December 07, 2010
It is only a matter of minutes before an oxygen-starved muscle begins to deteriorate. That is why it is imperative for someone experiencing a heart attack to get immediate medical intervention. Minutes are Muscle when it comes to heart attack because the heart is being deprived of the oxygen it needs to function. The faster oxygen supply is restored to the heart, the less damage the heart will suffer. West Houston Medical Center (WHMC) is working to educate the community on the appropriate steps to take when a heart attack is suspected.
“So often we see patients who waited to call 9-1-1 because they just weren’t sure they were having a problem,” said Tracy Schweinle, Cardiac Quality Manager, West Houston Medical Center. “The number of heart attack patients we see at West Houston Medical Center increases during the holidays for many reasons, but mostly because people just want to delay treatment until after their vacation time. We want to remind people they should never put off medical intervention, especially if they think they are having a heart attack.”
“It is amazing how many people who think they are having a heart attack will try to drive themselves to the hospital or ask a friend or coworker to drive them rather than call EMS,” said Todd Caliva, CEO West Houston Medical Center. “We want people to understand that, yes, it might take the ambulance a few minutes to arrive, but the intervention the EMTs provide can make a big difference in the outcome for that patient.”
Representatives from hospitals, private physicians, EMS providers, and public health organizations are working together to ensure the most efficient, consistent and expeditious care for patients experiencing cardiovascular trauma. Knowing that quick treatment is the best way to save heart attack patients, these healthcare professionals formed the Southeast Texas Regional Advisory Council (SETRAC). SETRAC’s Cardiac Care Committee works to coordinate efforts between agencies to provide the best cardiac intervention and treatment for Houston area communities.
Centers for Medicare & Medicaid Services (CMS) and The Joint Commission, that certifies hospitals for performance and quality standards, currently recommend that when patients arrive at a designated STEMI-Receiving facility like WHMC, that it should take less than 90 minutes from the moment the patient comes through the door of the emergency department to restore blood flow to the arteries surrounding the heart (door-to-balloon time). STEMI stands for ST-Segment Elevation Myocardial Infarction, a severe heart attack caused by clotting in one or more arteries. EMS agencies certify specific hospitals as STEMI-Receiving Centers to handle such cardiac emergencies.
In order to expedite the treatment of heart attack patients, emergency responders are trained to communicate with hospital personnel and utilize equipment such as a portable electrocardiogram (ECG) to communicate readings to the hospital STEMI team (interventional cardiologists, CV nurses, and technicians). The team then prepares for the arrival of the patient to the catheterization lab for the procedure that will restore the blood flow to the arteries surrounding the heart.
“Houston firefighter EMTs and paramedics are working in concert with nurses, emergency physicians and cardiologists,” said Dr. David E. Persse, Physician Director of EMS, City of Houston. “The result is a finely tuned routine that can dramatically reduce the amount of heart damage a person could suffer during a heart attack. The sooner a person recognizes they are experiencing the symptoms of a heart attack and calls for help (9-1-1), the better the results will be!”
57-year-old Bimal Chopra will tell you about the importance of getting immediate, professional care. Recently, Chopra was working from his West Houston home when he began to experience severe chest pain. Chopra lay on the couch for a few minutes hoping the pain would subside. When his pain did not go away, Chopra made the correct decision to call 9-1-1.
“The fire department was there within ten minutes,” recalls Chopra. “They had a portable ECG and were able to detect that I was having a heart attack and started communicating with the hospital immediately. It only took them 25 minutes from the time I got to the hospital to inflate the balloon and have my blood flowing through that artery.”
“When we are able to get a patient from the ambulance into the cath lab and correct the problem in just 25 minutes or less, we know that patient is going to have a much better chance at a good outcome than someone who decided to wait at home for their symptoms to get better,” said Dr. Naim M. Al-Adli, Cardiologist, West Houston Medical Center. “We have worked for several years to orchestrate a response network including EMS personnel. That team effort is succeeding, shaving off critical seconds in transport time and getting our patients the most highly effective treatment.”
Bimal Chopra had several risk factors for heart attack including high cholesterol and diabetes. He visited his doctor regularly to manage his conditions and knew that he needed to take the pain in his chest seriously.
Unfortunately, most people do not know their risk factors and are not familiar with the signs or symptoms of a heart attack.
According to the American Heart Association (AHA) the risk factors for heart attack include:
- Increasing Age
- Family History of Heart Disease
- High Cholesterol
- High Blood Pressure
- Physical Inactivity
- Being Overweight
- Alcohol Consumption
- Poor Nutrition
“We’ve got to educate everyone about risk factors and how to recognize a heart attack,” said Caliva. “We can continue to improve our door-to-balloon times, but our patients, their loved ones, co-workers, or just someone who witnesses another person’s symptoms—are the ones that really make the difference. We all need to recognize a heart attack and be programmed to call 9-1-1.”
“I tell people who are worried that they will call 9-1-1 because they are having symptoms, only to discover that they are not having a heart attack, that it is much better to be safe than sorry,” said Al-Adli. “The whole point of calling emergency response is to allow them to bring the emergency room to you. Let the experts determine whether or not you are having a heart attack. It is their job and they are happy to help.”
According to the AHA, most heart attacks are not sudden, but begin slowly with mild pain which is why most victims of heart attack wait to seek medical attention. The following are warning signs of a heart attack. These symptoms should never be ignored and a call to 9-1-1 should be placed immediately.
- Chest discomfort
- Discomfort in the center of the chest
- Lasts more than a few minutes, or goes way and comes back
- Uncomfortable pressure, squeezing, fullness or pain
- Discomfort or Pain in the Upper Body
- One or both arms
- The back
- Stomach (indigestion)
- Cold sweat, nausea, or lightheadedness
- Weakness and fatigue
According to U.S. News & World Report, researchers say women are slower to get help for a heart attack simply because they don’t believe they are having one. The list of heart attack warning signs experienced by women from most common to least common are:
- Chest pain: 90 percent
- Pain in the jaw or shoulder: 58 percent
- Sweating: 38 percent
- Nausea: 29 percent
- Shortness of Breath: 29 percent
- Indigestion and heartburn: 21 percent
- Weakness or fatigue: 8 percent
“We are constantly working to lower our door-to-balloon time,” said Charles Laird, COO West Houston Medical Center. “In working together with our EMS providers and hospital partners we are able to transport patients to our facility, not only from our community, but from outlying areas that do not have programs in place to treat heart attack patients. At WHMC we are consistently faster than the required 90-minute door-to-balloon time simply because we have made it a priority. Now we want to move that effort into the community with the Minutes are Muscle message and encourage people to utilize their EMS services to get them to the hospital.
About West Houston Medical Center
West Houston Medical Center is a 222-bed full service hospital located on Richmond Avenue just east of Dairy Ashford. The hospital has served the community for more than 20 years with 24 hour emergency services; an open heart surgery program; neurosurgery program; inpatient and outpatient surgery and diagnostic services; women’s services; wound care and many more. In Sugar Land, the Sugar Land Cancer Center and the Sugar Land Diagnostic Center are located on the Southwest Freeway at the Williams Trace and Sugar Lakes exit. The diagnostic center and the cancer center facilities are departments of West Houston Medical Center. Visit us at www.westhoustonmedical.com
12141 Richmond Ave. = Houston, TX 77082 = 281-558-3444 = www.westhoustonmedical.com
About HCA Gulf Coast Division
HCA Gulf Coast Division is a comprehensive network of hospitals, outpatient surgery centers, emergency centers, cancer centers and diagnostic imaging facilities. It offers a complete continuum of specialized health programs and services that meet the needs of Greater Houston and South Texas residents and businesses. HCA affiliated facilities in the Gulf Coast Division include 12 hospitals, 7 ambulatory surgery centers, 4 free standing emergency centers, 5 imaging centers, 5 cancer care programs and a Regional Transfer Center. The Regional TransferCenter provides ground and air patient transportation to and from any HCA Houston Affiliated Hospital and any other healthcare facilities. For more information visit our website at www.hcahouston.com
 Kotz, D. (2008). Women having heart attacks often slow to get help. U.S. News & World Report. Retrieved on 11/18/2010 from http://health.usnews.com/health-news/blogs/on-women/2008/5/2/women-having-heart-attacks-often-slow-to-get-help.html