When heart attack strikes, minutes save lives
Erik Hamilton is a great guy - hard worker, devoted husband and incredible businessman. But he, like many of us, isn't a good listener when it comes to taking heed of his body's warning signals.
Erik's heart was trying to tell him something was wrong, but rather than get help, he paced the floor of his home in the middle of night in the hopes that the pain in his chest would subside.
Fortunately, Erik's dog, Tigger, sprang into action and raced up the stairs to wake Erik's wife, Anastacia. She found him collapsed on the stairs. Erik was having a heart attack.
Using a new computer-guided 12 lead EKG system, paramedics knew Erik's situation was critical and bypassed other nearby hospitals to get him to Hoag - one of only a handful of hospitals in Orange County designated as a cardiac receiving center; and one of a few in the nation to achieve door-to-balloon times of 60 minutes or less. (Door-to-balloon time refers to the time between the patient's arrival at the hospital and when angioplasty treatment is administered.)
While in route, paramedics were in constant contact with Hoag's Emergency Care Unit, setting in motion a life-saving program called Code 60.
The term Code 60 represents Hoag Heart and Vascular Institute's goal of achieving restored blood flow to the heart muscle in 60 minutes or less. While paramedics are en route, Hoag's Code 60 team assembles in preparation of beginning treatment the moment the patient arrives at the hospital. This process, in which paramedics perform EKGs before a patient's arrival, in conjunction with the development of the Code 60 program, has substantially decreased the time between patient arrival and treatment.
"For individuals experiencing a heart attack, it is critical that medical attention be provided without delay," explains Richard Haskell, M.D., medical director of cardiology at Hoag. "Hoag's Code 60 program involves a multidisciplinary team of cardiologists, physicians, nurses, paramedics and technicians. The team responds 24-hours a day, which significantly expedites the transition of heart attack patients from arrival at the ECU to treatment in the cardiac catheterization lab."
And expedite they do. At Hoag, it takes no more than 60 minutes for heart attack patients to get from ECU arrival to treatment in the cath lab - well below the most recent national goal of 120 minutes.
"Our team is the best in the county," asserts Dr. Haskell. "They are a devoted group of individuals much like fire fighters - springing out of bed in the middle of the night to respond to the critical needs of our patients. When they get the page, they are here in minutes, getting the cath lab ready for the patient's arrival. It's an incredible level of commitment, but one that greatly benefits our patients."
Yet, there are two parts of the equation when it comes to rapid response to heart attack. The clock doesn't start ticking when the patient is in route to the hospital. It really begins with the first warning signs of a heart attack.
"Erik is not unlike many who experience heart attack," confirms Dr. Haskell. "Men, in particular, often wait to seek treatment, thinking that perhaps it's just a bad case of heartburn. It's important that people understand the urgency of the situation. Heart attack often presents with chest pain, but it can also present as pain in the neck, shoulders or arms. Individuals may also become very nauseated, sweaty and weak. If any of these symptoms occur, time is of the essence."
That's because a heart attack deprives the heart muscle of its blood supply. Once the blood supply is interrupted, the heart begins to suffer damage - the longer the heart is without blood, the greater the degree of damage.
"If a patient can get to the hospital and have the artery opened within 120 minutes of the onset of symptoms, which is the national standard, then a lot of heart muscle can be saved," explains Dr. Haskell. "At Hoag, our goal is to open the artery within 60 minutes of the patient's arrival at the hospital; and in Erik's particular case, we achieved it within 37 minutes of the time of his arrival."
"I feel fortunate to have received the best possible medical care when I needed it most," says Erik who started a new job only three days after his heart attack. "It was amazing how quickly the cardiac care team mobilized and worked together to save my life."
"This experience has been a real eye-opener," adds Erik. "It's taught me how important it is to listen to your body. I've been telling my friends, if you ever have chest pains, or any other pain for that matter, take action, not chances."
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