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A32 FEATURE
Tuesday 1 augusT 2017
U.S. hospitals set record for fast heart attack care

By MARILYNN MARCHIONE pain.
AP Chief Medical Writer —Pain or discomfort in one
There’s never been a bet- or both arms, the back,
ter time to be treated for a neck, jaw or stomach.
heart attack. U.S. hospitals —Shortness of breath,
have set a record for how which might include break-
quickly they open blocked ing out in a cold sweat, or
arteries, averaging under feelings of nausea or light-
one hour for the first time headedness.
since these results have “For women, the symptoms
been tracked. may not be the same. It
More than 93 percent of may not be the typical
patients now have their chest pain” but rather ab-
arteries opened within the dominal pain, nausea or
recommended 90 minutes unusual tiredness, said Dr.
of arrival. Annapoorna Kini, a cardi-
“Things have definitely im- ologist at Mount Sinai Hos-
proved” from a decade pital in New York City.
ago, when less than half of What to do? “Get medical
heart attack patients were help,” she said. “It’s bet-
treated that fast, said Dr. ter to worry after” about
Fred Masoudi, a University whether it was really a
of Colorado cardiologist stomach problem rather
who led a recent report ex- In this Feb. 16, 2017 photo, Dr. Annapoorna Kini, center, performs a non-emergency angioplasty than a heart attack.
amining response times. at Mount Sinai Hospital in New York. Angioplasty also is done
It’s based on records from The 82-year-old woke up utes last year, and only 39 minutes out instead of 5 for non-emergency condi-
about 85 percent of U.S. on March 31 with intense minutes during one recent minutes out can be a sav- tions, to treat chronic chest
hospitals that do the artery jaw pain, the same kind he quarter — is the work it has ings of 20 minutes of heart pain caused by arteries
procedure, angioplasty . had during a heart attack done to make its emergen- muscle.” that are clogged but not
Through a blood vessel in two years ago. His wife cy responders part of the But all that speed by the severely blocked, and its
the groin or an arm, doctors called 911. An ambulance cardiac care team, said hospital won’t do much use in that setting is more
guide a tube to the block- whisked him to the emer- the hospital’s EMS coordi- good unless patients act questionable. Often medi-
age causing the heart at- gency room, and “they nator, Peter Canning. fast, too, and call 911 if they cines and other things can
tack. They inflate a tiny were all waiting for me” at “We used our paramedics think they might be having be tried first, and angio-
balloon to flatten the clog, the door, he said. to extend our hospital into a heart attack. plasty can be avoided or
and leave behind a mesh delayed.
tube called a stent to prop The report shows that fewer
the artery open. people are getting these
The sooner blood flow is re- procedures inappropri-
stored, the less chance of ately. In 2014, about one
permanent damage. third of angioplasties were
“It’s one of the few things elective, for non-emergen-
in medicine where time, cy situations. Just over half
literally seconds, is of the were deemed to be done
essence. It’s where the for clearly appropriate rea-
phrase ‘time is muscle’ sons and another one third
comes from,” said Dr. Ajay were classified “may be
Kirtane, director of the lab appropriate” under guide-
that performs angioplasties lines from the cardiology
at New York-Presbyterian/ college and others. About
Columbia University Medi- 14 percent were deemed
cal Center. “rarely appropriate” — less
The risk of dying goes up than other research has
42 percent if care is de- found in the past.q
layed even half an hour
beyond the 90 minutes that
U.S. guidelines say patients
should be treated after ar-
rival.
In 2005, this “door-to-bal- In this Feb. 16, 2017 photo, Dr. Annapoorna Kini, center, reviews a patient’s angiogram before
loon” time averaged a beginning a procedure, as a colleague points to the screen at Mount Sinai Hospital in New
dismal 96 minutes, and the York.
American College of Car- Associated Press
diology led a drive to get
hospitals to improve. The An hour later he was sitting the patient’s home,” where The warning signs:
report shows it plunged to up in bed with a new stent. they do an extensive elec- —Discomfort in the center
59 minutes in 2014. “I was amazed,” he said. trocardiogram of the heart- of the chest lasting more
It was only 24 minutes for “Such a blessing.” beat and call results ahead than a few minutes, or that
George Smith at UConn One reason UConn is so to the hospital to get the goes away and comes
John Dempsey Hospital in fast — its median door-to- angioplasty room ready, back. It can feel like pres-
Farmington, Connecticut. balloon time was 56 min- he said. “Calling from 25 sure, squeezing, fullness or