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Network: February/March 2008 

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Jim Howley
Time is Muscle: Early Diagnosis Saves Life of Heart Attack Patient

It was August 2007 and flu season was months away. Yet Virginia Beach resident Jim Howley, out for a ride on his Harley-Davidson, felt what he described as flu-like symptoms – nausea, lightheadedness, fatigue. He pulled over, called a friend to come get him, and headed home to bed.

“I woke up at 5 o’clock in the morning and felt like someone had parked a truck on my chest,” said the 54-year-old. “I couldn’t breathe.”

He called 911 and a neighbor for help. Virginia Beach Emergency Medical Services (EMS) arrived quickly. Howley recalled, “The ambulance got here and the paramedics came in the house and gave me a nitroglycerin tablet, drew some blood, took off my shirt and put these sticky leads and wires all over my chest.”

Virginia Beach EMS has six sophisticated 12-lead EKG units carried in Paramedic Zone Cars, which allow three Sentara Hospitals ― Sentara Virginia Beach General Hospital, Sentara Bayside Hospital and Sentara Leigh Hospital ― to receive EKG information instantly so staff can be assembled and ready before a heart attack patient arrives. Sentara Virginia Beach General Hospital was an early adopter of this technology on the Southside, demonstrating a commitment to innovation and collaboration with the community that dates back to the initiation of the first volunteer rescue squad.

Sentara CarePlex Hospital also benefits from 12-lead EKG technology in the field. Working with their local EMS, Sentara Heart Hospital, Sentara Norfolk General Hospital, and Sentara Williamsburg Regional Medical Center, will obtain similar capabilities during 2008.
12-Lead EKG in the Field

It was the early application of these “sticky leads and wires” that helped save Howley’s life. Far from the flu, he had suffered an Acute Myocardial Infarction, a massive heart attack.

Called a 12-lead EKG because a dozen electrodes attach to the body, enabling a view of the heart from 12 different angles, the equipment immediately transmitted Howley’s condition to the Emergency Department at Sentara Virginia Beach General Hospital.

While commonly used as a first method of diagnosing a heart attack in hospital emergency departments, the equipment is now carried on board six Virginia Beach EMS ambulances. For some patients, having the equipment in the field can mean the difference between life and death.

Saving Heart Muscle
“The beauty of the system is advance notification and being able to make a diagnosis that mobilizes the interventional cardiologist and cath lab team to come in even before the patient arrives,” says Jeff Hartenberg, Director of Cardiac Administration for Sentara Virginia Beach General Hospital. “For us, time is muscle and the quicker we can obtain a diagnosis and reopen that artery, the more successful we are at saving heart muscle. This new technology helps us restore blood supply to the heart an average of 20 minutes faster.”

The cardiac team found two of Howley’s arteries blocked – one 100 percent and another 70 percent. During the procedure to implant two stents, Howley experienced multiple occasions of life threatening heart rhythms and needed to be shocked with paddles to bring him back. “He was at death’s doorstep,” Hartenberg said.

The Widow Maker
Physicans have told Howley he’s a lucky man. “The doctor told me they call my heart condition ‘the widow maker’ because very few people survive a heart attack like that. At one point they told my daughter I probably was not going to live through it, but she never gave up hope.”

Count Your Blessings
Howley acts as primary caregiver for his grown daughter who lives with him and was diagnosed with cerebral palsy at birth. Despite the challenges, that has brought, Howley said, “She was a gift, plain and simple. I know I was meant to be her father.”

A master carpenter by trade, Howley continues to recuperate from his heart attack and is not yet able to return to his job in remodeling and construction. To assist his recovery, he had a defibrillator with pacemaker capability implanted in his chest in December 2007.

“I have a whole new outlook on life and a better idea of what I want to be,” said Howley, who said he eats healthier now, drinks mostly water and walks two miles every morning. “I do feel extremely fortunate and I do know that I’ve been given a second chance at life, and I try to keep that in mind every day.”

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Read more of the Heart feature stories in Network and other Cardiac Patient Stories.

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