Paul Marquis is a happily married, 57-year-old San Clemente native with three children and two grandchildren. A family man at heart, he sits on a balcony that overlooks the ocean, recalling how difficult it was for him to simply walk on the beach just two years ago.

As the owner of a construction company, Paul is familiar with the aches and pains that come from a day of physical labor. But when he began experiencing fatigue on a regular basis, he knew something was wrong. Just chasing two grandkids around the house brought a degree of discomfort. What started as shortness of breath developed into serious chest pain, which impacted both his professional and personal life. It was time to seek help.

Years earlier, cardiologist, HoHai Van, M.D. had diagnosed Paul’s mother with coronary heart disease, or CHD. Coronary heart disease, also called coronary artery disease, is a narrowing of the small blood vessels that supply blood and oxygen to the heart. Having experience with Dr. Van, Paul visited his primary care doctor to request a referral.

With his mother’s history, Dr. Van recommended that Paul get screened as a preventative measure. The results of the tests concluded that Paul had coronary heart disease. Dr. Van promptly scheduled Paul for a coronary angiogram.

During the procedure, Dr. Van saw there were a number of blockages, and that the coronary disease was too significant to be treated with a stent. Quadruple bypass surgery was needed. Paul’s surgery was scheduled to take place four days after this new diagnosis. The successful quadruple bypass surgery was performed by Dr. David Perkowski, medical director of cardiac surgery at Saddleback Medical Center and pioneer of the “off pump” heart surgery.

Dr. Perkowski has performed more than 2,000 similar surgeries that have resulted in fewer infections, strokes, excessive blood usage and better overall results. He recently published his findings in the Journal of Therapeutic Advances in Cardiovascular Surgery, discussing the results and positive outcomes of his patients using his novel technique.

Feeling strong and healthy, Paul can once again walk on the beach for miles with his grandkids.

“Don’t ignore your symptoms. If you have any of the classic heart disease symptoms, go see your primary care physician. I am lucky I did not have a heart attack so don’t ignore it. Go see a doctor. See Dr. Van,” says Paul.


Saddleback Medical Center’s comprehensive heart care includes prevention programs, screenings and personalized state-of-the-art treatment for a wide range of conditions, such as atrial fibrillation (AFib) and valve replacement. This unique and comprehensive approach to heart care leads to better outcomes and shorter recovery times. Our award-winning team focuses on a multidisciplinary approach to care, which encompasses the team at every level of service from the ICU to the Cath Lab.


Chest pain is one of the most common reasons that patients come to the emergency room. After obtaining a full history on the patient, a number of tests are conducted including an EKG and Chest X-ray. Once all the information is collected, a clinical scoring system called a Heart Score is determined. The score helps ER staff assess chest pain patients and determine who are at risk of a major cardiac event. Scores are based on the History, EKG, Age, Risk factors and Troponin (HEART). Patients with low scores are likely to be discharged. Patients with high scores are likely admitted for further observation or treatment.

“Our Emergency Department is an Orange County Medical Services (OCEMS) designated cardiac receiving center that meets all best practices, with cuttingedge therapies, treatments and protocols and operates at the highest level,” says Marc Taub, M.D., medical director of the emergency department.


Saddleback Medical Center is in the middle of I’MAGINE, a space redesign project to enhance patient experience and create an even more comfortable, healing environment with modern medical technology, including a new state-of-theart hybrid surgical suite. The hybrid suite is an operating room that will feature state-of-the-art imaging technology. Typically, imaging is located in a different area, which can delay or postpone a lifesaving treatment. In the hybrid suite, heart and other complex procedures will result in even better outcomes because the surgeon has access to real-time imaging, while in surgery.

“The improved imaging technology in the Hybrid Suite will allow us to do more precise positioning of devices such as the Transcatheter Aortic Valve Replacement (TAVR), which benefits patients that were inoperable, high risk, or not candidates for surgical valve replacements before,” says Michael J. Gault, M.D., medical director of cardiology.


The program provides social support and education ranging from early prevention to end-stage options. What sets Saddleback Medical Center’s program apart is our unique approach to coordinated and centralized care with an in-house pharmacy, nutritionists, social workers and nurse practitioners.

“Providing more optimized services from a care perspective, the Heart Failure Program at Saddleback Medical Center seeks to be a good standard in heart failure management service. We put an equal emphasis on education and the social aspect of care that impacts the quality of life for our patients and their families. What sets us apart, is our human touch and the care we provide,” says Ryland Melford, M.D..