When 81–year–old Lucy Guzman came home after babysitting a grandchild in April, she felt ill. Stricken with sudden pain and nausea , her hand shaking as she struggled to drink a glass of water, she approached two sons who were in the living room.
"Please take me to the doctor's office," she told them, "I don't feel good."
Something told the sons this was serious. One son called 911 while the other gave her an aspirin, known to be a smart first aid move in the event of a possible heart attack.
In minutes, the mother of 12 from East Chicago found herself in an ambulance en route to St. Catherine's Hospital in East Chicago. The astute emergency medical technicians had alerted the emergency department and had them lined up at the door waiting to treat her when she flew through the big entry doors.
Almost immediately, an electrocardiogram (ECG) was done which proved Guzman was having an ST–segment elevation myocardial infarction (STEMI), the most critical type of heart attack, in which the coronary artery is entirely occluded by a blood clot.
Within one hour of coming through the door, Guzman was in the cardiac catheterization lab with interventional cardiologist Dr. Jay Pandhi opening up the occluded artery with a balloon and putting in a stent.
"I had no idea it was my heart," says Guzman, who admits the symptoms had her perplexed. In fact, she thought maybe it was the flu.
Gail Potchen, 68, was visiting her daughter in Schererville last July when she started experiencing intense pain that radiated to her left arm and jaw and she was sweating profusely and feeling nauseous.
Just as in Guzman's case, Potchen's quick–thinking family members gave her aspirin and called 911.
A few days shy of the one–year anniversary of the attack, Potchen recalls the urgent pleas she heard en route to St. Margaret Mercy Healthcare Centers' south campus in Dyer. "Stay with me Gail," they had said to her, again and again, until the doors flew open. There waiting for her was a crew of specialists who confirmed she was having a STEMI, the most critical type of heart attack that strikes some 400,000 people in the U.S. every year, ending their lives in many cases.
She stayed with them indeed, and 47 minutes later, she was on the cardiac catheterization table, with Cardiologist Dr. Michael Nicholas performing an angioplasty to open her blocked artery and putting in a stent.
She too, wasn't sure at first if the pain and discomfort was her heart, or the temporomandibular joint disorder she had experienced before.
In stories of miraculous survival like these, the victims often speak of their good fortune – how the best doctors "just happened to be in the house," or how flawlessly the chain of events just happened to work out in their favor.
In actuality, as accredited chest pain centers like St. Catherine's and both campuses of St. Margaret Mercy will say, it is by no means a fluke, but rather, the result of rigorous evaluations and procedure changes to create a collaborative approach between departments to seamlessly handle patients who may be in the midst of a heart attack.
According to sources at the other area hospitals, Community Hospital in Munster and St. Mary Medical Center in Hobart are both working towards earning accreditation for their chest pain centers. Porter Health System in Valparaiso is looking to receive accreditation in the first quarter of next year.
Many are familiar with what a trauma center is, an emergency room specially equipped to handle injuries involving blunt trauma to the body, like gunshot or stab wounds, head injuries and the like. At these hospitals and others striving to earn the accreditation from the Society of Chest Pain Centers, the concept of a chest pain center is emerging to more swiftly address the nation's No. 1 killer.
Dr. Eric Cook, medical director of the chest pain center at St. Margaret Mercy Healthcare Centers, says the process starts with ambulance personnel who are trained to perform and interpret a 12–lede electrocardiogam (ECG) right in the ambulance, if so equipped, so the cardiac catheterization lab staff and doctors can begin mobilizing even before the patient arrives. When the ECG shows ST elevations, a "Code STEMI," is called which summons the appropriate staff immediately.
This enables fast opening of the blocked vessel by inflating a tiny balloon. The American Association of Cardiology and the American Heart Association have set a standard that from the time the patient comes through the door to the time their blood vessel is opened, known as "door–to–balloon time," should be no more than 90 minutes.
Hospitals accredited by the SCPS consistently achieve this benchmark at least 75 percent of the time and have a volume of at least 36 patients a year, Cook says, an accomplishment that can be tough to coordinate without special measures put in place. For example, Cook says all cath lab employees have to be able to get to the hospital within 30 minutes.
Pandhi says mortality from heart attacks over the years has been dramatically reduced because of several factors, including the use of aspirin, the advent of new thrombolytic agents and blood thinners and immediate angioplasty. But despite advancements and awareness in treating a heart attack, those experiencing chest pain have to be able to recognize the signs and seek medical attention promptly.
While both these women experienced some of the classic signs of a heart attack, doctors say the signs aren't always immediately clear, especially in the case of women, the elderly and those with diabetes. It may be simply some shortness of breath or unusual fatigue – vague symptoms that inevitably cause doubt –– and delay –– when it comes to heart attack awareness.
Cook says statistics show that people experiencing chest pain wait two to four hours to call 911, during which time the heart muscle is deprived of blood and begins dying.
