Community's Chest Pain Centers strive to keep hearts healthy

For region residents facing a heart attack, every minute matters.

At Community Healthcare System's Accredited Chest Pain Centers, the teams strive to make the most of each minute beginning with the initial 911 call when a patient complains of heart attack symptoms.

The collaborative process is in place at all three locations: Community Hospital in Munster, St. Catherine Hospital in East Chicago and St. Mary Medical Center in Hobart. All of the Chest Pain Centers are accredited by the Society of Chest Pain Centers.

Dr. Arvind Gandhi, medical director of the accredited Chest Pain Center of Community Hospital in Munster, said if an individual is having a heart attack, 60 to 90 minutes is the optimum window for treatment to begin.

"If we can open up the artery within 60 to 90 minutes, the damage is very minimal and the patient will often resume a normal life," Gandhi said. "We want to take immediate and appropriate action."

He said Community's process is in place to help hit this desired door-to-balloon time, which is the period from the emergency call to the procedure when physicians open up the artery.

"We have been successful 90 percent of the time," he said.

Dr. Jagdish Patel, medical director of the accredited Chest Pain Center of St. Catherine Hospital in East Chicago, added in order to work toward this goal, it has to be a team effort.

"For the designation of accreditation, you have to have the process already in place, which involves the cardiologist, ER physician, nursing staff and most importantly, the paramedics. You have to involve all of the different units and bring them together," Patel said. "Without the process, it isn't as well organized. It took a lot of time and teamwork to reach this success."

"It is a mechanism that starts with the ER medical system when the paramedics come to your house," Gandhi explained. "It starts at the point when the phone call is made. Paramedics are doing an EKG at home and transferring it to hospitals so the treatment starts at home. By the time the patient arrives, we are waiting to take care of them."

The centers include a 24/7 full-service cardiac catheterization lab, which offers balloon angioplasty, stents, atherectomy and thrombolysis with blood clot dissolving drugs. There are also non-invasive diagnostic tests, including cardiac ultrasounds, treadmill stress testing and nuclear images of the heart.

"We are trying to ensure through policy and standards, planning and implementation to recognize and treat quickly and efficiently the symptoms of coronary heart disease," said Dr. Jack Ziegler, medical director of the accredited Chest Pain Center of St. Mary Medical Center in Hobart.

Beyond treatment, the centers provide cardiac rehabilitation and guidance for at-risk and current patients.

"For all the people who come in with chest pains and are not having a heart attack, but they are in danger of having one, we can start treatment at that time," Gandhi said. "We do a stress test or get them on the right cholesterol meds. It takes a team effort between the cardiologist and family doctors."

"Part of the Chest Pain Center is prevention. Anyone undergoing an angiogram or angioplasty is in the hospital for days and is seen by a cardiac nurse. We give them information about diet and cholesterol and they join the rehab program, which is eight to 12 weeks long,"  Patel added. "By the time they are done, they have tremendous knowledge and incentive to change a lot of things in their lives relating to exercise, weight management, diet and smoking."

Ziegler said while the importance of the exercise portion of rehab may be obvious, the group sessions are equally important as they touch on the emotional side of heart disease. He said a high number of patients become depressed.

"It's another way for patients to reach out and try to verbalize what they are going through. In a group setting, they have the confidence to articulate what they are experiencing," Ziegler said.

The directors also focus on awareness and education as they remain key to preventing heart disease.

"As a physician, you need to talk to every person that you come into contact with," Patel said. "With good medical management of diabetes, cholesterol and hypertension, we can tremendously reduce the possibility of heart attack or stroke."

"At the center, there is a huge stress on behavior modification and we have physicians give talks on preventive measures," Gandhi said. "In my own practice, the number of heart attacks has gone down."