If you’re having a heart attack you need to get to a hospital, fast. And not just any hospital. A hospital that can give you an emergency angioplasty. Heart attacks are caused by blockages of the coronary arteries. An angioplasty snakes a little balloon up through your blood vessels and inflates it at the site of the blockage, squishing the obstruction up against the walls of the coronary artery and restoring the normal flow of blood. The longer you wait before having an angioplasty, the more heart tissue dies. Cardiologists have a phrase for it: “time is muscle”. They also have a term for the length of time between when you show up at the hospital with a heart attack, and when you get an angioplasty: “door-to-balloon”.
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In recent years, door-to-balloon time has become an important metric of doctors who want to improve emergency care for heart attack patients. The AHA recommends a door-to-balloon time of 90 minutes. Hospitals and medical centers nationwide took the initiative to review their procedures and shorten wait times for angioplasty whenever possible to meet or surpass the AHA guidelines.
Apparently, their efforts have paid off. A newly released study reviewed heart attack statistics between 2005 and 2010. It found that only 44 percent of patients received an angioplasty within 90 minutes in 2005. By 2010, that number had zoomed up to 91 percent. The researchers also found that 70 percent of those patients were treated within 75 minutes, far surpassing the mere 27 percent treated by that time in 2005.
“Close coordination between local EMS, emergency departments and cardiac catheterization labs around the country has lead to this major improvement in patient care,” says Stephen Ellis, MD, Section Head of Invasive/Interventional Cardiology at Cleveland Clinic. “When a patient presents to the Cleveland Clinic Emergency Department with a clearly diagnosable heart attack, we get their artery opened within 60 minutes or less. Forty-minute times are not uncommon.”
Not all hospitals are able to do emergency angioplasties at all hours, so where you are taken when you have a heart attack matters. “Cleveland Clinic has catheterization lab nurses and physicians available in the hospital, and protocols to whisk heart attack patients through the Emergency Department,” says Dr. Ellis.