Healthbeat Report: Surviving Heart Attacks

September 16, 2011 4:57:05 AM PDT
Most heart attack victims are often at the mercy of the medical response team. Now there's a greater effort to make sure patients with the most severe heart attacks have a better chance of survival. But there are concerns that this process should move faster and be better organized.

"I woke up and came outside to do yard work. I swung a hammer twice, and that was it. Major arm pain, my throat was closing up and broke out in a cold sweat," said Bobbie Jeske, heart patient.

At first Jeske had no idea why she felt so sick so fast. She went inside to lay down and called her parents who live nearby. They rushed over, saw their daughter, and quickly dialed 911.

Paramedics Brenda Farlow and Brain Houdek with the Northlake Fire Protection District answered the call. They suspected a heart attack, and a piece of equipment called a 12 lead EKG helped determine it.

"It was clearly showing an acute MI...heart attack," said Farlow. "We called Loyola and told them we had another hospital that was closer but we felt it was better to come to them and they agreed with us."

Loyola has a 24 hour cardiac cathaterization lab, which means there is a team of specialists around the clock, ready to fix the problem fast.

Time to treatment is considered by many experts the most critical issue. When a patient arrives at the hospital, the quicker the blood flow is restored the greater their chance of survival. An emergency angioplasty is typically done where a balloon catheter is inflated in the blocked artery, destroying the clot.

"The paramedics come to the cath lab with the patient...and within minutes we would be inside the heart and able to open the blockage and stop the heart attack," said Dr. Fred Leya, interventional cardiologist, Loyola University Medical Center.

There's been a national push to improve treatment times for the most dangerous heart attacks technically known as stemis or the widowmakers. And the campaign seems to be working.

A surprising report in the journal "Circulation" finds hospitals are now treating almost all major heart attack patients much faster -- within the recommended 90 minutes of arrival. But many centers with special cardiologists and labs believe it should be even faster -- 60 minutes or less.

"By 90 minutes, you lose a lot of heart. So it's best to shorten this time to maybe 20-30 minutes," said Dr. Leya.

And then there is the issue of equipment.

Many suburban fire departments and private ambulance companies in the Chicago area have 12 lead EKG machines in their vehicles. The expensive device provides an electrocardiogram which reads the hearts electrical activity. This can help determine how severe the situation is so a hospital can mobilize before the patient arrives.

Many major U.S. cities have fire department ambulances with the 12 lead EKGs. Chicago does not.

"We really don't have any information on patients until they actually get to our emergency department. We do not have electrocardiograms we may have a symptom history, but its not enough to activate a cardiac cath lab," said Dr. Charles Davidson, interventional cardiologist, Northwestern Memorial Hospital.

Dr. Davidson says its emergency angioplasty times are really good. But he thinks they could be even better if the 12 lead EKG machines were in the ambulances.

"Chicago really needs to move forward with this as is being done in New York, Los Angeles and Boston," he said.

Loyola says in Jeske's case, her artery was opened and a stent put in in just 15 minutes. She believes the quick response, advance equipment, and the option to go to a particular hospital saved her life.

"They told me I was lucky to be alive...5 to 10 more minutes I would not be here," said Jeske.

A spokesperson for the Chicago Fire Department says the city needs uniform standards from the hospital network to implement the use of 12 lead EKGs. He says there are financial considerations but the overriding issues are standards and consistency. Many suburban communities have come up with their own system to address rapid response to heart attack emergencies.

Heart Attack: Heeding the Symptoms

Patients can also improve their odds of getting prompt treatment by getting to the hospital as quickly as possible if they suspect a heart attack.

To do that, know the potential warning signs. According to the American Heart Association, these may include:

  • Discomfort in the chest. This can feel like a squeezing, fullness, pain, or pressure
  • Discomfort in other upper body areas. These can include one or both arms, the back, the neck, stomach, or jaw
  • Shortness of breath
  • Breaking out in a cold sweat
  • A feeling of nausea or lightheadedness
  • Loyola University Medical Center Heart Attack Rapid Response Team (HARRT)

    American Heart Association

    Bluhm Cardiovascular Institute, which includes the angio lab:

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