Multidisciplinary Collaboration Reveals an Unexpected Diagnosis

February 23, 2022

As an active 87-year-old, James Freehill never suspected that his pneumonia-like symptoms could be the signs of an underlying blood flow condition.

In 2018, James was diagnosed with eosinophilic pneumonia – a rare disorder in which eosinophils, a type of white blood cells, accumulate in the lungs – by Valley Medical Group pulmonologist Nidal M. Matalkah, MD. Impressed with the care he received, James switched his primary care to Valley Medical Group and began seeing primary care physician, Timothy Brabston, MD

When James began to experience symptoms similar to his previous eosinophilic pneumonia diagnosis, including shortness of breath, fluid retention in his legs, an aching in his chest, and a deep cough, he visited Dr. Brabston for further evaluation.

“Eosinophilic pneumonia is known to cause increased numbers of eosinophils in the lungs and bloodstream. Having been previously treated and monitored to ensure James’ lungs were not impacted, I suspected James was now experiencing an underlying cardiovascular complication,” explained Dr. Brabston. “To ensure he received a full examination, I recommended that he follow up with a cardiologist.”

For further evaluation and diagnosis, James visited cardiologist Edward Julie, MD. To get a better understanding of James’ condition, Dr. Julie ordered three tests: an angiogram, which uses x-rays to visualize blood vessels; an echocardiogram, which uses ultrasound technology to check the heart muscle, valves, and blood flow; and a stress test, used to monitor the heart’s coronary blood flow. 

Together, the three imaging techniques revealed a severe form of mitral valve regurgitation – a condition in which the heart’s mitral valve does not close tightly, allowing blood to flow backward into the heart. 

“Dr. Brabston’s instinct of underlying cardiovascular complications was correct. His quick thinking and specialist referral positively impacted James’ diagnosis and treatment.” said Dr. Julie.

“Using James’ test results, I was able to determine the root cause of his repeating complications. To assist in the treatment of James’ mitral valve regurgitation, I called structural heart specialist, Rajiv Tayal, MD, Director of The Valley Hospital’s Cardiac Catheterization Laboratory and Structural Heart Program, to assist in the development of personalized treatment plan,” said Dr. Julie. 

To treat James’ mitral valve regurgitation, Dr. Tayal, with help from Dr. Julie, performed a MitraClip™ transcatheter mitral valve repair procedure. This minimally invasive procedure allows physicians to attach an implantable clip, smaller than a dime, to the mitral valve to help the valve close more completely. Once attached, the MitraClip helps to restore blow flow through the heart. 

“James was the perfect candidate to receive the MitraClip,” explained Dr. Tayal. “Based on Dr. Julie’s analysis and recommendation, I was able to successfully place the MitraClip device, significantly reducing James’ mitral regurgitation.”

Given the minimally invasive nature of the procedure, James was released from Valley several hours later. 

“I did not want to go through a cycle where my symptoms would dissipate and I would feel better, but a year later they would return and I would feel sick again,” said James. “I trusted the opinions of Dr. Julie, Dr. Tayal, and the rest of Valley’s heart team so I knew the MitraClip procedure was the right decision for me.”  

To aide in his recovery, James attends outpatient cardiac rehabilitation where he completes a series of exercise routines to improve his heart health, reduce the risk of future heart problems, and improve his quality of life. 

“Valley has been wonderful to me. I encourage everyone to visit Valley to verify their symptoms. All symptoms are susceptible to correction if you make the concise decision to help yourself and improve the quality of your life,” said James. 

To learn more about the MitraClip™ procedure, please visit