He thought he had severe acid reflux. Doctors found a much different problem.
For years, Rich Bugay struggled with constant discomfort and difficulty breathing. To deal with the sensation of a burning mouth, the father of three ate cough drops nearly nonstop. Just picking up his legs to walk was difficult, and intense fatigue was a constant struggle, leaving him exhausted.
Initial visits to doctors didn't provide many answers. Doctors thought his symptoms were linked to his gastrointestinal system, so he underwent a colonoscopy, which he said "ruled a lot of stuff out," 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 numerous treatments for the condition. Nothing made his symptoms any better.
Frustrated with 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 just a few hours. Halawi embarked on a typical GI workup — but took the extra step of listening to Bugay's heart after suspecting that his symptoms pointed to a larger issue.
"The symptoms seemed more systemic, more diffuse than tend to be blamed on just an acid problem," Halawi said.
Halawi's exam picked up what he called a "very suspicious" heart murmur. Bugay and his wife decided to stay overnight so he could have an echocardiogram the next morning. The cardiac exam unveiled a deadly surprise: A seven-centimeter aortic aneurysm that could fatally rupture at any moment.
"The bombshell kind of blew up at that point," Bugay said.
What is an aortic aneurysm?
An aortic aneurysm, also known as an enlarged aorta, is a bulge in the main artery of the body. They grow slowly and often do not cause problems, according to the American Heart Association, but a burst or rupture is fatal in most cases.
The aneurysm was 6.6 centimeters, according to cardiovascular surgeon Dr. Gabor Bagameri. Typically, aneurysms of 5 centimeters or more are surgically treated.
The echocardiogram also found that Bugay had a congenital heart disease called bicuspid aortic valve syndrome, when a person has just two flaps of tissue ensuring that blood flows correctly instead of the typical three. The condition can reduce blood flow to the heart or other complications. Bugay was experiencing a symptom called aortic valve regurgitation, where blood was flowing backward into his body.
The congenital disease was likely causing many of his symptoms, including fatigue, explained cardiologist Dr. Charles Jain, who read Buday's echocardiogram and was involved in his treatment. Some of the symptoms, like burning mouth, likely weren't caused by the condition, and aortic aneurysms are typically asymptomatic until they rupture.
"I would have been a ticking time bomb," Bugay said.
A "new lease on life"
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 discharged from the Mayo Clinic just a few days after the surgery.
Now, a year later, Bugay said that he has a "new lease on life" and feels "a hundred times better" than he did before. His six- and twelve-month check-ups at Mayo Clinic have gone well, he said, and he's made "small lifestyle changes" as well. Every day, he said, he's grateful for the extra tests that caught the deadly condition.
"If they had just run a few tests and sent me on my way, I might not be here," Bugay said.