians in screening for various heart conditions," says Dr. Friedman. "It's a powerful test, and it can have us point not our stethoscope but maybe our looking glass in the right direction, so we don't miss things that are important and that are treatable."

Mike takes his medication, continues to follow up with his doctors, and still stays busy.  

"I don't see any changes as far as my work ethic goes," he says. "I'm fortunate to be where I'm at, and I'm happy with Mayo Clinic and what they've done."

The post AI-ECG helps physicians detect hidden heart condition (VIDEO) appeared first on Mayo Clinic News Network.

Life on the mat 

For Casey Lamb, the mat has never just been a place to compete. It's where he's spent more than four decades teaching, mentoring and testing himself.

 "It's really who I am," Casey says.  

As a Brazilian jiu-jitsu instructor, gym owner and lifelong competitor, Casey's life has long revolved around helping others grow through the sport he loves. Then chest tightness during training forced him to imagine a future without the life he had spent decades building. 

A diagnosis that raised difficult questions 

While ramping up training at his Rochester, New York, gym for an upcoming jiu-jitsu competition and staying active with his children's wrestling, Casey began experiencing chest tightness and pressure. Having seen friends and students suffer serious heart-related emergencies, he decided not to ignore the warning signs. Hoping for reassurance and a quick return to training, he sought care at his local hospital. 

Instead, he left with an unexpected diagnosis: an ascending aortic aneurysm, a dangerous weakening of the body's largest artery that can tear or rupture without warning. 

Just as devastating for Casey, the diagnosis meant he was told to stop competing and avoid the heavy exertion that had defined both his work and personal life. 

At about 4.7 centimeters, Casey's aneurysm fell below the size threshold at which surgery is typically recommended. Physicians usually continue monitoring an aneurysm until it reaches 5 centimeters or larger. 

Until then, treatment often focuses on reducing risk through lifestyle changes, including avoiding heavy lifting and limiting strenuous activities that can place additional strain on the aorta. 

For Casey, avoiding strenuous activity wasn't a temporary inconvenience. Coaching, training and competing in jiu-jitsu were central to his livelihood and daily life.  

"I'd rather have 15 years doing what I love than 30 years miserable sitting in a chair," Casey says. 

For Casey, the diagnosis threatened far more than his health. It jeopardized the identity he had spent most of his life building. 

Searching for another option 

That conviction led Casey to seek another opinion at Mayo Clinic in Rochester, Minnesota. 

There, the conversation shifted. Instead of focusing only on the size of Casey's aneurysm, specialists from cardiology, vascular medicine, sports cardiology and cardiovascular surgery worked together to understand the person behind the diagnosis — his profession, his goals and the life he hoped to return to. 

Although his aneurysm had not yet reached the standard threshold for surgery, the demands of his life as a coach, competitor and gym owner called for a more individualized approach. 

"Guidelines are essential," says Dr. Thais de Azeredo Coutinho, a Mayo Clinic cardiologist and vascular medicine specialist in the Mayo Clinic Aortic Center. But they don't replace individualized care. Some patients deserve a closer look because their circumstances aren't fully captured by the guidelines. This was Mr. Lamb's situation." 

"It wasn't, 'Here's what you have to do,'" Casey says. "It was, 'Here are your options. What do you want to do?'" 

Rather than asking him to walk away from the sport, Casey's Mayo Clinic care team focused on helping him understand the risks, weigh his options and choose the path that aligned with his goals. 

"Let's figure out how to get you back doing what you want to do," Casey recalls. "We'll tell you the risks; we'll make the risks as low as possible; we'll let you know what they are; and you make the decisions." 

For the first time since his diagnosis, Casey saw a path forward — one that didn't force him to choose between protecting his health and preserving the life he loved. 

After weighing the risks with his care team, Casey decided surgery offered the best chance to continue the activities he wanted. 

A surgery built around his goals 

The expertise and collaboration he experienced at Mayo Clinic gave him confidence in that decision. 

"I believed I was at the best place to have this procedure, with the best surgeon and the best team," Casey says. 

Dr. Gabor Bagameri, a Mayo Clinic cardiovascular surgeon who specializes in complex aortic surgery, repaired the enlarged section of his ascending aorta while preserving his native aortic valve. 

"Our goal wasn't simply to repair the aneurysm," Dr. Bagameri says. "It was to repair it in a way that gave him the best opportunity to safely return to the life he valued." 

For Casey, the operation wasn't simply about repairing his aorta. It was about preserving something equally important: the opportunity to return to coaching, competing and the community he had built on the mat. 

Back to training 

Recovery didn't end after surgery. Working with Mayo Clinic's Sports Cardiology team, Casey gradually rebuilt the strength and confidence needed to return to high-level competition.   

Every walk, every rehabilitation milestone and every workout brought Casey one step closer to a single goal: getting back on the mat. 

"I knew if I made it through surgery, I would get back to where I was because that was the plan we had put together," Casey says.  

Just three months after surgery, that plan became reality. Casey stepped back onto the mats — not as someone watching from the sidelines but as a coach, mentor and athlete once again. 

"I was back on the mats," Casey says. "I was teaching classes. I was training again." 

For the first time since his diagnosis, Casey wasn't wondering what he might lose. He was back doing what he loved. 

His students once again had their longtime coach leading classes, demonstrating techniques and training alongside them. Stepping back onto the mat wasn't simply a return to training, it was proof that the future he feared might slip away was still within reach. 

"For someone like Casey, it's about helping him return to the activities that matter most while understanding the risks involved," says Dr. Kathryn Larson, a Mayo Clinic sports cardiologist who helps athletes safely return to activity after heart conditions and procedures. 

Looking ahead 

Nearly two years after surgery, Casey says he finally feels like himself again. 

Today, Casey continues coaching, training and preparing for future competitions, including a return to the World Master Jiu-Jitsu Championship. 

The chance to pursue those goals again is something he doesn't take for granted. 

"It's just the fact that I've gotten back to it at that level," Casey says. "Doing what I love and what I've gone through, in itself, it's a victory." 

For a man who once feared he might never return to the mat, stepping back onto it became more than a comeback. It became proof that personalized care can help restore the life that matters most. 

The post Personalized heart care helps a martial arts instructor return to competition  appeared first on Mayo Clinic News Network.

Tony Wazwaz was told he had days to live — until an innovative treatment approach at Mayo Clinic brought his heartbeat back into rhythm.

Tony Wazwaz is in his kitchen, cooking for his family. Clipped to his belt, two battery packs hum softly, powering the mechanical pumps inside his chest. One helps move blood to his body. The other to his lungs. Together, they do the work his heart no longer can. He takes his medications, sees his healthcare team regularly, and follows the routines that now keep him alive.

"It isn't easy," Tony says, "but I've never been more grateful."

Not long ago, his doctors in Minneapolis told the 44‑year‑old husband and father of two that no further treatment options remained. After months in and out of the hospital, his condition worsened as both sides of his heart began to fail. Fluid filled his lungs. Swelling spread through his body. Medications and temporary support devices no longer worked.

He was not a candidate for a heart transplant. Doctors told him he had about 10 days to live, and to go home to say goodbye to his family.

"That was the end of the road. There was no more road," Tony says. "But something inside me told me, 'You've got to keep fighting.'"

A new road ahead

Watch: Mayo Clinic performs its first dual mechanical heart pump procedure, giving father of two a path to transplant

Journalists: Broadcast-quality video (2:54) is in the downloads at the end of this post. Please courtesy: "Mayo Clinic News Network." Read the script.

At his mother's urging, he asked for a referral to Mayo Clinic. He made the call, got in the car and they drove to Rochester, Minnesota. He arrived in cardiogenic shock, a life-threatening condition in which the heart can no longer pump enough blood to sustain the body.

Within minutes of reaching the emergency department, his heart stopped.

"I flatlined," he says. "But when I woke up, I was in the ICU at Mayo Clinic, surrounded by a team already working to find a way forward."

Leading that team was Dr. Mauricio Villavicencio, surgical director of Heart and Lung Transplantation and Mechanical Circulatory Support at Mayo Clinic.

Dr. Villavicencio and his team moved quickly to stabilize Tony, ultimately placing him on extracorporeal membrane oxygenation, or ECMO, a form of life support that circulates blood outside the body, allowing the heart and lungs to rest.

"ECMO can keep you alive," Dr. Villavicencio says. "But it doesn't get you out of the ICU. The goal is to find a way to transition to something that allows the patient to recover, leave the hospital and move forward."

For many patients, that path involves a left ventricular assist device, or LVAD, a mechanical pump designed for long-term use that helps the heart move blood through the body. But those devices are designed to support the left side, the heart's main pumping chamber. Durable options to support the right side of the heart are limited. When both sides of the heart are failing, as in Tony's case, there are often no viable treatment options.

'Sign me up'

Dr. Villavicencio proposed something that had never been done at Mayo Clinic: implanting two durable LVADs, one to support each side of Tony's failing heart. He believed the paired devices could get him off ECMO, out of the ICU and potentially onto a path toward heart transplant eligibility.

Around Tony, a multidisciplinary team of surgeons, cardiologists, intensivists and nurses weighed the risks. They had spent weeks at his bedside, adjusting care and closely tracking his condition.

"Tony pushed the balance to do it," Dr. Villavicencio says. "And that really made it happen."

For Tony, the choice was clear.

"Sign me up," he says. "I knew this was my chance. From the time I arrived, it wasn't just one doctor, it was the whole team around me. They took the time to talk to me and get to know me. I trusted them."

A bridge to the future

Inside the operating room, the challenge was precision. Each pump had to be carefully balanced. Too much support on one side could overwhelm the other. Too little could send his organs into failure. Throughout the procedure, Dr. Villavicencio and the team adjusted the devices until his circulation stabilized.

With both pumps in place, blood flow steadied through his body. In the days that followed, his condition improved, marking a turning point in his recovery. Weeks after the surgery, Tony returned home.

Now, back in his kitchen, the rhythms of daily life have resumed as he rebuilds his strength and works toward a goal that once felt impossible: becoming eligible for a heart transplant.

"Going to Mayo Clinic saved my life," Tony says. "Dr. Villavicencio gave me another chance and I'm going to make the most of every minute."

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What began as a routine check for swelling quickly turned Randy Ramey's life upside down. When pneumonia and swelling were diagnosed as stage 4 cirrhosis of the liver, Randy, of Denton, Texas, struggled to understand how it was all connected. 

A series of visits with local specialists revealed a fatty liver disease called metabolic dysfunction-associated steatohepatitis, or MASH. For Randy, the diagnosis set off a cascade of life-or-death decisions that led his wife and him to Mayo Clinic, where he underwent a complex series of three lifesaving procedures, including a double coronary artery bypass surgery, liver transplant and, just months later, a kidney transplant. They found themselves navigating one health obstacle after another.

Randy is sharing his story to raise awareness during Donate Life Month.

Watch: 3 lifesaving surgeries and a second chance

Journalists: Broadcast-quality video (1:47) is available for download at the end of this post. Please courtesy: "Mayo Clinic News Network." Read the script.

"I was shocked. I mean, we didn't see that coming at all. It's right out of left field. You know, at that point, I wasn't physically sick. I was just swollen," says Randy.

When pneumonia and swelling became a diagnosis of stage 4 cirrhosis. Randy came to Mayo Clinic for a liver transplant evaluation. What doctors found made his situation far more urgent and far more complex.

"I went into the lab for a chemical stress test, but that's where they confirmed the two blockages. So what they ended up deciding, we're going to do two surgeries in one day. We're going to do your heart surgery — your double bypass — and we're going to do the liver. The worst I felt was the day before I got transplanted. The next morning when I woke up and had to do the walk, I still felt better than I did before the surgery," he says.

From the hospital window, Randy's wife, Elise, watched the mountains outside and saw their journey ahead — every peak, every valley — another procedure, another decision, another climb.

"We're going to have to climb every one of those mountain ranges," Elise says as she recalls their journey. "We're going to have to ascend and descend and ascend and descend every one of those mountain ranges."

"I'm getting rebuilt from the ground up," Randy says. "My kidney took off running, and it hasn't stopped. I don't know how you pay somebody for saving your life. I get emotional because you can't put it in words, but I've tried."

And with smiles as big as Texas, Randy and Elise are home after 27 weeks in Arizona. 

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A successful consultant and avid athlete, Lauren lived at full speed — until a leaky heart valve turned life-threatening. Robotic surgery at Mayo Clinic helped her rebound quickly. 

As a little girl, Lauren rarely thought about her mitral valve prolapse, a heart condition she'd had since birth. Although the bulging valve caused blood to leak backward in her heart, it didn't stop her from dancing competitively. 

"I never experienced it as something wrong with my heart, but as, 'Your heart makes a silly sound,'" she says.  

Lauren joined the Notre Dame dance team in college. She began running races, including half-marathons and marathons. She enjoyed pushing her body, and her heart never slowed her down. 

In the summer of 2023, that abruptly changed. While running in downtown Minneapolis, Lauren felt unusually exerted. After only half a mile, she slowed to a walk. Was the Taylor Swift concert from two nights earlier catching up with her? "Maybe I'd screamed too hard," she says. 

Then Lauren checked her wearable — a gold ring that tracks health data — and noticed a change in her heart rate variability, an indicator of cardiovascular fitness. "It dropped off a cliff, and my heart rate had elevated," she says. 

Feeling uncertain, Lauren headed to an urgent care. They reassured her she was the healthiest person they'd seen all month. Yet Lauren continued to feel "off" for weeks.

After listening to her heart, her husband, Joe, a cardiologist, suggested an echocardiogram, or heart ultrasound. The scan confirmed his concern — her mitral valve prolapse had progressed, causing the left side of her heart to balloon, a risk factor for heart failure or sudden cardiac arrest. Lauren would need surgery to repair her valve — and she'd need it soon. 

"To go from running a 10-mile race at a 7:40 pace to being told the left side of my heart was 40% enlarged didn't seem possible," she says. "Anything I pushed my body to do, I could do. Now, the word 'severe' just echoed in my brain."  

Facing the possibility of open-heart surgery, Lauren started searching. 

Finding a solution close by

For the last two decades, Mayo Clinic in Rochester, Minnesota, has combined its world-renowned surgical expertise with advanced robotics to offer a less invasive alternative to open-heart surgery. From their medical community, the couple learned Mayo was a pioneer in robotic mitral valve repairs.

"Instead of cutting the sternal bone, we make tiny 'keyhole' incisions on the side of the right chest," explains Dr. Arman Arghami, a cardiovascular surgeon at Mayo Clinic in Rochester. "With the robot, we can provide the same gold standard repair while cutting the recovery in half."

 
Minimal scarring and a quicker return to daily rhythms and exercise appealed to Lauren. After meeting with Dr. Arghami, she felt confident Mayo was the right choice. "I had like 30 questions, and we talked through every single one," she recalls. "It felt like his focus on me was limitless."

While awaiting her surgery, Lauren kept running to maintain her heart's strength. She also began working with her therapist to build emotional resilience. 

As an athlete, "I do a lot of visualizing before a performance or a race," she says. "Since I wasn't going to be the one doing the surgery, I focused my thoughts on having a team of people I trust."

"Thank you, I trust you" became her surgery-day mantra — carefully chosen words of surrender that she repeated to every care team member. During the few seconds of solitude before surgery, Lauren pictured a successful repair one last time. 

She was ready to let others fight for her. 

Recovering her identity 

When Lauren woke up, her husband's smiling eyes told her she was OK. Her relief mounted when Dr. Arghami handed her a stethoscope. The rhythmic reassurance of a fully functioning heart had replaced the clicking she'd heard since childhood. 

"It's good?" she asked, and Dr. Arghami replied with a smile, "It's very good." 

Watching the echocardiogram, her husband marveled that he'd never seen such an effective repair. "My valve was totally torn," Lauren says, "and now it was sealing perfectly." 

Less than 24 hours later, she was ready to start moving. With a nurse next to her, Lauren lapped the intensive care unit. That afternoon, she walked herself to the step-down unit. 

"I know there was pain from the surgery, but my mind can't drum up that feeling anymore," Lauren says. "What I can access is the memory of listening to my heart, of seeing my echo on the screen, how my nurse made me feel confident. I felt really empowered." 

Before her flower deliveries could arrive the next day, Lauren was discharged to go home. Four weeks later, she was back to running. Three months later, she could hold a plank in Pilates class. 

While visiting with Dr. Arghami, Lauren eagerly showed him her wearable data. Her heart rate variability was moving back toward baseline. Her heart rate was once again that of an athlete. 

"The data so powerfully confirms how my body feels," she says. "I have no limits in my activity or my life." 

Lauren also recognizes that freedom is no longer a given.

This sense of vulnerability has nurtured a deeper gratitude for her body and all it allows her to do, including a 10-mile race last fall. Although Lauren didn't train as hard — or run as fast — as she once did, that didn't matter because she was back to doing what she loves. 

"I didn't take any of those miles for granted. Crossing that finish line was awesome," she says. "Running and moving through life without worry was the goal, and I got there." 

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Randy McKnight makes award-winning barbecue, runs marathons and owns a small business. He puts his heart into everything he does — just not the heart he had when he was born.

Randy was among the first 10 heart transplant recipients at Mayo Clinic in Florida, a program that is now marking its 25^th anniversary.

Watch: 'Live for today': Looking at life nearly 25 years after a heart transplant

Journalists: Broadcast-quality video pkg (2:14) is in the downloads at the end of the post. Please courtesy: "Mayo Clinic News Network." Read the script.

"It was in the summer of 1998," Randy says. "We were having a lot of fires in Jacksonville along I-95, and (I was) having a hard time breathing."

Randy was 35 years old when his care team in Jacksonville, Florida, discovered he had an enlarged heart.

"I was in full-blown heart failure with fluid in my lungs," Randy says. "(My doctor) basically said, 'You need a heart transplant.' I couldn't believe it."

Randy was placed on the transplant list in Rochester, Minnesota, and spent almost three years traveling back and forth for appointments, waiting for a heart.

"My son must have been 8 or 9, and I knew that I had to survive to help raise him and support him," Randy says.

Then, in 2001, Mayo Clinic started a heart transplant program in Jacksonville, which gave Randy a chance to be closer to home.

"I met Dr. Yip when the program first started, and from day one, he and I have connected," Randy says. "I've always felt like I've had a personal connection with the team here, and it just made the whole process so much easier."

After listing and waiting several more months, the day finally came.

"I had my heart transplant on May 27, 2002," Randy says.

"You have someone who is literally on death's doorstep to be able to live a full, healthy life, back to things that they want to do, going back to work, raising their children, going to graduations, going to weddings, raising their grandchildren. That is satisfying," says Dr. Daniel Yip, a Mayo Clinic cardiologist who helped start the heart transplant program in Florida.

Over the last quarter century, Dr. Yip has seen progress in heart transplantation — from advances in medications to new options for patients with the greatest need.

"Being able to expand the donor pool using organs that, in the past, we would say maybe we shouldn't think about using them, but knowing with time, with research, with innovation, with technology, to be able to use these organs," Dr. Yip says. "And now we're able to go a lot farther, even across the country, to be able to get the right heart for a patient. I think that's the biggest thing — to be able to serve patients who need our help."

According to the United Network for Organ Sharing (UNOS), nearly 4,000 people in the U.S. are waiting for a heart transplant.

Randy is grateful for the years he's been given, and he's made it his mission to help others.

"My quality of life before transplant — being sick, being limited — was really hard because I'm go, go all the time," Randy says. "Just learn to live each day for today, live every day for today and appreciate life."

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With a failing heart and little hope of healing, Alan Lewis sunk into depression, gaining 330 pounds. After he came to Mayo, bariatric surgery enabled the transplant he'd sought for so many years.   

Alan Lewis was lying on the floor — the only position that eased his discomfort — watching a football game. When a Mayo Clinic commercial came on, the tagline seemed to leap off the screen.

"You know where to go."

With heart failure sapping his strength, Alan had begun to doubt there was an "other side" to his condition. At age 41, he'd already lived a decade with a poorly pumping heart, diagnosed during a hospital visit for a broken ankle. 

For years, Alan had relied on a left ventricular assist device, or LVAD, to help his heart circulate blood through his body. After the first one malfunctioned, he received a second device in 2018.

What Alan really needed was a new heart.

Even after bariatric surgery helped him lose weight, he still wasn't added to the transplant list. "When we'd ask about transplant, our care team would just say, 'Oh, he's doing fine. Just keep doing what you're doing,'" says his wife, Vida.

As months became years, Alan's hope of healing waned. His mental health spiraled.

"I was a nervous wreck," he recalls. "What if the LVAD malfunctioned? What if there was a power failure? I was scared to go places, worried about backup batteries. I was in my head 24/7. It was torture."

Deeply depressed, Alan gained 330 pounds during the pandemic, reversing his previous weight loss. Without a clear path forward, he resigned himself to dying.

Then, in 2022, Alan saw the Mayo commercial — and Vida saw an opportunity. She made the decision for them. They were going to Rochester.

A journey toward hope

After driving from Chicago, weak and rapidly declining, Alan sought help from Mayo Clinic.

There, Vida's long-simmering concern was confirmed —a tough-to-kill bacteria had infected the wiring that linked his LVAD to its external battery. The battery for his defibrillator was also dead, leaving him vulnerable to potentially deadly arrhythmias.

Right away, Alan received IV antibiotics, a new defibrillator and an introduction to the transplant team. "Day one, they spoke of transplant," says Vida. "I was shocked."

At his first follow-up visit, Sarah Schettle, a physician assistant on the LVAD team, could see the emotional strain of all that Alan and Vida had been through. "There was a lot of hesitancy — 'Will Mayo accept us?'" she recalls. "I also remember the hopefulness, the desire to know what was possible here."

Recognizing that Alan needed complex, multidisciplinary care, the team began formulating a plan.

Within two weeks, the couple relocated to Rochester — and just one year into marriage, Vida unflinchingly pivoted to her new role as caregiver.

"It was embedded in me to love as hard and as much as you can," she says.

Vida vowed to do that for Alan.

Preparing for tomorrow

The team said Alan needed to adopt a healthier lifestyle before a second bariatric surgery — a necessary step toward transplant. So Vida signed them up for a gym. She walked next to him on a treadmill, urging him on. She made healthy meals. She pored over the lengthy care plan, still shocked that they had one.    

"Back home, no one gave us clear answers. How long would he have the LVAD? Could he ever get a transplant?" she says. "At Mayo, we never experienced that. The focus was always on getting him well enough for a transplant, like he deserved to be transplanted."

Still, there was fear that the new heart wouldn’t happen. Sensing Alan's struggle, Adrian da Silva de Abreu, M.D., Ph.D., one of his cardiologists, spent an hour at his bedside, mostly listening.

"I'd never seen a doctor take that time," says Alan. "I put it all out there, and I could tell he was hearing me."

Peace replaced his once-crippling anxiety. At last, he knew his team wanted what was best for him. As Vida says, "They had a vision. They had a plan. It was healthcare like I've never seen before."

A risk with great reward

Alan's first bariatric surgery shrunk his stomach to the size of a banana.

To help him lose the weight he'd regained, Omar Ghanem, M.D., a bariatric surgeon, planned to reroute part of Alan's small intestine so food would bypass a long segment of his bowel. Known as a modified duodenal switch, this would reduce how many calories and nutrients he absorbed and alter the secretion of hunger-related hormones.

Dr. Ghanem knew the already complex surgery would be even more challenging in Alan's case.  

With his heart essentially outside his body, monitoring — and maintaining — his vitals would be difficult. Blood thinners to prevent clots in his LVAD would also elevate his risk of bleeding. Then there was the looming infection, suppressed but still active, only curable if the LVAD was removed.  

Seven Mayo Clinic teams — from Infectious Diseases to Anesthesiology — worked together to help Alan beat the odds.

"Where else do you have all this expertise in one place? I don't think anything like this can be done outside of a place like Mayo," says Dr. Ghanem. "Here we're able to safely push the limits."

Knowing this path was his best chance at healing, Alan and Vida agreed to go forward.

Despite its complexity, the revision was a success, and so was the recovery. Within months, Alan lost enough weight to qualify for a heart. He was finally on the transplant list.  

Moving forward at last

Six weeks later, a middle-of-the-night call brought Alan back to Mayo Clinic.

After years of heart failure, two LVADs, two bariatric surgeries, dozens of pounds lost and hundreds of tears shed, Alan was receiving another chance at life. He was receiving a new heart.

Less than five hours after opening his chest, Philip Spencer, M.D., a cardiovascular and transplant surgeon, brought Alan to the "other side" of heart failure — that place he'd once thought didn't exist.  

"We had an infection to deal with. And there was scarring within his chest," says Dr. Spencer. "But, once the LVAD was out, it went very well."  

IV steroids enabled his body to accept the organ, and with the LVAD out, his infection could finally clear. Even from his hospital bed, Alan felt his confidence returning.

"I'd had this yoke on me. I couldn't move without the LVAD. I couldn't bathe without it. I couldn't eat without it. It was always present," he says. "Mentally, I'd been down so long. Now I had freedom."

For the first time in years, there were no wires to wrestle with. There was no battery to worry about.

Alan could be himself again.

A new life for Alan

With Alan's heart fully functioning, the couple is now back in Chicago, enjoying a renewed zeal for life.

For Alan, that means showing his gratitude for everyone who supported him — his family, his close friends and, of course, Vida. Every day, he focuses on caring for her in every way possible.  

"When I wake up, I start catering to her," he says. "She had to cook and clean. She helped bathe me and put on my shoes and socks. It's a joy for me to be able to do things for her now."

During the night, Alan sometimes reaches across the mattress, making sure Vida is still there, even though he knows she always will be. She is his safe person, and Mayo Clinic is the safe place that showed him what healthcare should be.

Both their hearts remain in Minnesota, where hope first began to beat, strong and steady, in Alan's chest. The tagline from a football game ad — "You know where to go" — still feels like a summons.

"To have so many people involved in your care, and each one be a beautiful experience, is so rare," says Vida. "God has blessed him, and Mayo has been there for him. We want to move back because Rochester feels like home, you know?"

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