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Recognizing a Heart Attack

Have you ever had shortness of breath or fullness in the chest? How about prolonged indigestion or a vague tiredness? These might be signs of a heart attack and you could be wrong to dismiss them - dead wrong. Gina Henson of Yreka, California, almost did and almost was.

She described her heart attack symptoms as "a kind of tightness in my chest, like when you have a cold and you feel congested. It didn't get worse, it just stayed the same."

At 65, in good health and with no family history of heart disease, Gina tried to ignore these signs for more than three days in June 2004. "Heavens, a heart attack was the last thing I thought of," Gina remembers. "I just thought I overdid it from working around the house."

It was her daughter, Koye Chapman, who finally brought Gina to Fairchild Medical Center early that Friday morning. Sure enough, the blood vessels bringing oxygen to Gina's heart were blocked, damaging the heart muscles - Gina was having a heart attack, an acute myocardial infarction. Within minutes after arriving at Fairchild, Gina was in an ambulance on the way to Rogue Valley Medical Center where she was delivered directly to the cardiac catheterization lab and into Dr. Kent Dauterman's expert care.

As a regional center for excellence in cardiac care, Rogue Valley Medical Center serves many hospitals in Southern Oregon and Northern California. It is the only hospital in this region with a team of on call interventional cardiologists and lab on call 24 hours a day that can handle a variety of techniques to open up the blood vessels that carry oxygen to the heart.

Fairchild Medical Center's prompt response to Gina's heart attack was due to the regional ASSET protocol developed by Dr. Brian Gross, who's with The Heart Clinic in Medford. The protocol or treatment guideline outlines how community hospitals, physicians and paramedics assess the extent and severity of a heart attack so that patients can be taken to RVMC as quickly as possible. They can then be treated with a stent to prop open the blood vessel, with medicine to help dissolve the blockage or with surgery. According to Dr. Dauterman, "The [ASSET] protocol has clearly shortened the time, no matter where you are in Southern Oregon or Northern California, to treatment - to opening that blocked artery. Once that artery is opened up, the pain goes away."

"We've discovered how important time is [in caring for a heart attack patient]," says Tim James, Mercy Flights operations supervisor. "We have a saying: time is muscle." And the window before the heart muscle is severely damaged, says Dr. Dauterman, is about 90 minutes after the start of the acute phase of a heart attack.

Most paramedics and emergency workers in the Rogue Valley carry the LifePak, a portable device that can diagnose a heart attack in the pre-hospital setting. James reports that the LifePak is used 25-30 times a day to evaluate patients' heart rhythms and to monitor patients during transport.

"If we see certain rhythms or certain changes in rhythms we can deliver [the patient] directly to the Rogue Valley Medical Center cath lab and bypass the ER," says James. "We're saving 20 minutes by bypassing the ER ...." If you have a heart attack, saving 20 minutes can save your life.

But why do people sometimes wait days before they seek treatment?

In June 2004, it took three days of discomfort for Gina Henson to go to the hospital, arriving just moments before having a terrible heart attack. And in September of that same year her daughter Koye's husband, Mark, came home from work on Friday complaining of tightness in his chest. Koye says, "I kind of suspected [a heart attack] because of what I'd gone through with my mother."

"I tried talking to him, all day Saturday and Sunday, trying to get him to go to the hospital," Koye remembers. "He's very stubborn when it comes to going to the doctor and kept saying, 'I'm 47, I'm too young to have this happen.'" Mark ended up having a quintuple bypass at Rogue Valley Medical Center that September.

A heart attack isn't always a great crushing pain in the chest. A heart attack can be sneaky and creep up on you, especially in women. "Don't wait," urges Koye. "Getting to the hospital early and telling what your signs are could be a life saver."

To defend yourself, know the warning signs of a heart attack. Watch for chest discomfort, pressure, squeezing, fullness or pain that lasts more than a few minutes or that goes away and comes back. Watch for pain or tingling in the arm, back, neck, jaw or stomach. Watch for shortness of breath. And remember that time is muscle.

Recognizing a Heart Attack