Heart Attack Treatment Often Delayed After Bypass
Finding blockages can be trickier when blood vessels have been rerouted, expert says
By Amy Norton
MONDAY, Dec. 28, 2015 (HealthDay News) -- Heart attack patients need quick treatment, but a new study finds that those with a history of bypass surgery often face delays at the hospital.
Guidelines say that heart attack patients should receive angioplasty -- a procedure that clears the blockages causing the heart attack -- within 90 minutes of hospital arrival. That should be enough time for doctors to get images of the heart blood vessels and see where the trouble lies.
But in the new study of nearly 300 U.S. hospitals, researchers found that delays were common for heart attack sufferers with a history of bypass surgery. About one-quarter were not treated within 90 minutes -- double the number of heart attack patients who'd never had the surgery.
The findings appear in the Dec. 28 issue of the Journal of the American College of Cardiology: Cardiovascular Interventions.
The study could not dig into the reasons for the delays. But lead researcher Dr. Luis Gruberg said that finding blood vessel blockages can be trickier when patients have had bypass surgery.
Heart attacks occur when an artery-clogging "plaque" -- a buildup of fat, calcium and other substances -- ruptures and completely blocks blood flow through the vessel.
When people arrive at the hospital with an apparent heart attack, doctors try to locate the blockage by doing a form of X-ray called an angiogram. They inject a dye into the heart arteries, then take images of blood flow throughout the heart.
If they pinpoint the obstruction, angioplasty can be done to push the blockage aside and restore normal blood flow.
The faster that process goes, the less damage to the heart muscle, said Gruberg, a professor of medicine at Stony Brook University in New York.
But when patients have had bypass, he said, doctors typically need more pictures of the heart vessels before angioplasty can be done. "And that takes time," Gruberg said.
People typically undergo bypass surgery for extensive heart disease, where multiple arteries are hardened and narrowed with plaques. A surgeon takes arteries or veins from elsewhere in the body and uses them to reroute blood around the diseased vessels.