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Cardiac Care Begins At Your Door

Our Cardiac Care Begins at Your Door

April 1 started out as an ordinary day for John O’Connor, 65, of Cheshire. He was at work, replacing a roof, when he suddenly realized he didn’t feel right. He asked his son, Brendan, who was working with him that day, to take him home.

O’Connor’s lightheadedness was soon compounded by a heavy feeling in his chest.

“We were home maybe 10 minutes when I said, ‘I think you’d better call 911,’” O’Connor recalled.

Although heart disease runs in his family, and he was taking medication to control his cholesterol levels, O’Connor never suspected he was having a heart attack. By the time the ambulance arrived, O’Connor was sweating profusely and in noticeable pain.

“They got me in the ambulance and started for Waterbury,” O’Connor recalled. “It’s amazing how fast everything went.”

Emergency medical services (EMS) personnel administered medications en route to Saint Mary’s Hospital and forwarded the results of an electrocardiogram to the Emergency Department. When the ambulance arrived at the hospital, O’Connor was triaged and transported within minutes from the Emergency Department to the Cardiac Catheterization Lab, where a team led by Stephen Widman, MD, interventional cardiologist at Saint Mary’s, was already waiting.

A 90-minute Window

The type of heart attack O’Connor suffered is called an ST-elevation myocardial infarction (STEMI), which means that one of the major arteries supplying blood to his heart was completely blocked.

“The heart muscle sends out pain signals when it doesn’t get enough blood,” Dr. Widman explained. “It also produces symptoms that can include tightness or heaviness in the chest; wheezing; pain in the arm, neck, jaw or mid-back; shortness of breath; and sweating.

Treatment for STEMI may include angioplasty, which involves inserting a tiny balloon into the artery to immediately restore blood flow to the heart. A wire-mesh stent also can be used to keep the artery open. In O’Connor’s case, as with any heart attack, it was important to act quickly.

“The amount of damage to the heart is completely dependent on the amount of time the heart muscle doesn’t receive blood and oxygen,” Dr. Widman explained. “Time is myocardium—heart muscle: The shorter the time, the less damage. Beyond 90 minutes, patients don’t benefit a lot from what we can do.”

Minutes  Mean a Lot

When Dr. Widman inserted the balloon to open John’s blocked artery, O’Connor said he felt an immediate release. “

It was incredible,” O’Connor said. “When you look at the time it took to get me here and get me upstairs, it just seemed awfully, awfully rapid. It was almost a blur. That’s when you learn that minutes mean a lot.”

Ten weeks after his heart attack, O’Connor was enrolled in Saint Mary’s cardiac rehabilitation program and said he never felt better. He’d lost 50 pounds and he and his wife, Mary, and son, Brendan, have all been eating healthier.

“I’m very thankful to Dr. Widman and to Saint Mary’s,” O’Connor said. “I can’t imagine any place where treatment would have been quicker or more efficiently done. The doctor said, ‘You had what they call a widow maker. You shouldn’t be here.’ It’s one of those things that very few people live through. I feel very fortunate.”

Cardiac Patient and EMT

Pushing the Envelope

Within hospitals, the 90-minute “door-to-balloon time,” is a measurement of how quickly patients receive angioplasty from the time they arrive in the Emergency Department. Saint Mary’s Hospital has consistently achieved door-to-balloon times of 60 minutes on average, garnering gold quality awards from the American Heart Association’s Get With The Guidelines® program for five years in a row. Now, the American Heart Association is raising the bar by asking hospitals to track the percentage of heart attack patients who receive life-saving treatment within 90 minutes of the arrival of emergency medical services (EMS) personnel.

“The American Heart Association keeps pushing the envelope in terms of moving people to treatment as fast as possible,” said Paul Kelly, MD, a cardiologist with Saint Mary’s who has championed the hospital’s involvement in Get With The Guidelines. “EMS
personnel in the field have become the critical link between the patient and preservation of heart muscle. These men and women in the field are checking electrocardiograms in patients’ living rooms and transmitting that information to the hospital so we are treating patients before they even leave home.” This year, the American Heart Association honored Saint Mary’s with its Mission: Lifeline® Bronze Award for treating more than 75 percent of STEMI patients within 90 minutes from the time the emergency responders arrived. Saint Mary’s average time is 85.5 minutes.

“Our goal is to get to the patients quickly and get the artery opened as fast as possible, which can prevent complications of a heart attack,” Dr. Kelly said. “Our times are absolutely amazing.”

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