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Lowering heart attack treatment times across the country


Heart disease is the leading cause of death in both men and women in the United States, but the number of heart disease related deaths has declined over the past 50 years and continues to do so.

This week on “Take Care,” New York Times health and science reporter Gina Kolata talks about the minor changes hospitals have made to heart attack treatments that might have an impact on heart disease deaths in the U.S.

Kolata authored a recentfour-part series in the New York Times that shed light on what hospitals across the country are doing to save heart attack victims.

Heart disease describes several problems related to plaque buildup in the walls of the arteries. Coronary heart disease, heart attacks and congestive heart failure are all considered heart diseases.

“What happens in a heart attack is that an artery, a blood vessel supplying blood to your heart is blocked and your heart is not getting blood. At first [the heart] is kind of stunned but as it continues your heart muscle just starts to die,” Kolata says.

Within an hour of the initial signs permanent damage can occur. Cardiologists call this the golden hour.

Most hospitals, however, used to take more than 90 minutes to treat heart attack patients with any time under that being labeled as a miracle.

Kolata says that hospitals thought times under 90 minutes were impossible, due to all of the moving parts it takes to treat heart attack patients.

“You have to get an electrocardiogram, then you have to call the cardiologist, then look at the electrocardiogram and then call all of the staff who needs to be present,” Kolata says.

With all of those steps happening before the patient is treated, hospitals looked at 90 minutes as the fastest time possible.

That time, however, was beaten by a handful of hospitals around the country that found ways around those steps, while still having the ability to treat patients effectively.

“[These hospitals] had the paramedics transmit the electrocardiogram to the hospital, they had the emergency room doctor make the call on if it was a heart attack or not and they pressed a button which pages all the staff who needed to be present” Kolata says.

With the improvements, those hospitals were able to get their heart attack patients treated within the golden hour if not less. Kolata also says that competition between doctors helped decrease the times.

Door to balloon, or “D to B,” time became the ultimate sign of success.

“They call it door to balloon time. Door for when you come through the door. Balloon for when they open your arteries with a balloon. Each hospital and doctor wanted to be the best and have the best time and all of a sudden times started dropping all over the nation,” Kolata says.

With the national average below an hour, most hospitals were able to treat more patients they wouldn’t have been able to treat in the past with, as Kolata says, the population of those being treated expanding as a result.

“There has been a dramatic downhill slope in the past 50 years in heart disease death with the latest factor in the decline stemming from the decline in heart attack treatment times,” Kolata says.

With the death rates gradually declining and minor adjustments continuing to work, Kolata believes that heart disease deaths could fall from the top cause of deaths in the United States within the next few years.