Nearly one million Americans have heart attacks each year, according to the latest estimates of the American Heart Association (AHA). And an estimated 181,000 people die yearly as a result. That means someone suffers a heart attack every 25 seconds—and someone dies from one about every minute.
A heart attack, also called a myocardial infarction or MI, occurs when a blood clot causes a blockage in any one of the three arteries supplying the heart muscle. Without adequate blood supply, the impacted part of the heart loses its ability to function. The most severe type of heart attack is known by the acronym STEMI, which is short for “ST segment elevation myocardial infarction.” In this type of heart attack, a blood clot completely blocks off a coronary artery and all of the heart muscle being supplied by that artery begins to die. “People who suffer this type of heart attack are at high risk of dying unless treated veryquickly,” said Peter Pelikan, MD, a board-certified cardiologist and the Medical Director of Saint John’s Cardiac Catheterization Laboratories. “Time equals muscle.”
The New Saint John’s Health Center features a four-lab catheterization unit, strategically located in the Howard Keck Center, just one floor above the emergency department (ED), which allows for quicker access. The facilities are equipped with the most advanced imaging equipment available, producing crisp, detailed images. And with the new electronic communication system in place, X-rays and digital images, including CT scans and MRIs can be imported within seconds to the cath lab monitors for review. Increased data and better images result in more accurate diagnosis, safer and more precise treatment, and improved outcomes for patients with MI and other cardiac problems.
Because of Saint John’s technological capabilities and expertise, the Health Center was asked to become a STEMI Receiving Center as part of the STEMI Program—a nationwide initiative developed by the American College of Cardiology (ACC) and the AHA to improve the treatment of patients with symptoms of a heart attack who had been entered into the medical emergency 911 call system. The Program is a partnership among paramedics, hospital EDs and cardiologists designed to ensure that patients experiencing STEMIs are diagnosed, transported and treated quickly.
Saint John’s is among 30 hospitals in Los Angeles County designated to receive STEMI patients. As soon as a person with a suspected heart attack is placed in the ambulance, a paramedic does an EKG with an automated system that is able to identify a STEMI. If the patient is found to be experiencing a STEMI, the paramedic immediately notifies the ED of the nearest STEMI Receiving Center and the hospital moves into high gear. “It’s like an Indy 500 pit stop, where everyone rushes to be in place before the patient arrives,” explained Dr. Pelikan. “Entering through the ED, the patient is rapidly transported to the team waiting in the cath lab.”
Once in the cath lab, images are taken of the patient’s heart to determine the location of the blocked artery. The cardiologist then performs a balloon angioplasty. The procedure begins with the insertion of a catheter into the groin. The catheter is then carefully threaded into the artery that has been shown to have a blockage. Once the catheter is in place, a balloon is released, which moves the blood clot and opens the artery. Subsequently, a tiny scaffolding called a stent is inserted into the artery to ensure that it remains open. “One of the keys to success of the STEMI program is the availability of a cardiologist 24/7, which we offer as well as, four fully equipped new cath labs,” said Dr. Pelikan.