Lying in a hospital bed, Steve Grandizio gazed at a nearby monitor as his heart rate plummeted. Lightheaded and struggling to breathe, he thought about his kids, Emme, then 8 years old, and 13-year-old Marshall. Then there was Beth, his wife of 23 years, who was standing next to his bed at Thomas Jefferson University Hospital in Philadelphia.
Help was on the way, she told him. But the Media native didn’t know how much more his body could take.
Five days earlier, on Aug. 9, Grandizio underwent a 10-hour surgery to repair his heart’s mitral valve and stem and replace its aortic valve and stem. He also underwent a coronary bypass using a vein transplanted from his leg. The temporary external pacemaker wasn’t supposed to come unattached—but it did, prompting his heart rate to plummet into the 30s. As monitors beeped and alarms rang, Grandizio told Beth he loved her and said goodbye. What he knows now, six months later, is that the whole ordeal could’ve been avoided.
The weekend before Father’s Day, Grandizio was a few sips into his first beer at the Flying Pig Saloon in Malvern when the first symptoms hit. “I started getting the chills even though it was a 90-degree night,” recalls Grandizio, a talented athlete who played minor league baseball for the St. Louis Cardinals, has a successful career in the mortgage industry and cofounded the nonprofit Little Smiles, which provides much-needed fun for kids in local hospitals and homeless shelters.
Grandizio’s fever segued into fatigue, lack of appetite and strange headaches. “It hurt in the front of my head and the back of my neck,” he says.
Over the following weeks, Grandizio saw doctors in urgent and primary care, as well as infectious disease. They tested his blood for a variety of ailments, but none of them ran a routine blood culture. If they had, they would’ve found the culprit: a bacterial infection.
On day 34 of the fever, Grandizio—20 pounds lighter and leveled by fatigue—headed to Jefferson’s ER. “I didn’t think of my case as an emergency,” he admits. “But I couldn’t think of anywhere else to get medical help.”
At the hospital, routine blood work detected the infection, which is easily treated with targeted antibiotics. But the damage was done. The infection was lodged in Grandizio’s heart, where it had wreaked havoc for more than a month.
Endocarditis wasn’t the only thing that was missed. Grandizio also had a bicuspid aortic valve, a congenital heart defect that went undetected for all of his 46 years. People with BAVs have two flaps, instead of three, on their aortic valves. More than two weeks passed before the Jefferson team decided he needed surgery. (Despite numerous requests, Grandizio’s Jefferson cardiologist did not make himself available for an interview.)
Dr. Scott Goldman, a cardiac surgeon and director of the structural heart program at Main Line Health’s Lankenau Heart Institute, says it’s not unusual for BAVs to go undetected until symptoms—murmurs, shortness of breath, fatigue—emerge. Many don’t need repairing until patients are in their 60s. As for Grandizio’s endocarditis, Goldman acknowledged that it could be tough to diagnose. “But if the diagnosis is that the infection is in the heart, I’d consider surgery right away,” he says. “The earlier the surgery, the better, so damage to the heart is minimized.”
Grandizio’s infection can be traced to a trip to the dentist. Many cardiologists advise BAV patients to take antibiotics before dental work to prevent oral bacteria from getting into the blood stream and attacking valves. Grandizio didn’t know he had a BAV—and even if he had known, recommendations have changed as concerns have risen about the overuse of antibiotics. Goldman, however, still endorses them. “I’m the guy at the end of the conveyor belt who sees the problems created when BAV patients don’t take them,” he says. “The side effects of taking the antibiotics are low and, generally speaking, don’t outweigh the risk of endocarditis and damaging the heart valve.”
Grandizio had a pacemaker surgically installed in his chest and continues to recover. He also has an interesting theory behind his misfortune. “At some point in heaven, one of my kids had this bicuspid aortic valve and I said, ‘No, give it to me. I’ll take it. Let it be me so my children don’t suffer.’”