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Difference between life, death may be just minutes

By Jim Ritter
Chicago Sun Times
Copyright 2006 Chicago Sun-Times, Inc.
All Rights Reserved

Just 34 minutes after arriving at a Downers Grove hospital with heart attack symptoms, Bruce Bagley was getting an emergency balloon angioplasty.

Thanks to that fast action on Oct. 20 — which reopened a blocked artery — Bagley’s heart suffered little damage. He was back at work in a week.

“I feel terrific,” he said.

On Monday, the American College of Cardiology launched a campaign to speed up angioplasties in heart attack patients like Bagley, who suffer total or near-total artery blockages. About one-third of all heart attacks fall into this category.

QUICK ANGIOPLASTIES CRUCIAL
A blocked coronary artery stops blood flow to heart muscle, which slowly dies, leaving permanent damage. The best treatment is an immediate angioplasty: A doctor inserts a catheter — a thin tube — into the groin and threads it up to the heart. At the site of the blockage, the doctor inflates a tiny balloon, which reopens the artery and restores blood flow.

Every minute is critical. Only 1 percent of heart attack patients who get angioplasties within 60 minutes of the attack die. But among those who get angioplasties after 90 minutes, 6.4 percent die, said Dr. Peter Kerwin, director of the catheterization lab at Advocate Good Samaritan Hospital in Downers Grove.

Good Samaritan did 84 emergency angioplasties last year. On average, patients received angioplasties within 61 minutes of arriving. The national average is 106 minutes, Kerwin said.

The hospital has trained local paramedics to administer EKGs and alert the hospital before heart attack patients arrive.

‘EVERYONE GOING DOUBLE TIME’
Cardiac Alerts are announced on the intercom. About 40 hospital staffers, from the cardiologist to the chaplain, spring into action. If the alert occurs off hours, a cardiologist and three assistants are paged at home. Regardless of the hour, they’re supposed to arrive within 30 minutes.

The patient is whisked past admitting — insurance forms can wait. Various staffers hurriedly give the patient X-rays and blood tests, and take a medical history that skips all but the most essential questions.

“Everyone is going double time,” said Dr. John Giardina, who performed Bagley’s angioplasty. “Your own heart rate goes up.”

Bagley, 59, is himself a doctor. He was in town from Kansas City, giving a talk to fellow family physicians, when it felt like he had indigestion. He also was sweating and felt pain in his upper arm.

After opening Bagley’s artery with the balloon, Giardina inserted four metal stents to keep the artery open. Bagley’s heart, Giardina said, suffered “very minimal damage.”