Call 911 if you want to live
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First Medical Contact
Time Is Muscle
Early one morning, a 54-year-old building contractor named George went to Home Depot to pick up a few things he needed for the job he was working on. He was with his business partner, who happened to be an off-duty paramedic.
George was very healthy and commonly worked up to 12 hours a day, five or six times a week. He didn’t have a history of any sort of medical problem—but he also hadn’t seen a doctor in almost 15 years.
George didn’t realize it, but he had many significant risk factors for having a heart attack.
His father died suddenly of a heart attack at age 58. His mother and his sister both had type 2 diabetes, a major risk factor for heart disease.
George was a chronic tobacco user, smoking a pack a day since age 17.
He was about 15 pounds overweight and carried it mostly in his belly. His favorite lunch, which he enjoyed too many times each week, was a double meat/double cheese burger with large fries and a chocolate shake.
10:20 a.m.
At the check-out counter, George suddenly experienced severe substernal chest discomfort and nausea. He broke out in a cold sweat. (Looking back, George thought his symptoms may have been provoked by the exorbitant increase in the costs for building supplies.)
10:24
His co-worker immediately realized George was having a heart attack and called 911 right away.
10:29 a.m.
Paramedics arrived in just 5 minutes. They did a 12-lead EKG in the ambulance. The results showed George was having an acute heart attack, probably caused by a blockage in the right coronary artery of his heart. The EMTs called ahead to the nearest STEMI receiving center (SRC) and notified the emergency room that they were transporting a heart attack victim. The ER doctor activated the cath lab and notified the interventional cardiologist on call.
The arrow points to ST elavations (tombstones) in leads II, III, and AVF consistent with heart attack.
10:44 a.m.
George arrived at the heart attack center. He was quickly evaluated by the ER doctor, who felt he was a good candidate for emergency angiography and possible angioplasty and stent placement.
10:54 a.m.
George arrived in the cath lab and coronary angiography is performed. The results show the right coronary artery is totally closed .
[SB2]Video here looks good--do a caption.
11:07 a.m.
The cardiologist inflated a balloon within the blocked artery, which immediately restored the blood flow.
A stent was then placed to keep the artery open.
George’s chest pain went away and his EKG returned almost to normal.
The Results
Time from 911 call to EMT arrival: 5 minutes.
Door to balloon time: 23 minutes.
First medical contact to open artery: 38 minutes.
Because his partner recognized the symptoms of a heart attack and called 911 at once, and because the EMTs were able to take him directly to a specialized heart attack center, George got treatment to open his blocked artery in under an hour. He’s a good example of how time is muscle—prompt treatment meant George had no damage to his heart. He was home two days later and was back at work in a week. He now sees his doctor once every six months and is working to quit smoking and make better choices at lunchtime.