When a heart attack is textbook perfect, it can be a beautiful thing

Participating in a patient’s first heart attack can be an extremely stressful event. Thirty years ago, I was an ER doc.  At the end of a typical shift, I would come home to my wife and, often, would remark about how nervous family docs got when dealing with emergencies like heart attacks.

Thirty years later, I’m the family doc and heart attacks are unnerving.  Yes, I know what to do.  We have an emergency protocol and handle heart attacks well.  It’s still unnerving.

Today’s heart attack was textbook perfect.  I’m in room one with a patient.  Three rapid and insistent knocks on the door and the door opens.  “Doc, I need you in room three now!”  The look on Ginny’s face said it all.  The patient in room three was conscious, pale, sweaty, and in pain.  It takes 90 seconds to ask a rapid fire procession of questions.  Heart attack, for sure.  Rapid fire orders, nurse one brings oxygen, aspirin, and nitroglycerin: all life saving treatments in a heart attack.  Nurse two is on the phone with the paramedics.  The front desk gathers information the paramedics will need and won’t have to waste time collecting on their own.

After reassessing vital signs, 325 mg of aspirin are given to the patient.  “Chew this please.  It will taste lousy.”  Oxygen canulas in place, nitroglycerin given.  “You are going to get the worst headache you’ve ever had.  How’s your chest pain?”

Minutes seem like hours but Lake Zurich’s paramedics arrive promptly.  They go into action.  Monitor, IV’s, EKG done efficiently.  Lake Zurich’s paramedics are, literally, a lifesaver.   Their training, skills, and equipment make them indispensable.  Heart attack confirmed; ER notified of “cardiac alert.”

Time is of the essence as prompt care preserves heart function.  “Cardiac alert” is the equivalent of “Defcon One.”  The cardiac catheterization lab goes into motion.  The on-call cardiologist is notified and is in transit.  The ER gears up for incoming.  As the ambulance rolls in to the ER, everything is in place.

When it all comes together, it’s a beautiful thing.  The call comes in from the cath lab.  The patient is stable; the blocked artery is open.  All is well.  I finally can breathe.

Time is of the essence. Paramedics are well-trained (actually, they are incredible) and drive around in a mobile intensive care unit.  If you think you are having a heart attack, stay where you are and call the paramedics.  The minutes you save may well be what saves your life. Remember, please don’t drive.  Please don’t take a “wait and see” attitude.  Make sure you survive your first heart attack by acting quickly.  Then work hard on being healthy so that you don’t experience a second one.

Stewart Segal is a family physician who blogs at Livewellthy.org.

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  • carolynthomas

    Excellent info here, Dr. Segal, particularly on the importance of “acting quickly” in seeking immediate help. As a heart attack survivor, however, I suspect that only somebody who has never actually experienced a real-life cardiac event would ever describe it as a “beautiful thing”.

    There is nothing remotely “beautiful” from the patient’s perspective about this truly terrifying experience. What may be “beautiful” about this story is the fact that your own staff protocol worked efficiently, that the paramedics arrived promptly, that your patient was nicely handed off to the hospital where his/her condition was described as “stable”, and that YOU could finally breathe a sigh of relief. 

    The reality is that modern medicine can stent us, bypass us, drug us, burn or zap our electrical circuits, but no intervention – no matter how “beautiful” – can address what originally caused that coronary artery damage in the first place, often decades earlier.  I wonder if your patient, now newly diagnosed with a chronic and progressive condition, thinks of life as being as “beautiful” as you do. 

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