Medicine Today: Treatment time improving for heart attacks

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Heart attacks are one of the scariest medical conditions because they can kill quickly – in seconds to minutes. A new study in the New England Journal of Medicine suggests that we might be getting better at treating them.

The heart pumps blood to the body and is the hardest working muscle in the entire body. A heart attack occurs when blood flow to the heart is interrupted, often by a blood clot. When this occurs, the heart does not receive enough nutrients to pump properly and can start to die. The death or loss of heart muscle is called a heart attack.

Some heart attacks can be small, and the heart might continue to pump, albeit with less power. The scary part is that if the heart attack is large, the heart may no longer be able to pump blood adequately and a person can die.

The primary treatment is to restore blood flow to the heart by removing the obstructive clot. The quicker the clot can be removed, the better the chance the heart will survive.

Because of the importance of time to treatment in heart attacks, the national standard for removing a clot in the heart is within 90 minutes of arrival of an ambulance or arrival to an emergency room.

Dr. Daniel Menees, an assistant professor of medicine at the University of Michigan, and colleagues from Duke, Yale and the University of Colorado, analyzed how often patients from across the country had blood flow restored to their heart within 90 minutes.

They examined a national sample of almost 100,000 heart attacks to and found that from 2005 to 2009, the number of patients treated within 90 minutes had risen from 60 percent to 83 percent.

Augusta’s hospitals rank well in this national standard. Georgia Regents University Medical Center, University Hospital and Doctors Hospital all treat over 90 percent of patients with heart attacks within 90 minutes.

Although the care of patients inside the hospital has improved, the authors emphasize that more can be done to reduce the number of people who die from heart attacks, particularly in improvements outside the hospital.

First, it is important to recognize heart attacks early. The average person having a heart attack waits two hours before calling 911 or coming to the hospital. Second, more than half of patients having a heart attack are not transported to the hospital in an ambulance, a fatal mistake in many cases.

Ambulances have the ability to evaluate the heart earlier, treat early complications, triage the patient to higher-level hospitals and notify the hospital that a possible heart attack is arriving, all steps that will increase the chance of survival.


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