Kevin Flynn (second from right), pictured with his wife and three children, hopes his story will inspire others with a family history of heart disease to undergo proactive screening.

Kevin Flynn, 52, of Natick, had none of the classic warning signs of heart trouble — no chest pain, no shortness of breath, no racing heartrate. But he does have family history of heart disease, a detail that became an essential piece of information to share during a routine appointment with his primary care provider.

Flynn would later learn he had an immense blockage in the main artery supplying blood to his heart. Its location was deadly: right at the opening of the lower-left chamber. This type of blockage precedes what is known as a “widow-maker” heart attack, named for its dire outcomes.

“When you’re 50, you think you’re too young for a problem with your heart,” said Flynn, a father of three, high school teacher and youth sports coach. “But you don’t know what’s going on inside you.”

Today, he has a clean bill of health and more energy than ever — an outcome he attributes to the vigilance, expertise and seamless collaboration of his multidisciplinary care team at Newton-Wellesley Hospital (NWH) and Brigham and Women’s Hospital (BWH), where he successfully underwent coronary bypass surgery in April 2023.

“They were the A Team,” Flynn said. “I felt like the left hand and right hand were working together. They all seemed very invested in me, which I’m thankful for, and they were all talking to and bouncing ideas off each other.”

Members of Flynn’s care team weren’t surprised to hear that feedback, citing longstanding partnerships between clinicians at the two institutions and a shared commitment for delivering patient-centered care. Their close collaboration is just one example of the teamwork that is increasingly taking place across Mass General Brigham, where cardiovascular care teams at different institutions are using their collective expertise to address and improve patients’ heart health.

“I feel incredibly privileged to work at a place that consistently puts patients at the forefront and centers all of our decisions around them, and I’m very blessed to work with colleagues who do the same,” said Brigham interventional cardiologist Ajar Kochar, MD, MHS, who was among those involved in Flynn’s care. “A lot of times, the decision on how to intervene with heart disease is quite nuanced, with multiple medical factors to consider along with patient preference. You need a team approach. It’s absolutely essential for patient-centered care, and there’s a lot of data supporting that patients experience better outcomes when it’s a team-based decision.”

Flynn’s experience left him with another powerful takeaway: If you have a family history of heart problems, be proactive about screening — even, or especially, if you feel fine today.

“Don’t be afraid to get checked out. If you have a family history, go to your primary care provider and start having that conversation,” Flynn said. “If I didn’t do that, who knows if I’d be here today?”

***

In January 2023, Flynn had a routine checkup with his Newton-Wellesley primary care provider, Jen Snider, MSN, BSN, FNP-C, a family nurse practitioner at Wellesley Family Care Associates.

“She started asking questions and noticed that, despite being on medication since my mid-20s for high cholesterol, my numbers weren’t great,” Flynn said.

Health visits like this typically made Flynn a little nervous, he said, for fear of receiving bad news. But Snider’s genuine interest and warmth instantly made him feel at ease. It’s an approach she says she brings to every patient encounter.

“A basic of nursing is you’re considering all the components of what makes up a person: Where do you live, and who do you live with? What kind of job do you have, and how stressful is that? What do you do for fun?” Snider said. “Asking patients about these factors not only is important for building trust, but it also gives us better insight into their overall picture of health.”

During their conversation, Flynn shared that his father needed heart surgery at a relatively early age after a close call.

“When I heard he had been on a statin since his 20s and his father’s history, it got my Spidey sense tingling,” Snider said. “My concern was that we had an indolent disaster pending.”

Snider ordered a coronary calcium scan — a standard, dye-free CT scan that looks for deposits of calcium plaque in coronary arteries — and scheduled Flynn for a nuclear stress test, which evaluates heart function and blood flow at rest and during exercise.

The calcium results prompted Snider to make an urgent call to Flynn: The scan showed significant plaque buildup in one of his coronary arteries, very close to his heart. She advised him to see a cardiologist as soon as possible.

***

The timing was all a little uncanny. About a week prior, Snider had listened to a presentation by Stefanos Parpos, MD, assistant chief of Cardiology at Newton-Wellesley, about imaging technology newly available at NWH known as coronary computed tomography angiography, or coronary CTA. It uses powerful X-rays and contrast dye to provide a more detailed visualization of blockages in the heart and surrounding blood vessels. While common at larger academic medical centers, few community hospitals like Newton-Wellesley offer such innovation.

That presentation was fresh in Snider’s mind when she reached out to Parpos, who reviewed the calcium score.

“It was off the charts — and not in a good way,” Parpos said.

He agreed that the results warranted a closer look with the coronary CTA, which he used in conjunction with another technology called CT fractional flow reserve, or CT-FFR. This approach produces a personalized, 3D digital model of the coronary arteries and illustrates how severely any blockages are affecting blood flow.

For Flynn, however, the imaging and the computer analysis told two different stories.

“When I looked at the pictures myself, the area didn’t look that bad on visual inspection,” Parpos said. “But then you look at that computer simulation and think, ‘Boy, that looks really bad.’ And then you look at Kevin and think, ‘Boy, he looks really good.’”

For reasons science is still working to fully understand, a person’s genetic makeup can affect their risk of developing coronary artery disease, high blood pressure and related conditions — even if they don’t smoke, remain active and maintain a healthy diet.

“There is an important group of young people who look like the picture of health but are sitting on a lot of risk,” Parpos said.

Parpos reached out to the Brigham’s Cardiac Catheterization Lab so they could get a better understanding of how Flynn’s heart was functioning. He sent a message about the case to a trusted colleague who would be doing the procedure: Ajar Kochar, MD, MHS, an interventional cardiologist at BWH.

That very evening, just as Parpos was putting his children to bed, his phone rang. It was Kochar.

***

The two cardiologists agreed the case was puzzling and made a plan: The Brigham’s Cath Lab team would snake a catheter through Flynn’s wrist artery, toward the heart, to better assess his condition. Through the catheter, they could take X-ray images of the heart’s arteries to get more precise visual. And using special pressure-sensing wires, they would measure how severely the blockage was restricting blood flow — clues that would help determine the best treatment plan.

If the blockage was moderate, Kochar would treat Flynn directly in the Cath Lab by inserting stents to open the blood vessels. If it was severe, they would end the procedure and refer him for open-heart surgery.

“The blood flow was quite profoundly reduced,” Kochar recalled. “It would have been very reasonable to treat that in the Cath Lab, but one important consideration for Mr. Flynn was that he was 51 at the time.”

After a stent is placed, cells in the body will eventually start to develop inside it, causing the blood vessel to ultimately narrow again, Kochar explained. For an older patient, that may be less cause for concern. But for someone in their 50s with no other major health problems, it would not eliminate their future risk of a heart attack, and they would almost certainly need another procedure in the near future.

Flynn remembered the mixed emotions that news brought.

“I knew I had a great team of people really caring for me and wanting the best result, but it was hard walking out of the Brigham knowing I had to have open-heart surgery,” he said.

His unease dissolved the next week after he met his cardiac surgeon: George Tolis Jr., MD, section chief of Coronary Surgery and General Cardiac Surgery at the Brigham.

“When I walked out of his office, I was really confident. Dr. Tolis was amazing — an absolute genius — and answered all my questions,” Flynn said. “Not that I have ever been in a huddle with Tom Brady, but if I was, with less than a minute left and we needed to get a touchdown, that’s how I felt.”

Tolis recommended a single-bypass surgery, which would create a new path for blood to flow.

“Mr. Flynn had a unique problem: He had a critically occluded single artery, but it was located in the most important artery in his heart,” Tolis said. “A single bypass might not be as ‘dramatic’ as a triple or quadruple bypass, but in his case, it was the only intervention that would both restore blood supply and add to his longevity.”

A few days later — a little more than two months after his primary care provider first flagged the concern — Flynn successfully underwent surgery at the Brigham. That was followed by eight weeks of cardiac rehabilitation at NWH, where he helped regain his strength, endurance and confidence through exercise and education.

“There are patients like Mr. Flynn who feel duped by the fact that they’ve done all the right things but still need open-heart surgery — like nothing they did matters,” Tolis said. “This is a normal reaction, but it very much does matter. All the hard work you’ve done to stay healthy works to your advantage going into surgery because you can restore your lifespan to a normal, or possibly even better one, than the average person walking down the street.”

Sure enough, Flynn soon returned to his busy life at work and home. This spring, as he marks the first anniversary of his surgery, he looks forward to hitting the golf course again and enjoying time with his wife, Amy, and their children.

“After listening to all these amazing and smart people, I was like, ‘I’ve got to get this procedure.’ And I’m very grateful I did,” he said. “I’ve still got so much living to do.”