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Heart Attack Care at Sentara 

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Why is Heart Attack Care Unique at Sentara Heart?
Sentara Heart, including all seven Hampton Roads hospitals, works closely with local Emergency Medical Service (EMS) staff to rapidly diagnosis and treat heart attack patients. One key to success is the use of a 12-lead EKG in the field by EMS staff, and the communication between EMS and emergency room physicians to recognize heart conditions before a patient reaches the emergency room door. Another key to success is having highly skilled expert Sentara Heart cardiologists, the same that practice at the nationally ranked Sentara Heart Hospital, standing by to quickly treat patients having a heart attack. 

 Learn more about heart attack symptoms in the Cardiac Media Library.

What is Door-To-Balloon Time?
Door-to-balloon time is a measurement of the time between when a patient having a severe heart attack comes through the “door” of the emergency room and is rushed to a catheterization lab where a slender balloon-tipped tube catheter is threaded from an artery in the groin to reach the trouble spot in the heart. The “balloon” is then inflated, which compresses the blockage and widens the narrowed artery to restore blood flow. This procedure is also known as angioplasty and is sometimes used in conjunction with placing a small metal device called a stent at the site of the blockage to hold the artery open. 

Why is Measuring Time to Treatment Important?
When you have a heart attack, the faster you get treatment, the less damage there is to the heart – time is muscle. In fact, providing life-saving catheterization procedures to reopen clogged arteries within 90 minutes after the patient reaches the emergency room door (also known as door-to-balloon time) is a national target benchmark.

What is the National Benchmark?
The American Heart Association and the American College of Cardiology along with many other national agencies recommend that the door-to-balloon time interval be no more than 90 minutes.

What Does Median Time Mean?
Door-to-balloon time is reported using the median (or middle value) for all the times from a particular location that performs the angioplasty procedure for heart attack patients. To calculate the median time, the times are ordered from lowest to highest. The median time is the number exactly in the middle – half the times are larger, and half the times are smaller. For example, the median value of these five door-to-balloon times (25 minutes, 38 minutes, 43 minutes, 50 minutes, and 59 minutes) is 43 minutes.  

Why is Median Time Used?
The Centers for Medicare and Medicaid Services (CMS) and the seven hospitals within Sentara Heart, as well as other regional hospitals, work together to provide publicly accessible quality report information. In regards to door-to-balloon time information, CMS uses median time measurements.

What is a Heart Attack?
heart attack (myocardial infarction) occurs when a blockage created by a blood clot or ruptured plaque cuts off blood flow in a coronary artery. The most deadly type of heart attack is a STEMI, or ST-Elevation Myocardial Infarction. The process can occur three ways:

1) The artery wall becomes coated with a fatty, sticky substance over time and plaque develops — blood may not be flowing freely enough through the coronary artery to reach the heart muscle.

2) A blood clot develops suddenly on the ulcerated plaque, blocking blood flow so that oxygen cannot reach the heart muscle.

3) A plaque within the artery wall ruptures abruptly creating a blockage preventing blood rich in oxygen from reaching the heart muscle. Once these things occur, the oxygen-starved muscle begins to die, resulting in pain and permanent damage. The damage may also cause an irregular heart rhythm, known as arrhythmia.

Anyone with heart attack warning signs needs to get medical treatment right away. 
Minutes matter!  Fast action can save lives.

Don't wait more than five minutes to call 9-1-1 and avoid driving to the emergency room. By calling 9-1-1 and taking an ambulance you will get to the hospital and treated in the fastest way possible. There also are other benefits to calling 9-1-1:

• Emergency personnel can begin treatment immediately— even before you arrive at the hospital.
• Your heart may stop beating during a heart attack. Emergency personnel have the equipment and training needed to start it beating again.
• Heart attack patients who arrive by ambulance tend to receive faster treatment on their arrival at the hospital.


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