Surviving a Heart Attack

When Every Minute Counts: How You Can Survive a Heart Attack
by Robert C. Stauffer, MD, Cardiologist
Published in The Joplin Globe
Tuesday, February 3, 2009

There is an old saying in cardiology that time is muscle. When a person has a heart attack and blood flow to an artery stops, the heart muscle begins to die. The average person has four to six hours, if the artery is not reopened, before the muscle completely dies. Therefore, the sooner the patient gets to the hospital, the better. People who get to the hospital very quickly and get their artery opened often do very well with very little damage; whereas, people who wait a long time after the onset of a heart attack, often experience severe outcomes such as congestive heart failure or even death.

What can you do to minimize damage, if indeed, you think you are having a heart attack? By far, the most important thing is go to the hospital as soon as possible. The sooner you go to the hospital, the quicker the process can begin to open up the artery. Patients who wait four to six hours wait way too long. If you think you might be having symptoms of a heart attack, get help immediately and let the emergency room know you are having chest pain. 

The second part of the equation, door-to-dilatation time, is more complicated. That phrase describes the time it takes from the patient’s arrival at the hospital to the time the heart artery is opened and blood flow resumes. The national recommendation for door-to-dilatation time is less than 90 minutes. Unfortunately, many hospitals have a lot of variation in this time. Hospitals in the 60 to 70 minute range are considered to be doing a very good job. The time at Freeman, based on a recent study of my patients last year, was 47 minutes—one of the lowest door-to-dilatation times in the state and nation by far. Every minute counts when it comes to saving heart muscle, and the difference between 50 minutes and 75 minutes, in terms of the amount of heart muscle saved, is huge. Freeman, over the last several years, analyzed literally every minute from the time a patient enters the hospital to the time that patient’s artery is reopened. Through this process we have discovered and eliminated roadblocks, or time-wasters, on the path to the catheterization lab. This has allowed us to make the best use of each precious minute and open blocked arteries as quickly and efficiently as possible.

In summary, to survive a heart attack, follow these rules: 
    1. If you feel chest pain, or even think you might be having a heart attack, call 911 or go to the hospital as soon as possible. EMTs can get things started immediately by doing an on-site EKG and faxing the results to the hospital so the heart experts can be ready for your arrival.
    2. Know your hospital’s door-to-dilatation time; that is, how long it takes to stop a heart attack after you arrive at the hospital. The maximum time should be around 75 minutes; however, a door-to-dilatation time of 60 minutes or less is best. When you get to the hospital quickly and the door-to-dilatation time is less than 60 minutes, your chances of surviving a heart attack are excellent, and the chances of you having any significant residual damage is also greatly reduced.

About Dr. Robert C. Stauffer:
Robert C. Stauffer, MD, is a cardiologist at Freeman Heart & Vascular Institute