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    Not All Hospitals Equal for Treating Heart Attacks

    continued...

    But suppose there are two hospitals within a reasonable distance? "We are convinced that angioplasty is much more effective than thrombolytics," Giannitsis says. "If I could reach a hospital that offers angioplasty by driving an extra 10 or 15 minutes, I'd go there. However, if would take an extra hour, then it makes more sense to go to a closer hospital, even if it doesn't do angioplasty."

    Stephen Siegel, MD, agrees. The hard questions, he says, arise in situations where it takes an extra 30 or 40 minutes to reach a hospital with a cath lab. "We don't know the exact point where the benefit cancels out." Siegel is a clinical assistant professor of medicine in the division of cardiology at the New York University School of Medicine in New York City.

    In rural areas, hospitals are less likely to have angioplasty available. In large cities, some hospitals have it, but not all of them by any means. "In a big city, if you have a heart attack, you're probably within 10 minutes of some hospital that can do angioplasty," Siegel says. "Talk with your doctor now about which hospital he or she wants you to go to in an emergency and what facilities that hospital has."

    A suburban doctor may be affiliated with three or four different hospitals, Siegel points out, so it's worthwhile to talk about different options ahead of time. When you're choosing a new doctor, ask about the hospitals he or she uses, and the methods the hospital has available in an emergency.

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