McGowan Institute for Regenerative Medicine faculty member Joon Sup Lee, MD, Clinical Director of the Cardiovascular Institute (CVI) at the University of Pittsburgh Medical Center (UPMC), and his colleagues support such urgent patient situations such as unstable angina pectoris, acute myocardial infarction (heart attack), and cardiogenic shock. To provide this invaluable patient care the CVI’s Cardiac Catheterization Program is staffed with specialists in the management of patients needing elective and emergency heart procedures. During a heart attack, one of the keys to preventing irreversible heart damage is to re-establish blood flow to the heart before the heart muscle begins to experience oxygen starvation. In many of these cases, using a balloon to reopen a narrowed blood vessel is considered the most effective method for restoring blood flow.
To help speed the delivery of lifesaving angioplasty to heart attack patients, the CVI has instituted a door-to-balloon-time protocol which aims to assess patients before they arrive at the Emergency Department (ED) and streamline the triage process, so that—if needed—they are more quickly routed to the cardiac catheterization lab. CVI physicians have worked with local EMS providers to help train them on delivery of electrocardiogram (EKG) testing on the patient while en route to the hospital. The EKG results are sent via wireless technology to UPMC's Command Center, which notifies the ED. A patient's condition can be assessed before he or she arrives, and physicians and staff can prepare to treat the patient. UPMC Presbyterian's door-to-balloon time—the time from when a patient enters the door to when they have angioplasty—is typically less than 90 minutes.
“The goal is to restore blood flow to the heart muscle within 90 minutes of hitting the ED door, because evidence-based medicine has shown that patients truly benefit from door-to-balloon times of 90 minutes or less,” says Dr. Lee.
The Cardiac Catheterization Program features the largest group practice in Pennsylvania and one of the largest in the country for catheter-based therapy. Annually, they perform more than 12,000 procedures to diagnose heart attack, and more than 4,000 interventional procedures to treat it. UPMC's cardiologists encounter an extraordinarily wide range of cardiovascular diseases—gaining intensive experience with those that are very common and those that are extremely rare—that is uncommon among practicing cardiologists.
Dr. Lee is also an Assistant Professor of Medicine at the University of Pittsburgh and Associate Chief in the Division of Cardiology at the University of Pittsburgh School of Medicine.
Illustration: © 2008 Nucleus Medical Art, Inc. –UPMC.
UPMC Extra! (05/16/08)
UPMC Cardiac Catheterization Program
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