By Dr. William Dillon
Your Voice Contributor
Every year, heart attack patients die needlessly by driving themselves to the hospital.
Why? Maybe the person is in denial about having a heart attack. Or he or she could be embarrassed that it might not be a heart attack and is really something less threatening. Maybe the person is concerned that he or she might have expensive hospital or ambulance bill.
The fact is this: you have a much better chance of surviving a heart attack by dialing 911 and having trained emergency medical services (EMS) personnel care for you.
Whatâ€™s the difference between the ambulance and your car?Â First, the dispatcher who answers the 911 call will direct you to take life-saving steps, such as taking an aspirin. Second, EMS can perform an electrocardiogram (ECG) immediately at the scene. That ECG is electronically sent ahead to the hospital so its cardiac cath lab team is alerted and ready.
Several hospitals allow paramedics to diagnose the heart attack and call to activate the cath lab from the scene. (Paramedics in our area correctly diagnose a heart attack more than 90 percent of the time.) This early activation saves valuable time early in a heart attack that can spare heart muscle and lives.
The EMS crew will know which hospitals are equipped to rapidly treat heart attack patients. Not every hospital has the ability to perform the life-saving procedure called percutaneous coronary intervention (PCI, commonly called angioplasty) thatâ€™s often needed to stop your heart attack.
To perform a PCI within the recommended 90 minutes (measured from the time the patient first receives care until the heart attack is stopped) requires committed EMS, a dedicated Emergency Department, skilled cardiac cath lab personnel and an interventional cardiologist on call 24 hours a day and available within 30 minutes of notification.
If you drive yourself, you may go to a nearby hospital or urgent care thatâ€™s not properly equipped. This leads to delays in treatment which could greatly affect your future health. Time lost means heart muscle dying.
Hospital systems such as Baptist Health have worked closely with EMS throughout the region to improve pre-hospital care of heart attack patients with great strides made locally.
Early recognition by the patient that there is a problem is critical to long-term outcome. On average, patients wait more than 90 minutes before seeking medical attention. That is a long time when your heart is dying. Every hour delay in opening the blocked artery increases your chance of dying by 10 percent.
The symptoms to look for:
- Pressure or crushing discomfort in the center of the chest that may radiate down the left arm or into the jaw area
- Excessive sweating
- Shortness of breath
- Women and the elderly may not have chest pain and have an increased likelihood of atypical symptoms (fatigue, weakness, indigestion, etc.)
Any chest pain that last more than 10 minutes could be a sign of a heart attack.
For your part, make that 911 call right away. EMS is trained to diagnose heart attacks and take you to the nearest equipped hospital/PCI center that performs angioplasty. More than 90 percent of PCI centers in Kentucky perform an angioplasty for heart attack within the nationally recommended time limits.
The real advances in heart attack care going forward will be with early recognition by patients and with hospitals that work with EMS to streamline the process.
How serious is the problem? Cardiovascular disease is the most common cause of death in Kentucky and the United States. Kentuckians have one of the highest mortality rates from heart attack in the country. The most recent statistics put us at 49th out of 50 states for heart attack mortality.
The best medical treatment for a heart attack is a rapidly performed angioplasty/PCI performed at a hospital with the proper equipment and personnel.
You just have to get there.
Donâ€™t be a statistic. Do your part and call 911 immediately so we can do our part in saving your life.
William Dillon, MD, is an interventional cardiologist with the Louisville Cardiology Group, part of Baptist Medical Associates. He has been instrumental in creating a 14-county network to help ensure that heart attack patients are taken to a properly-equipped facility. He is the co-chairman of Mission Lifeline Kentucky, which is an effort through the American Heart Association to improve heart attack care in Kentucky. Dr. Dillon also helped gain approval from the Kentucky EMS Board to allow EMTs to perform EKGs.