Having a Heart Attack
Having a heart issue of any kind can be a very scary experience, and when it comes to symptoms of a heart attack or an actual heart attack, we will take great care of you.
Watch how The Heart & Vascular Center at Memorial treats heart attack patients as a heart attack is happening.
Here are the steps potential heart attack patients will go through at Memorial Hospital.
If not coming by ambulance, a potential heart attack patient will go to the registration desk. From there, Memorial will get the patient's name and the patient will be taken immediately to triage or the bay. If the patient is alone, they will be registered in the bay; if they come in with family, a family member will register the patient. While in the bay, the patient is put on a portable heart monitor.
Our rule is to give an EKG to a patient with heart attack symptoms within five minutes of arrival, whether they've been having symptoms for three months or three minutes.
The first EKG is done in the bay, along with blood work. Blood work may be done right after the EKG or at the same time. The second EKG is performed at the 10-minute mark in either the bay or in the ER.
Heart Attack Diagnosis
If at any moment a heart attack is diagnosed, a Code STEMI is called. This means all areas involved should prepare for a heart attack victim, including the Cath Lab. STEMI is a type of heart attack in which a blood clot completely blocks a coronary artery, causing the affected heart muscle to die. National guidelines by the American College of Cardiology and the American Heart Association recommend for the management of patients with STEMI that the blocked artery be reopened in 90 minutes or less. At Memorial, the number of STEMI patients who receive balloon angioplasty or stenting, referred to as door-to-balloon (D2B) treatment, within 90 minutes has increased from 55% in 2006 to 97% in 2009.
Cath Lab Prep
If chest pain is present in the ER, the patient might be given nitroglycerin, an IV, or heparin if necessary. Usually, the patient's groin is also shaved in the ER to save time when the patient gets to the Cath Lab.
Once in the Cath Lab, the staff meets the patient and takes them to the procedure room where they are moved from the stretcher to the x-ray table. At this point they are taken off the portable monitor and put on a regular monitor. Then the patient is draped and prepped with an antiseptic solution.
Next the doctor comes in wearing a lead barrier, and the nurses tie the doctor in a sterile gown. The doctor and the technician begin the cardiac cath procedure while nurses hand them supplies and medication. There is also a tech recording everything.
During the catheterization, a sheath is inserted near the groin. The sheath is like a large IV, and when it is inserted is when the patient will feel most of the pressure. Through the sheath, wires and dye are shot through the artery. The dye causes a warm, flushed feeling, and digital images of the heart are taken from different angles.
The doctor then decides if the issue can be resolved with a balloon or stent in the Cath Lab or if another course of action is needed, such as a meeting with a thoracic surgeon or medication management.
Once the catheterization is completed, the patient is returned to a stretcher or bed and taken to a recovery room in the Cath Lab or the ICU.