For years, Rich Bugay suffered from constant discomfort and difficulty breathing. To cope with the burning sensation in his mouth, the father of three had to swallow cough drops almost continuously. Even lifting his legs to walk was difficult and the intense fatigue was a constant struggle, exhausting him.
Early doctor visits didn’t provide many answers. Doctors thought his symptoms were related to his gastrointestinal system, so he had a colonoscopy, which he said “ruled out a lot of things” but didn’t provide any new answers. Some doctors thought he might have gastroesophageal reflux disease, or GERD, a chronic form of acid reflux. Bugay tried many treatments for the condition. Nothing improved his symptoms.
Frustrated by his inability to get answers, Bugay asked a friend to get him an appointment at the Mayo Clinic. He and his wife traveled from Escanaba, Michigan, for an appointment with gastrointestinal specialist Dr. Houssam Halawi, intending to stay only a few hours. Halawi began a standard gastrointestinal exam, but took the extra step of listening to Bugay’s heart after suspecting his symptoms indicated a more serious problem.
Mayo Clinic
“The symptoms appear to be more systemic, more diffuse than what is usually attributed to a simple acidity problem,” Halawi said.
Halawi’s exam revealed what he called a “highly suspicious” heart murmur. Bugay and his wife decided to stay behind so he could have an echocardiogram the next morning. The heart exam revealed a deadly surprise: a seven-centimeter aortic aneurysm that could rupture fatally at any moment.
“That’s when the bomb went off,” Bugay said.
What is an aortic aneurysm?
An aortic aneurysm, also called an enlarged aorta, is a dilation of the body’s main artery. They grow slowly and usually don’t cause problems, but a rupture is fatal in most cases, according to the American Heart Association.
According to cardiovascular surgeon Dr. Gabor Bagameri, the aneurysm measured 6.6 centimeters. Typically, aneurysms of 5 centimeters or more are treated surgically.
Mayo Clinic
The echocardiogram also revealed that Bugay had a congenital heart condition called bicuspid aortic valve syndrome, when a person has only two flaps of tissue to keep blood flowing instead of the usual three. The condition can reduce blood flow to the heart or lead to other complications. Bugay had a symptom called aortic valve regurgitation, where blood would back up into his body.
The congenital disease was likely the cause of many of her symptoms, including fatigue, said Dr. Charles Jain, a cardiologist who read Buday’s echocardiogram and was involved in her treatment. Some of the symptoms, such as the burning sensation in her mouth, were probably not caused by the disease, and aortic aneurysms are typically asymptomatic until they rupture.
“I would have been a ticking time bomb,” Bugay said.
A “new breath of fresh air”
Once the aortic aneurysm was discovered, Bugay was immediately scheduled for open-heart surgery to remove the aneurysm and repair his heart valve.
The complex operation took several hours, Bagameri said. The aneurysm was removed and a mechanical aortic valve was implanted. Bugay had a “relatively smooth” recovery, Jain said, and was released from the Mayo Clinic just days after the surgery.
Today, a year later, Bugay says he has “a new lease on life” and feels “a hundred times better” than before. His six- and 12-month checkups at the Mayo Clinic have gone well, he said, and he’s also made “small lifestyle changes.” Every day, he says, he’s grateful for the additional testing that helped detect the deadly disease.
“If they had just done some tests and let me go, I might not be here,” Bugay said.
