Jamaica on New Year’s Day
and adverse outcomes when a heart attack occurs. What is often inadequately appreciated is how what may appear to be a small delay in appropriate care could be the literal difference between life and death.
A heart attack occurs when a cholesterol/fat plaque abruptly ruptures and forms a clot, blocking or limiting blood flow in a heart vessel. This abrupt interruption in blood flow leads to progressive heart muscle damage and unless immediate intervention is undertaken to restore flow, extensive heart muscle damage occurs and may lead to heart failure, arrhythmias, and death. The most appropriate intervention for heart attack is urgent coronary angiogram with angioplasty and stent placement. This procedure involves using a tiny wire to access the heart vessels to obtain pictures and determine the extent and severity of the blockage. Following that, balloon inflation is performed to open the blockage and a drug infused metal mesh is deployed to hold the vessel open
We use the concept of door-to-balloon time (D2B) to monitor efficiency of appropriate intervention in patients having a heart attack. This refers to the time it takes for a heart attack victim to receive balloon angioplasty from the moment they arrive at the hospital. The best cardiovascular centres around the world aim to keep the D2B at less than 90 minutes. At the HIC Heart Hospital, we have maintained a door to balloon time of less than 65 minutes.
A new year’s gift of life
Back to the 49-year-old man with a heart attack on New Year’s Day presenting at a rural hospital. When the team at the Heart Hospital was contacted, it was clear that without timely intervention, death or another adverse outcome was likely. The HIC Heart Hospital team worked collaboratively with the local team at the rural hospital to provide advice and guidance on medical treatment that could be safely initiated with the goal of rapid transfer by ambulance to the Heart Hospital for intervention. The team was mobilised and waiting, and patient was in the Catheterization Lab within minutes of arrival as he was taken into the lab from the ambulance. Within 20 minutes of arrival, the blocked vessel was opened by HIC Heart doctors and patient outcome dramatically changed for the better.
Working collaboratively between a public hospital in rural Jamaica and a private hospital in Kingston, the life of a 49-year-old Jamaican was saved despite all odds. This was a fitting way to start the new year.
Common heart Attack signs And symptoms include:
· Pressure, tightness, pain, or a squeezing or aching sensation in your chest or arms that may spread to your neck, jaw or back, sometimes associated with cold and profuse sweating and a feeling of “impending doom”.
· Shortness of breath · Fatigue · Lightheadedness or dizziness
· Nausea, indigestion, heartburn, or abdominal discomfort
If you or someone you know is experiencing any of these symptoms and you think you or they might be having a heart attack, please seek emergency medical assistance, have an ambulance or someone drive you to the nearest heart hospital and demand immediate attention. This is how lives are saved.
Dr Ernest Madu, MD, FACC, and Dr Paul Edwards, MD, FACC are Consultant Cardiologists at Heart Institute of the Caribbean (HIC) and HIC Heart Hospital.
Dr Madu is a main TED Speaker whose TED talk has been translated into 19 languages, seen, and shared by more than 500,000 viewers. He has received the Distinguished Cardiologist Award, the highest award from the American College of Cardiology and has been named among the 100 most influential people in health care and among the 30 most influential in public health. Dr. Madu is also a recipient of the Global Health Champion Award from the University of Pennsylvania. Dr Madu was past CEO of HIC and is currently the Chairman of IHS Holdings Ltd, an asset management company with interests in the USA, Africa, and the Caribbean.
Correspondence to info@ caribbeanheart.com or call 876-906-2107