Time is of the Essence with Heart Attack Treatment

July 9, 2010

Best Rated - Cardiac CareIs it heartburn, a stomachache, or a heart attack? Many people have these symptoms and debate the importance of going to the hospital. Even though heart disease is the number one killer in the United States, only 27 percent of people surveyed by the Centers for Disease Control in 2005 were aware of all major warning signs of a heart attack and knew to call 9-1-1 if someone might be having one.

To raise awareness, Floyd Memorial is launching a campaign called, “Know the Signs. Know the Number.“ Tom Harris, MD, is a board certified emergency medicine physician in Floyd Memorial’s Emergency Center. “Studies show that one of the toughest parts of increasing heart attack survival rates is getting people to access help sooner. When you call 9-1-1, you speed up response time for care. All ambulances are outfitted with defibrillators and many with EKGs, which allows critical information to be transmitted to the hospital before the patient arrives. It also allows us time to activate our 24/7 interventional team before the patient arrives so that they can be taken directly to the Cardiac Cath Lab, explained Dr. Harris.

Tom Harris, MD
“The first objective of treating a heart attack is to start treatment as soon as possible. Muscle tissue dies permanently in six hours. The sooner you restore circulation to the heart, the more muscle tissue you can save. The longer you wait, the greater chance of irreparable damage. That’s why the saying we use is;‘Time is muscle.’

Tom Harris, MD
Board Certified Emergency Medicine Physician
Floyd Memorial Emergency Center

Know the Warning Signs

When it comes to warning signs, most people think of crushing chest pain. According to board certified Cardiologist Srini Manchi, MD, knowing what to watch for is key since many of the symptoms of a heart attack can mimic other less serious conditions.

“Any constant or recurrent chest pain is a signal to seek medical attention, Dr. Manchi said. “People who have risk factors for having a heart attack should really be cautious of warning signs, including unusual shortness of breath or significant sweating. While gastrointestinal problems, dizziness, passing out and nausea are not as common and can mimic other conditions, they are still major warning signs of a heart attack that warrant attention.

Heart Attack Warning Signs

  • Indigestion or gas-like pain
  • Chest discomfort
  • Dizziness
  • Shortness of breath
  • Pain spreading to the jaw, neck, shoulders or arm
  • Unexplained weakness or fatigue
  • Discomfort or pain between the shoulder blades
  • Nausea
  • Sense of impending doom

Men and women’s most common heart attack symptom is chest pain or discomfort. But women are more likely to experience other common symptoms, particularly shortness of breath, nausea, and back or jaw pain.

action For a free Signs and Symptoms of a Heart Attack magnet, call 1-800-4-SOURCE (1-800-476-8723).

The Only 24/7 Interventional Team in Southern Indiana

In 2009, Floyd Memorial partnered with other local agencies on Mission: Lifeline, a program that helped to equip local ambulances with 12-lead EKGs so critical information on possible heart attack patients could be transmitted to the hospital before the patient arrives.

According to Dr. Harris, an EKG is used to identify if a patient is having a STEMI, or an ST-Segment Elevation Myocardial Infarction. “A STEMI is the most severe form of a heart attack because it indicates that arteries are completely blocked, which is why it is so critical to have access to a 24/7 interventional team who can take the patient to the Cath Lab for an angiogram as soon as they arrive.

To support this initiative, the hospital created its 60 Minutes Team, an initiative focused on improving door-to-balloon time, which is the time a patient presents to the Emergency Center with signs of a heart attack to the time it takes to restore blood flow to the artery in the Cardiac Cath Lab.

“The national standard is 90 minutes. Through the efforts of our 60 Minutes Team, we have been hugely effective in meeting and exceeding this standard. Our average right now is 74 minutes, and we’re working to get it even lower. The problem is people wait too long to access medical care, said Dr. Harris.

What Happens During a Cardiac Catheterization

Dr. Manchi explains the process once a patient is brought to the Cath Lab: “First we perform a heart catheterization or angiogram, which allows us to visualize the blocked arteries.

The angiogram involves the injection of dye into the arteries to identify completely blocked arteries or areas of blockage and clotting.

“If an artery is blocked, we then perform a balloon angioplasty which involves the insertion of a catheter with a small balloon on the end into the artery. The balloon is inflated and opens the artery. A stent, which is a small mesh tube, is then positioned to keep the artery open.

Srini Manchi, MD
“Many hospitals will treat heart attack patients in the Emergency Center with thrombolytics, which is a blood thinner, to try to open the clot. When this doesn’t work, patients are then in a rescue situation. Thombolytics are shown to have 50 to 55 percent efficiency. Our process eliminates the “wait and see strategy by taking heart attack patients directly to the Cath Lab for an angioplasty as soon as they arrive. This process has shown a 90 percent success rate.

Srini Manchi, MD
Board Certified Cardiologist
Cardiovascular Associates of Southern Indiana, PC