Chest discomfort and shortness of breath may be nothing at all, or they could be the signs of a serious heart condition. The key is listening to your body and not ignoring its warning signs. The faster you seek emergency medical help, the greater your chances of receiving lifesaving treatment.
Mercy’s accredited Chest Pain Center located in the Emergency Department allows physicians to reduce the time to treatment during the critical stages of a heart attack. Mercy was the first in the state to receive national accreditation by the Society of Chest Pain Centers. We are also are ranked among the top hospitals in the United States in “door-to-balloon” time, averaging just 55 minutes between a heart attack patient's arrival in our Chest Pain Center and the start of lifesaving percutaneous coronary intervention (PCI), also known as balloon angioplasty or coronary stenting. The national target for time from arrival in the emergency room to the artery being opened is 90 minutes or less.
Heart Attack Warning Signs
Some heart attacks are sudden and intense and there is no doubt what is happening; however, most heart attacks start slowly, with mild pain or discomfort. Often people aren't sure what's wrong and wait too long before getting help.
Warning signs of a heart attack
- Chest discomfort: uncomfortable pressure, squeezing, fullness or pain in the center of the chest that lasts more than a few minutes or goes away and comes back.
- Shortness of breath: may often occur with or before chest discomfort.
- Discomfort in other areas of the upper body; this may be felt in one or both arms, the back, neck, jaw or stomach.
- Sweating, nausea or dizziness.
- Women, the elderly or diabetics may be more likely to present with symptoms other than chest pain — such as shortness of breath, back pain, or nausea and vomiting.
If you believe you are having a heart attack, call 9-1-1 right away.
Risk Factors for Heart Disease
It is important you know your personal risk for heart disease. Every risk factor counts. Risk factors are conditions or habits that increase your chances of developing a disease or having it worsen. The more risk factors you have, the higher your risk for developing heart disease.
There are a number of factors that may put you at risk – some are controllable, others are not.
Uncontrollable risk factors include:
- Age – Heart disease is more likely to occur as you get older, especially after age 65.
- Male gender – Men have a greater risk of heart attack than women do, and men have heart attacks earlier in life than women. However, beginning at age 70, the risk is equal for men and women.
- Family history of heart disease – You have an increased risk of developing heart disease if you have a parent with a history of heart disease, especially if they were diagnosed before age 50. Ask your doctor when it’s appropriate for you to start screenings for heart disease so it can be detected and treated early.
- Race – African Americans, American Indians, and Mexican Americans are more likely to have heart disease than Caucasians.
Controllable risk factors include:
- Smoking – One the best things you can do for your heart health is to stop smoking. It contributes to plaque formation in the arteries, which may lead to a heart attack or stroke. There is nothing easy about this, but with a plan of action, you can do it. Start to become aware of your personal “triggers” to smoking and replace them with new activities. Eating healthy and starting an exercise program can also help. Do not be afraid to use quit aids, either over-the -counter or prescription, group or individual counseling to help you through this.
- Abnormal Cholesterol – Keeping your cholesterol levels healthy is a great way to keep your heart healthy – and lower your chances of getting heart disease or having a stroke. Cholesterol can be tricky to understand, though, because not all is bad for you. Some is actually good for you. Your total cholesterol – LDL (bad) cholesterol, HDL (good) cholesterol and triglycerides – should be 200 mg/dl or lower. LDL (bad) cholesterol should be less than 100 mg/dL and HDL (good) cholesterol greater than 50 mg/dL. Your doctor can provide specific guidelines.
- High Blood Pressure (greater than 120/80 mmHg) – High blood pressure means your heart has to work harder than normal. Left untreated, it can weaken artery walls, leading to atherosclerosis, a narrowing of the arteries caused by fatty deposits. Adults and children should have their blood pressure measured each year. Those with borderline pressures should be measured more frequently.
- Obesity (BMI higher than 30 kg/m2) – Obesity makes the heart work harder, increasing risk for heart disease. In many cases, it also indicates a sedentary lifestyle, and a low HDL level.
- Diabetes (HbA1c greater than 7.0) – If not properly controlled, diabetes can contribute to significant heart damage, including heart attacks and death. Control diabetes through a healthy diet, exercise, maintaining a healthy weight, and taking medications as prescribed by your doctor.
- Physical Inactivity – Many of us lead sedentary lives, exercising infrequently or not at all. People who don't exercise have higher rates of death and heart disease compared to people who perform even mild to moderate amounts of physical activity. Exercise is an important part of reducing your risk for heart disease. Most people should exercise 30 minutes a day, at moderate intensity, on most days.
Level 1 Heart Attack Protocol
Over the years, Mercy has played a major role in transforming care for victims of heart attack in central Iowa.
In 2004, Mercy collaborated with community hospitals and emergency medical response (EMS) teams to implement the Level 1 Heart Attack Protocol – a program designed to reduce the time to treatment for rural Iowans who suffer from heart attacks and cannot quickly access the level of treatment often offered only in urban areas.
Fast action saves lives
The Level 1 Heart Attack Protocol begins when a patient with acute myocardial infarction (heart attack) arrives at a community hospital, such as Newton, Grinnell, Centerville or Boone. After evaluating and stabilizing the patient, the community emergency department declares a Level 1 heart attack. Coordination immediately begins on a number of different fronts. Trained personnel, who understand that fast response is essential to aid recovery, coordinate emergency transportation and promptly arrange with air or ground crews for the quick transport of the patient.
The Level 1 team at Mercy begins work immediately. Before the patient even arrives, admission staff complete registration information based on data submitted by the community hospital to ensure a bed is available. Designated nurses work closely with key hospital departments to share patient information such as intubation, cardiac arrest, interpreter requirement and changes in patient status. A full cath lab team are prepared to act when the patient arrives.
Patients are moved from the helicopter or ambulance directly to the cardiac cath lab, where the team is standing by. The treatment goal is to direct angioplasty/stenting within the national goal of 90 minutes or less from the time the patient arrives at their local emergency department to balloon inflation at the Mercy cath lab; Mercy’s average time is 55 minutes.
Today, 24 hospitals participate in the in the protocol and more than 1,000 patients have benefited from the program.