Ah, vacation. You have the morning all to yourself. Feet up, you settle in with your newspaper and a cup of coffee, but something isn't right. You take a deep breath, trying to release the odd pressure you feel on your chest.
You think back to those tacos the night before. Heartburn? The clamp in your chest tightens. A heart attack? No way! You do a set of sit-ups just to prove to yourself you can. But when you stand up, the room spins. There's tingling in your arm. Now you're really getting scared.
You reach for your car keys, but then you remember the neighbor years ago who had a fatal car crash driving himself to the ER. Bad idea. In a cold sweat, you pull out your cell phone and call 9-1-1.
When F-M Ambulance arrives, the crew moves quickly. They ask about your chest pain then attach the pads for an EKG. "ST-elevation," announces a paramedic, then radios the information to MeritCare. You wonder what that means.
Sirens blaring, the ambulance picks up speed. This must be serious. The paramedics start an IV, monitor vital signs, give oxygen and two aspirin and provide nitroglycerin to reduce pain.
You arrive at MeritCare. Everything's a blur, yet you're aware there's order. Each person knows exactly what to do. The process moves quickly. The Emergency Center is ready for you, and then you get whisked to the cardiac catheterization lab where you meet your heart team.
You're given a light sedative, but you still hear people talking to you. Friendly voices. The eyes above the surgical masks look kind. You feel a hand pat your arm. People ask how you are and explain what they're doing.
You can't feel it, but they thread a narrow tube from a large artery in your leg up to your heart to locate the blockage. You notice how calm and confident they are, as if they do this every day. "There it is," you hear someone say. Your chest pain stops.
Within 55 minutes from the moment you entered the hospital, your blocked artery is open.
One chain when minutes count
At MeritCare Heart Center, this scenario happens every day 365 days a year. In 2006 we joined the "Door to Balloon Alliance," a national effort to bring faster care to people having heart attacks. Faster care stops heart attacks, saves lives and significantly reduces permanent heart damage.
Participating hospitals aim for a 90-minute "door to balloon" time. This means that within 90 minutes of entering the hospital doors, heart attack victims have their blocked arteries opened with balloon angioplasty.
At MeritCare, we exceed the 90-minute goal. Patients who arrive by F-M Ambulance can now expect blockages to be cleared in 55 minutes, even as few as 31. Three steps make it possible:
- Pre-hospital diagnosis. F-M Ambulance or LifeFlight nurses and paramedics can now diagnose a heart attack in progress. If the EKG shows ST-elevation – an indication of a heart attack, paramedics radio MeritCare Emergency Center to activate the chain of care. If there are any unclear questions patients will be evaluated at the MeritCare Emergency Center.
- Mobilizing the angioplasty team. As the patient travels to the hospital, the angioplasty team arrives at the cardiac cath lab. Even at night, the on-call team, including an interventional cardiologist, is only a heartbeat away. MeritCare has four interventional cardiologists. If more extensive treatment is needed, such as heart bypass surgery, a cardiovascular surgeon is always available. MeritCare has two.
- Experience counts. Research shows that heart centers with high volumes produce the best outcomes. To treat heart attacks, we perform 3,500 cath lab procedures annually, 1000 cardiac interventions including 600 emergency angioplasties.
The final link: You
After successful angioplasty, you move on to MeritCare's Cardiac Intensive Care Unit. But first, your family. They've been waiting for you in the family room next to the cardiac cath lab. You see the tears as they greet you.
You go home within the next few days, grateful your life was saved. And you're glad to know there's something you can do to help prevent another heart attack: take heart medications as directed, adhere to follow-up visits with your doctor and participate in cardiac rehab. Permanent lifestyle changes include no smoking, exercise and a heart-healthy diet.
A week later, you return to work. Your coworkers look shocked when you tell them your vacation included a heart attack, but thanks to fast treatment the heart attack was stopped and permanent damage minimized. And the sit-ups? They just smile and shake their heads.