Minutes Matter

June 21, 2015 12:07 PM

A Sea Change in Treating Heart Attacks (NYT) Dr. Mahesh Bikkina, the director of the cardiac catheterization laboratory at St. Joseph Regional Medical Center in Paterson, N.J., tells his trainees about the old days: heart muscles that tore, with blood leaking out of holes, and valves that ruptured, leading to sudden death if not repaired immediately with open-heart surgery. “I tell them you will read about these things in textbooks,” Dr. Bikkina said.“You will almost never see them.”
posted by CrystalDave (14 comments total)

I had a stent installed last year, within days of my 50th birthday. Without modern medicine and health insurance I would almost certainly be dead today. Thanks, guys, keep up the good work.
posted by Bringer Tom at 12:31 PM on June 21, 2015 [19 favorites]

OMG this is so cool, I had no idea.
posted by shelleycat at 1:38 PM on June 21, 2015

Oh man I worked at Lourdes last year with Dr. Momplaisir and other folks at Lourdes Cardiology. I think the article only captures the fraction of the politics that it takes to get those times. Our healthcare system is so fragmented patients get stuck or lost in handoffs between organizations or people.
posted by roguewraith at 1:57 PM on June 21, 2015 [4 favorites]

My abiding memory of working as the junior on one of these teams a couple years back (in the UK) was waiting by PCI entrance at 3am in the morning in scrubs shivering whilst using the unfilled checklist and notes as a cushion against the scalding radiator. It was snowing and there was slush all the way from the ambulance parking space to the door. My croc-a-likes got soaked through when we ran out to meet the ambulance and I squelched all the way to the cath lab, simultaneously shivering and writing the notes for the Reg. I was never so keen to put the leads on.

I guess it's a strange thing to remember - routine takes over from the time you reach the cath lab so even if confidentiality was not a problem I can't remember anything else about that intervention or the patient. But I remember that ice!
posted by zeripath at 1:58 PM on June 21, 2015 [5 favorites]

Awesome article cheers.
posted by supercrayon at 2:42 PM on June 21, 2015

There's an active twitter discussion here questioning some of the merits of the faster-is-better approach.

Good article, though!
posted by cacofonie at 2:44 PM on June 21, 2015 [1 favorite]

It's amazing how much of this boils down to "Let's stop fucking around." Yes, call the people who need to be there right away and not waste time with phone trees. And then of course the immediate backlash "Treating people who are dying faster doesn't actually help. It only seems that way because less people are dying." How is this is in any way a helpful way to look at it? Should we not treat dying people as fast as possible?
posted by bleep at 2:47 PM on June 21, 2015 [3 favorites]

I had 2 stents installed 6 weeks ago (90% and 70% blockage). Without modern medicine, our national Health Service, and especially the excellent staff at the cardiac unit of Edinburgh's Royal Infirmary I would probably be feeling rather ill at the moment.

Those reading this who are fortunate not to have needed the services of a cardiac unit should know this: the early signs of a heart attack can be very subtle, mine was nothing more than minor chest discomfort, rather like food not having gone down correctly, this came on while walking up a slight incline, there was no pain. "Hollywood heart attacks" are very rare and unless you have been ignoring symptoms for a prolonged period almost never occur as a first attack. If in doubt seek help immediately, I did and dodged a bullet.
posted by epo at 3:22 PM on June 21, 2015 [3 favorites]

Although sad to see they mentioned "groin shaving" does anyone know - are angios still done primarily femorally in the States? They're mostly radial at my hospital unless there's an access issue.
posted by supercrayon at 3:23 PM on June 21, 2015 [1 favorite]

Supercrayon, it's been a few years now since my angio was done, but it was done femorally.
posted by BigHeartedGuy at 3:48 PM on June 21, 2015

Mine was femoral. I actually needed two, on successive days with a hospital night in between, because my cardiologist ran out the limit on contrast dye on the first attempt. On the second he found my 85% blocked LAD and put in the stent.
posted by Bringer Tom at 3:49 PM on June 21, 2015

I need to start exercising. Today I went downtown and walking with my roommate, I was sooooo out of breath. This article comes at a good time to shake me out of complacency.
posted by symbioid at 7:29 PM on June 21, 2015

Supercrayon, radial (UK). The wrist clamp was a minor discomfort and probably the worst thing about the whole procedure.
posted by epo at 1:46 AM on June 22, 2015

I believe here in Australia they do the angiograms through the wrist, but they prep patients for the groin in case they can't get in through the wrist.
posted by GeckoDundee at 1:47 PM on June 22, 2015