Care for the pregnant woman and her babyNew approaches to heart attack care
Gifford teams with Fletcher Allen Health Care
By Dr. Markus Meyer
From symptoms to the emergency room
A heart attack is induced by an acute blockage of an artery that supplies the heart muscle. These arteries are called coronary arteries. The blockage is usually induced by a blood clot that forms on a cholesterol plaque within a coronary artery.
Typical symptoms of a heart attack include severe and sustained chest pressure, shortness of breath and nausea. The first action you should take if you experience symptoms of a heart attack is to call 911 and then to chew two normal sized aspirin tablets (325 milligrams). Aspirin helps to stop the ongoing build-up of a clot inside the affected artery.
Since the heart muscle tissue starts to die within minutes after the blood flow is interrupted, it is critically important that the 911 call is not delayed. Some of the ambulances that serve our region can transmit the electrical recordings (electrocardiogram) obtained from your heart to your hospital’s emergency room. This allows the hospital to prepare for you. You will get oxygen and other medications to alleviate your pain while driving to the emergency room.
From the emergency room to catheterization
For the past 25 years, “clot-busting” blood thinners have been used to thin the blood to an extent that the artery opens and the blood flows again through the affected region of the heart muscle. Unfortunately, they don’t work in every patient and in some circumstances can lead to serious side effects, such as a stroke.
Through large-scale research over the last several years, it has become evident that an expedited mechanical opening of the affected artery within 90 minutes is better than using a “clot buster.” This is only possible, however, if within 90 minutes you can reach a hospital that has 24-hour catheterization laboratory available. It is therefore of major importance that you are moved as fast as possible to such a facility.
Through a collaboration of Gifford Medical Center in Randolph and Fletcher Allen Health Care in Burlington, a protocol is now in place at Gifford that strives to achieve this. Your physician in the emergency room at Gifford can alert the Fletcher Allen cardiologist directly and, by the time you arrive, the catheterization laboratory staff is ready for you.
At the catheterization laboratory, a plastic tube (catheter) will be advanced to your coronary arteries from a groin artery. A wire is advanced through the catheter into your artery. This wire is used as a guide for a second catheter that has a balloon attached to its tip. Around the balloon is a wire mesh (stent) that gets expanded with the balloon. It remains in place to keep the artery open after the balloon is deflated.
Follow-up care
Once your artery has been successfully opened and you are discharged, you will be able to receive your follow-up care close to home in Randolph at Gifford. You will receive state-of-the-art therapy, and Gifford is fully equipped to perform all the necessary tests and procedures to assess the condition of your heart.
Of course, the best course of action is always doing your utmost to avoid having a heart attack. Heart attacks can be prevented by a healthy lifestyle. Typical risk factors for heart attacks are smoking, high cholesterol, high blood pressure and diabetes. Weight awareness, heart healthy food choices and lots of cardiovascular exercise can help avoid heart attacks as well as many other adverse health conditions.
Dr. Markus Meyer of Randolph is an assistant professor of medicine at the University of Vermont and a Fletcher Allen Health Care cardiologist working at Gifford Medical Center in Randolph. A Randolph resident, Dr. Meyer is an internationally recognized expert on heart failure with more than 35 scientific publications and many book chapters. He has won several research prizes, including currently being funded through a $250,000 American Heart Association grant.
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