Louisville visitor goes to Norton Audubon Hospital with intense stomach pain — not a moment too soon

When Rob Priest arrived by ambulance at Norton Audubon Hospital, he learned the truth was far worse than a tainted meal. An aneurysm on Rob’s aorta had ruptured in his abdomen.

Visiting Louisville on a business trip, Rob Priest thought he might have come down with a terrible case of food poisoning. As pain in his abdomen grew more intense and deeper, he called 911 in the middle of the night from his hotel.

When Rob arrived by ambulance at Norton Audubon Hospital, he learned the truth was far worse than a tainted meal. An aneurysm on Rob’s aorta had ruptured in his abdomen.

“I was in a life-threatening situation,” said Rob, who was 57 at the time of the emergency. “I had bled 40% of my blood into my body cavity.”

The aorta supplies blood from the heart to the body, running through the chest and abdomen. A weakening in part of the aorta wall can result in an aneurysm, an enlarged area that stretches like a balloon and can burst without warning. A ruptured abdominal aortic aneurysm (AAA) can kill very quickly.

Rob’s deep abdominal pain symptoms were not unusual for a AAA. An enlarged AAA often strikes with no symptoms. Some patients have described what may feel like a heartbeat in your stomach or near your bellybutton.

Ferenc P. Nagy, M.D., a vascular surgeon with Norton Heart & Vascular Institute, was on call when Rob arrived at the emergency room.

“A person who has a ruptured aneurysm is actively dying because there is no way for the body to stop that bleeding on its own,” Dr. Nagy said.

A burst pipe that needs to be fixed — fast

Dr. Nagy likened Rob’s situation to a pipe bursting in a house. The pipe needs to be replaced or rerouted — quickly. In Rob’s case, Dr. Nagy chose a minimally invasive procedure to insert stents rather than performing conventional surgery.

“With the stenting procedure, we’re able to realign his blood flow. We’re fitting a new pipe inside the pipe that burst on him,” Dr. Nagy said. “You essentially are diverting all of his blood flow within the new pipes back down to normal areas, and you’re preventing any blood from getting into the aneurysm.”

On his way to the hospital, Rob called his wife, Kelly Priest, at their home outside Dayton, Ohio, to tell her what was going on. She and their daughter got in the car and to make the 2½-hour drive to Louisville. En route, they talked to the staff at Norton Audubon Hospital.

“The very, very friendly and professional staff was keeping us in contact as we were on our way there,” Kelly said. “And they did mention that he was a very sick. So if the staff is telling you that [the patient is sick], you know it’s serious.”

Just before Rob’s wife and daughter arrived at 3 a.m., Dr. Nagy performed the stenting procedure on Rob. Forty minutes later, the vascular surgeon came out to give Kelly the good news, and she was able to see Rob.

At Rob’s bedside, Kelly was overwhelmed.

“Once he looked at me, tears of joy came because I knew he was alive, and we had come through this,” she said.

Few with ruptured AAAs even make it to the hospital

Rob had beaten the odds. Half of patients who have a ruptured aneurysm don’t make it to the hospital. Half of those who get to the hospital don’t make it to the operating room.

Norton Heart & Vascular Institute has a dedicated team to handle emergency cases like Rob’s, where time is critical, and a patient’s life is in the balance.

Rob’s arrival at Norton Audubon Hospital launched the team into action, and preparations started immediately for his lifesaving procedure.

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“I don’t feel like there’s a better place in the city that can take care of aneurysm disease. We’ll do anything we have to do to make sure patients are well taken care of,” Dr. Nagy said.

Most people with aneurysms don’t realize they have them unless they are being examined for another reason, according to Dr. Nagy. For example, patients complaining of a kidney stone might find out that it’s actually an abdominal aortic aneurysm.

Risks factors for abdominal aortic aneurysms include age, being a current or past smoker, being male, being white, having an aneurysm elsewhere and having a family history.

Once someone has had an abdominal aortic aneurysm, they are at risk for aneurysms elsewhere and need to be monitored closely. Rob had a chance to see a doctor closer to home for his follow-up. He chose to stay with Dr. Nagy, who has since found aneurysms in both of Rob’s legs.

“I’m very confident I’ve got the right people keeping an eye on me,” Rob said.

Abdominal aortic aneurysm screening guidelines

The U.S. Preventive Services Task Force (USPSTF) recommends abdominal aortic aneurysm screenings for men ages 65 to 75 who smoked 100 or more cigarettes in their lives. Those in that age group who have never smoked may want to have a screening in consultation with their health care provider.

The USPSTF does not recommend screening for women who have never smoked and says there isn’t enough evidence to support screening of women ages 65 to 75 who have smoked 100 or more cigarettes.


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