Prevention is the Best Medicine
Dan Klingenberg was saved by good timing. In this case, it was quick timing, but it also occurred at the right time.
The Scottsdale resident had just finished an exercise class when he collapsed in a locker room in 2005 with a heart attack.
He had no warning and paramedics had to resuscitate him twice on a defibrillator on the way to the hospital. Since then he has had several stent and angioplasty procedures at Scottsdale Healthcare.
Today, Dan leads an active and healthy life. He enjoys outdoor activities and his life has returned to normal. But he remains vigilante about his health. “I was very close to expiring. Once you have heart damage,” he said, “you’re vulnerable, so I am very careful.”
Dan benefitted from a process known as “Door to Balloon (D2B).” It features a 90-minute guideline from American College of Cardiology and the American Heart Association for the time it takes for a patient entering a hospital to receiving balloon catheterization inflation to restore blood flow to the heart.
Here’s how it works: People like Dan who suffer an ST segment elevation myocardial infarction (STEMI) – a specific type of heart attack – require a visit to the cardiac cath lab when they reach the hospital. There, doctors insert a catheter, usually into the femoral artery in the right groin area, and feed it through to the heart. Medical dye helps identify the blockage on an X-ray. After poking a thin wire through the clogged area, the doctor inserts and then inflates a tiny balloon that spreads the vessel open to restore blood flow. This is known as angioplasty.
Research shows that the greatest benefit is received within 60 minutes of opening the vessel. The benefit begins to decline after 120 minutes. So, someone who receives treatment in 90 minutes has a much higher chance of returning to normal activities, not just a lower risk of death, according to Scottsdale Healthcare Emergency Department physician Kurt Solem MD.
To stay healthy, Dan exercises, watches his diet and gets plenty of rest and sleep. “My doctor jokes that I’m a poster boy,” he said.
Scottsdale Healthcare joined the D2B Alliance in July 2007 and has seen steady progress in reducing treatment times. During the first month, D2B times were around 80 minutes at both the Osborn and Shea campuses. By November they had dropped to 66 and 64 minutes. Most recent figures show times averaging 60 to 70 minutes at those two hospitals.
“Door to Balloon” is a cooperative community effort. The hospitals work in tandem with the Scottsdale Fire Department’s Emergency Medical Service and other Valley EMS systems to coordinate communication about patients who have called 9-1-1 because of chest pain. When en route to the hospital, paramedics can identify changes in a patient’s 12-lead ECG and notify the emergency department before arriving at the hospital. This helps the emergency department to better prepare for a patient’s arrival and alert the cardiac cath lab of a potential STEMI.
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