Methodist Hospital of Southern California has been approved as a STEMI receiving center by the Los Angeles County Department of Health Services’ Emergency Medical Services Agency, effective Jan. 1, 2007. This certification means that when paramedics identify patients as having an acute cardiac myocardial infarction (heart attack), they are instructed to bring the patients directly to one of the approved STEMI receiving centers, such as Methodist Hospital.
In support of a research study that was published in The New England Journal of Medicine on Nov. 30, 2006, which surveyed 365 hospitals to identify strategies that were significantly associated with a faster “door-to-balloon” time, the American College of Cardiology (ACC), together with the American Heart Association (AHA) and other key national health care organizations, recently launched a national initiative to improve “door-to-balloon” timeliness in treating patients who present at hospital emergency rooms with a common type of heart attack called ST-elevation myocardial infarction (STEMI). “Door-to-balloon” time refers to the interval between arrival at the hospital and the opening of a blocked artery with an angioplasty balloon.
Previously published guidelines developed by the ACC and AHA recommend that hospitals treating STEMI patients with percutaneous coronary intervention (PCI, also referred to as balloon angioplasty) should reliably achieve a door-to-balloon time of 90 minutes or less. Accomplishing this level of performance is an organizational challenge for many hospitals and countless patients are not treated within the recommended guidelines. However for more than 10 years the chest pain team at Methodist Hospital has been successfully treating STEMI patients well within that timeframe.
“We have known for a long time that for patients who exhibit symptoms of a heart attack, PCI administered within 90 minutes of the time they present is the preferred treatment that offers patients their best chance at recovery without suffering long-term adverse side effects,” said Terrence Baruch, M.D., medical director of the cardiac catheterization lab at Methodist Hospital. “We’re pleased that the L.A. County’s Emergency Medical Services Agency recognizes that our team provides some of the best cardiac care in Los Angeles County.”
At Methodist Hospital, a cardiac care team is accessible 24 hours a day, seven days a week so that patients who need their care can receive it at any time. When STEMI patients present at Methodist Hospital’s emergency room, the highly-trained emergency medical staff assesses their symptoms and brings in a chest pain team that’s “on call” to effectively treat their symptoms. “The Los Angeles Department of Health Services’ approval is a formalization of what we’ve already been doing here for many years,” said Jacob Fakoory, M.D., medical director of the Methodist Hospital emergency department. “I’m glad that we’ll be able to help more patients avoid the adverse effects heart attacks can have on their lives.”
Heart Attack Warning Signs
According to the American Heart Association, most heart attacks start slowly, with mild pain or discomfort. Often people affected aren't sure what's wrong and wait too long before getting help. The following are signs that can indicate a heart attack:
- Chest discomfort: Most heart attacks involve discomfort in the center of the chest that lasts more than a few minutes, or that goes away and comes back. It can feel like uncomfortable pressure, squeezing, fullness or pain.
- Discomfort in other areas of the upper body: Symptoms can include pain or discomfort in one or both arms, the back, neck, jaw or stomach.
- Shortness of breath: May occur with or without chest discomfort.
- Other signs: These may include breaking out in a cold sweat, nausea or light-headedness. As with men, women's most common heart attack symptom is chest pain or discomfort. But women are somewhat more likely than men to experience some of the other common symptoms, particularly shortness of breath, nausea/vomiting, and back or jaw pain.