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New Jersey
Lourdes Nurse Catches Potentially Fatal Heart Problem in Newborn Baby
Story Number is : 110517105
PROVIDED
Lourdes Health System

 
Provided
Lourdes Mother/Baby nurse Helene Pietrangelo, RN, BSN (center), along with parents Tim and Gisell Cornish, and their daughter, Iliana. Helene was baby Iliana’s nurse after she was born and helped catch a rare heart anomaly that required the baby to have open heart surgery. Iliana is doing well today and her parents credit nurse Helene.
Fifty-seven-year-old Helene Pietrangelo, RN, BSN, calls herself a “new nurse.” She worked as a unit secretary in the Intensive Care Unit at Our Lady of Lourdes Medical Center for 14 years before accomplishing her dream of attending nursing school. She graduated five years ago.

Since that time, she’s worked as a nurse in Lourdes’ Maternity department. She loves her job but being a “new nurse,” she feels she has a lot to learn from veteran nurses who have years of patient care experience, as well as from physicians and other clinical staff she works with.

But Pietrangelo’s nursing skills were anything but novice when she caught what could have been a fatal heart condition in a newborn baby under her care in early June.

“There are no words to express how extremely thankful and grateful I am for Helene,” wrote Gisell Cornish, the baby’s mother, in an email to Lourdes after she and her baby were home. “My daughter's pediatrician and other doctors have said she is one heck of a nurse because it is hard to hear clicking in a baby’s heartbeat. As an update for my daughter's condition, she received open heart surgery since leaving Lourdes. She is doing well today and we pray for a successful and speedy recovery.”

Pietrangelo is thankful the baby is doing well. She humbly says she was just doing her job that day.

“It was a typical day, where I had a mom and baby under my care,” explained Pietrangelo. “I was doing an assessment of the baby and listened to her heart with my stethoscope. I heard a noise I hadn’t heard before. I don’t know how to describe the sound, other than what it sounds like when a train goes over tracks—instead of lub-dub, it was click-click, click-click.”

Pietrangelo spoke with the pediatrician on the patient floor. “I spoke to the doctor and he listened to the baby’s heart but didn’t hear a clicking sound then. He noted that it’s not uncommon for babies’ heart rhythm to transition in the first 24 to 48 hours.”

Being a “new nurse,” Pietrangelo thought she had learned something new. The baby’s color was good and her electrocardiogram was normal.

The next day the baby was under Pietrangelo’s care again. “I listened to the baby’s heartbeat again and heard the same clicking sound, except this time it was more pronounced and more erratic. Although the baby was cleared by a pediatrician, I felt uncomfortable. Something didn’t seem right. I asked the pediatrician doing patient rounds that day to listen to the baby’s heartbeat. Even if the sound was only ‘transitioning,’ I needed to know more and make sure everything was ok.”

The second pediatrician heard the clicking sound and asked Pietrangelo to contact one of the consulting cardiologists from The Children’s Hospital of Philadelphia (CHOP) to assess the baby at Lourdes.

While talking with the cardiologist on the phone, she noted that the baby’s EKG was normal and her color good, but there were a few times where her pulse oximeter (which measures her oxygen levels) fluctuated – sometimes it was 95, then drifted to 90, then back up to 95. The cardiologist came right over.

In the meantime, Pietrangelo was also keeping mom updated on her baby’s condition. “Mom and baby were scheduled to be discharged. Mom saw me listening to the baby’s heart for a long time. I let mom know I had heard an unusual sound and it may be nothing but we want to double-check to be sure, just for peace of mind. Mom was upset but obviously wanted us to do all we could to make sure her baby was ok.”

The CHOP cardiologist ordered an echocardiogram, or an ultrasound of the heart, for the baby and saw an abnormality. The process was then started to transfer the baby to CHOP for additional cardiac follow-up. The doctor let Pietrangelo know it was a good catch hearing the baby’s clicking sound and following-up on it.

The baby was now going to be kept at Lourdes so she could be monitored until the process to have her transferred to CHOP was complete. Mom stayed with baby in one of Lourdes’ Intensive Care Nursery nesting rooms. That night, the baby’s oxygen levels dropped twice, and she turned blue, her mother says, but she recovered. The baby was transferred to CHOP the next day.

“It was very emotional because we were supposed to be discharged,” said Cornish. “I was happy we were going home. Then to learn that my daughter had a heart condition, everything changed. I can’t say how thankful I am that Helene was persistent. If not for her, God forbid I would have taken the baby home. That scare in the ICN said it all.”

“Being a new nurse, I know there’s still a lot to learn, but each day, I pray asking God to give me the knowledge to do the right thing for my patients. I’m grateful I was able to help that day. I questioned myself at first, but I am a patient advocate, and I knew I had to find out what was happening to make sure the baby was ok. I was really just doing my job.”

The baby spent two days at CHOP, had more cardiac testing done. She was diagnosed with Cor triatriatum dexter (CTD), a congenital anomaly in which the right atrium of the heart is divided into 2 parts by a membrane or fibromuscular band. The condition is extremely rare and is often associated with other congenital anomalies. Symptomatic patients typically have surgery. Because some patients don’t always experience symptoms, it can be a hard condition to catch.

The baby was discharged from CHOP and the Cornish’s were asked to follow-up with a cardiologist. A few weeks later, the baby had open-heart surgery at CHOP and was hospitalized for five days. She recovered well, her mother says. “It was very scary because I learned through research that her condition is very rare,” said Cornish. “They normally only see it on an autopsy because it’s that hard to catch. I can’t say enough how grateful we are to Helene.”

Patricia Cerveny, RN, CBC, C-EFM, Nurse Manager, Women's and Children's Services at Our Lady of Lourdes Medical Center, is Pietrangelo’s supervisor. She says, “We are very proud of Helene. She is conscientious and caring, as a nurse and as a person. She continually goes above and beyond in caring for her patients, and baby Cornish is a great example of that. I am very grateful to have Helene on our team.”



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