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HEART ATTACK TRANSFER

There is a warning tonight for those at risk of a heart attack. New research says you should make sure you or someone you love is taken to a hospital that can perform the procedure called angioplasty.
The fact is, many patients who live in outlying areas are not transported directly to a hospital that can perform this important procedure which opens up blocked arteries. And if then the person is transferred to a hospital that does do it, in many cases, it’s simply too late.

Now, new research released by the American Heart Association shows that heart attack patients who are transferred from one hospital to another so that the patient can get emergency balloon angioplasty often experience such a long delay in treatment, that the benefit of doing the procedure is diminished markedly, almost making the transfer meaningless.
Researchers at Yale University School of Medicine studied more than 4000 cases in which patients were transferred to another hospital, in many instances more than three hours elapsed from the time the patient arrived at the first hospital for treatment to the start of the actual procedure at the second hospital.
Dr. Harlan Krumholz, the study researcher says, it’s simply taking too long, and heart muscle is dying that can’t be regenerated. “
Balloon angioplasty involves placing a catheter inside the heart artery that is blocked, inflating a balloon at the end of the catheter which pushes aside the clot, reopening blood flow. Often, a metal stent is placed which keeps the artery open.
It’s well established now that balloon angioplasty is superior to treating the patient with clot busting drugs which medically dissolve the clot, but which is the only treatment available at smaller hospitals which do not perform angioplasty.
But as time goes on, the treatment is much less effective at saving the heart muscle starving of oxygen and nutrients due to the blockage.
Only 25 percent of hospitals in the u.s. perform angioplasty, meaning, in many cases the choice is to either give the less-effective medicine, or transfer the patient to a hospital that does perform angioplasty and then suffer this significant time delay. It may mean it’s better to keep the patient where he or she is and give the medicine instead.
“ ,” says Dr. Krumholz.
The American Heart Association and the American College of Cardiology recommend that angioplasty be performed within 90 minutes of arrival at the hospital, or that the clot busting drugs be given within 30 minutes of arrival for effective treatment. Among patients transferred, only 4.2 percent got angioplasty within the 90 minute recommended time period.
Experts say once that patient arrives at the first hospital it’s a real problem getting the person to the other hospital.
It takes time to evaluate the patient, make sure he or she is stable, out of pain. If the person comes to a small hospital or comes after hours there is inevitably going to be a more significant delay due to fewer resources. So perhaps the delay can be shortened somewhat, but in many instances it can’t.

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