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Your First Heart Attack
Your First Heart Attack
By Steven DeGalan, MD
Your first heart attack should be your only heart attack! Let's face it – none of us wants to have a heart attack. That's why we don’t smoke, we eat healthy, we exercise, and we see our doctors regularly, right? It is those other people who have heart attacks. Keep in mind if you do have a heart attack, it is recognition, time and treatment that will determine your outcome. Knowing these three things can clearly save your life.
Recognition starts with you, the patient. When people think about having a heart attack, they picture the overweight male, clutching his chest and complaining of severe pain. That is known as the classic 'textbook' heart attack. Unfortunately, many hearts have not read the textbook! Their owners may only feel fatigue, indigestion, or any number of unusual symptoms. However, they do know something is wrong, and we hope they call the ambulance.
Recognition also applies to the qualified ambulance crew that comes to your assistance. Even if you don't think you're having a heart attack, they will recognize it and take you to the nearest hospital that provides immediate treatment for heart attack. Those of us living in Alameda County are now fortunate to have a county-wide program in place designating hospitals or 'Cardiac Receiving Centers' as the most beneficial destination to bring patients experiencing a heart attack. That translates into lives saved…maybe yours!
Cardiac Receiving Centers have the most qualified health care teams and technology in place to care for patients experiencing heart attacks. If you live or work in Hayward, San Leandro, San Lorenzo, Castro Valley, or Union City, St. Rose Hospital is the nearest Cardiac Receiving Center to you (one of only four in Alameda County). At St. Rose, a cardiologist is on 30-minute call, 24 hours a day, 7 days a week. He or she has 30-minute access to a Cardiac Cath Lab for angioplasty, also on-call 24/7.
All of this may sound like an awful lot of bother, but treatment is everything.
A heart attack is usually a blood clot which forms as an area of cholesterol builds up and blocks the artery which supplies blood to the heart. The heart muscle can live on for some time with its blood supply blocked, but eventually it will die. Once it dies, it cannot be replaced. Even as early as 30 minutes without blood, the deprived muscle will begin to die. Clearly, the sooner the blockage can be opened, the heart damage will be minimized.
In the 1980s and early 1990s, cardiologists used 'clot-busting medicines' with some success to open up blockages, but these medicines were too slow and often failed to restore blood flow. In the late 1980s, we also saw the emergence of angioplasty. In angioplasty, the blockage is crossed with a very fine wire, and a balloon is used to open up the blockage. With time and refinement, the procedure became easier, faster, and much more successful than "clot-bluster" medicines. In addition, we now place a wire tube or “stent” in the artery to increase the success the rate of this procedure.
Now that we have recognized the heart attack and we have the treatment, all we have to do is to put it all together…quickly! Remember, the heart muscle is dying the entire time. When the ambulance picks up a potential heart attack patient, the crew calls ahead to St. Rose, providing the health care team vital information, such as an electrocardiogram and the patient's history, even before the patient arrives. Once at the hospital, the patient will be immediately evaluated and if indicated the cardiologist and Cath Lab are notified and will be readied for an angioplasty.
The American College of Cardiology recommends having the blockage opened within 90 minutes of arrival to the Emergency Room. Currently, St. Rose Hospital has surpassed this recommendation and is averaging 70 minutes from arrival to the hospital to treatment.
Now you are equipped with all the knowledge to stay healthy and get the best possible treatment. Of course, you're probably not going to have a heart attack. But when the other guy does, we will be ready and waiting.
St. Rose Hospital has been designated as one of four Cardiac Receiving Centers throughout Alameda County. The other centers are Washington Hospital, Summit Hospital and Valley Care Health System.
Dr. DeGalan is board-certified in Internal Medicine and Cardiovascular Disease and is affiliated with St. Rose Hospital and Washington Hospital. His offices are located in Hayward and Fremont (510- 887-3068).
We welcome your questions!
Physicians on staff at St. Rose Hospital are interested in responding to your questions about health care and related topics such as health education and prevention.
Please send any questions to: TheDoctor@strosehospital.org