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Surviving Heart Attack: Get Me To The Door On Time!
Angioplasty can stop a heart attack in its tracks, but only if you get to a hospital that offers angioplasty, and only if you get there fast enough.
Cardiologists like to say “Time is Muscle”: every minute a heart attack continues the likelihood of permanent heart damage increases.

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A heart attack occurs when the blood flow to the heart has been cut off, resulting in heart muscle damage and potentially death. If cardiologists can reopen blocked blood vessels with an angioplasty balloon within a couple of hours after a heart attack begins, blood flow can be restored and heart damage prevented.

Door-to-Balloon Time Getting Shorter
Time from arriving at the hospital to receiving angioplasty is called “door-to-balloon time” and in the past few years many hospitals have made significant strides in shortening “D2B” time, often treating patients with angioplasty within an hour.

Angioplasty within 90 minutes of arriving at the emergency department is the gold standard of treatment for heart attack, recommended by all the major medical societies.

But right now, many heart attack victims are not receiving this treatment. To get access to the best emergency care, heart attack sufferers have to do get to a hospital quickly, and they have to get to a hospital that offers angioplasty.

There are an estimated 5,000 emergency departments in the United States. There are an estimated 2,000 catheterization labs, facilities equipped to perform angioplasties. That means that less than 50% of hospitals can offer heart attack victims on-site emergency angioplasty, the gold standard of treatment.

To Get The Best Care, Have a Plan In Place and Don’t Wait to go to the ER
If you or a member of your family is at risk for heart attack (have coronary artery disease, a family history of heart disease, or risk factors such as high cholesterol or high blood pressure), it makes sense to educate yourself ahead of time, and make a heart attack emergency plan. Just as you might plan a family escape route in the event of a fire or keep flashlights around in case of a power outage, it’s a kind of practical insurance to know that you have a plan, and will know just what to do, in the event of a possible heart attack.

1) Learn the Symptoms: Listen to Your Body. Familiarize yourself with the range of heart attack symptoms. Heart attacks can involve slow and subtle warning signs; people rarely collapse to the floor clenching their chest as in the movies. Pay attention to your body and what it is telling you -- no one wants to be a hypochondriac, but when it comes to heart attack, it’s way better to be safe than sorry. Most heart attack victims wait hours before going to the hospital, greatly decreasing their chance to benefit from angioplasty. For angioplasty to be most effective, the quicker you get to the hospital to get checked out the better.

2) Call an Ambulance: Know the number to call an ambulance and don’t be embarrassed to use it; don’t drive yourself or have a family member drive you unless it’s your only option. Ambulances are usually equipped to begin administering tests and emergency care en route, saving you precious time. And, you will be attended to more quickly when you get to the ER if you arrive by ambulance. Time is muscle; you don’t want to be delayed by traffic or bureaucracy. While you wait for the ambulance, take an aspirin, which can help thin your blood and discourage clotting.

3) Plan Ahead to get the Best Care: Do some research ahead of time to determine which hospital in your area offers the best heart attack treatment. It’s good to know what your options are. In some parts of the country, sophisticated systems have been set up to transfer heart attack victims from community hospitals to regional centers that have cath labs.

You want to go to the closest ER that has a catheterization lab, or if there are no cath labs in your area, go to a community hospital that has an effective system for quickly diagnosing and then transferring heart attack victims to a facility that offers angioplasty services.

Your spouse or support person should be aware of the urgency and educated to ask about access to emergency angioplasty. If initial tests indicate an acute myocardial infarction (or STEMI) is occurring, your family member can tell hospital and emergency personnel that you prefer to be transferred to a facility with a cath lab immediately, so that you can be treated within the desired “door-to-balloon time” of 90 minutes.

For more on when to suspect heart attack and how to prepare ahead of time:
Heart Attack Signs (PDF)


Reported by Deborah Shaw, Patient Education Editor, October 1, 2011