Medically Reviewed by Fred M. Krainin, MD
Medical personnel call it “door-to-balloon” time. For the rest of us, it means how quickly can a heart attack patient make it from the door of the Emergency Department until a Cardiologist uses an angioplasty balloon to open a blocked artery. McLeod Cardiologist Fred Krainin, MD explains that time is critical to a patient’s recovery:
Here’s a summary of Dr. Krainin’s comments:
When it comes to a heart attack, the most important thing to remember is that time equals muscle. When someone begins to have a heart attack, every minute the artery remains closed leads to further heart muscle damage and worse outcomes – all sort of complications and a higher rate of death.
The quicker we can open up the artery that’s causing the heart attack, the better a patient will do. When I first started 25 years ago, a heart attack patient stayed in the hospital 7 to 10 days. The mortality rate was 25% — one out of every 4 patients did not survive their hospital stay. Now, a patient with a heart attack is in the hospital 48-72 hours. The mortality is about 2-3%. We rarely see the complications that patients suffered years ago.
The bottom line: every minute delay in treatment leads to further heart muscle damage. We try to get the patient to the Cath Lab and open that artery as fast as possible. Some 15 years ago, the magic number was 90-minutes – from the time a patient arrives at the door of the Emergency Department until the artery is opened, often by expanding a balloon inside the artery. We call this “door to balloon” time. Now, we try to do that all in less than 60-minutes.
And it’s one thing to have a heart attack during business hours Monday through Friday 8-5, when the Cath Lab is open and everyone is at the hospital ready to respond, versus 2 o’clock Sunday morning everyone has to be called in from home. Over the years, we’ve reduced the door-to-balloon time. As a result, you can see a corresponding improvement in outcome, fewer deaths and all sorts of other complications.
Every minute that we can save will prevent further heart damage. So as soon as you think you’re’ having symptoms that may be a heart attack, call 911. Don’t delay. Don’t try to drive yourself.
It’s very common for the EMS personnel to do an EKG in the patient’s own house. They transmit this to the Emergency Department and activate a specially trained team – Cardiologists, Cath Lab staff and others. So frequently, the team is waiting before the patient arrives, reducing door-to-balloon time significantly.
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