Experts Call for Speedier Heart Care
Hospital Care Within 90 Minutes of Arrival Cuts Risk of Heart Attack Death
6 Steps to Quicker Treatment
To design the program, Bradley and colleagues surveyed 365 hospitals for
four years. They found six underused yet effective strategies to cut
- Requiring the staff that performs angioplasty to be at the hospital within
20 minutes of being paged. That could save 19.3 minutes, they say.
- Having a cardiologist on site at all times; this would save 14.6
- Having paramedics perform an ECG en route to the hospital. This could alert
the ER that a person is having a heart attack and activate the
angioplasty team at the hospital, for a savings of 15.4 minutes.
- Having a central operator page the angioplasty team, using a one-call
system rather than having ER staff alert each individual doctor. Savings: 13.8
- Letting ER doctors activate and prepare the procedure room for angioplasty
instead of waiting for a cardiologist to review a case and decide what to do.
That would save 8.2 minutes.
- Giving real-time feedback to the ER staff and those involved in the case:
8.6 minutes saved.
"With each step, we can wring out a few minutes," Bradley says.
More than 200 institutions have already joined the effort, endorsed by the
National Heart, Lung, and Blood Institute, according to the researchers. Among
those participating: Premier Health Care Services, Kaiser Permanente, and the
Though this program is aimed at doctors, Nissen urges the public to do their
share as well.
Most people wait two hours or more before calling 911, usually due to
denial, he says.
"To really make a dent in the problem, people have to act more quickly
if they have signs or symptoms of a heart attack," he tells
"Despite the fact they're suffering chest pain, they'll say it's not a
heart attack. It's even a bigger problem for women, who may have symptoms that
are not typical -- such as sweating or nausea," says Bradley. "We need
to get people to the hospital right away."
According to the AHA, warning signs of a heart attack that rate a 911 call
- Chest discomfort. Most heart attacks involve discomfort in the center of
the chest that lasts for more than a few minutes, or goes away and comes back.
The discomfort can feel like uncomfortable pressure, squeezing, fullness, or
- Discomfort in other areas of the upper body. This can include pain or
discomfort in one or both arms, the back, neck, jaw, or stomach.
- Shortness of breath. This comes along with chest discomfort but can occur
before such discomfort.
- Other symptoms. These may include nausea, lightheadedness, or breaking out
in a cold sweat.
While women may be more likely than men to have some of the other symptoms
of heart attack, chest pain continues to be the most common symptom in both
If you experience these symptoms, don't wait; call 911.