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Forbes Heart and Vascular Center


What is the Impact of Heart Disease?

According to the American Journal of Cardiology, acute myocardial infarction (AMI), or a heart attack, is the leading cause of death in adults in the United States. Each year, more than five million Americans enter the hospital with chest pain. Of those, 1.25 million will present cardiac distress symptoms and 600,000 will die of heart disease.

Recent advancements in the treatment of heart attacks have greatly reduced its mortality and morbidity, but successful treatments are time dependent and necessitate rapid initiation. For good outcome, the patient must quickly recognize the signs and symptoms of a heart attack and the physician must quickly diagnose the heart attack and initiate treatment.

Why is time important in the treatment?

Historically, patients have waited too long after the onset of symptoms of a heart attack before seeking medical care. On average, a patient arrives in the emergency department (ED) more than 2 hours after first noticing symptoms. In fact, a small number of people wait more than 24 hours before seeking medical attention.

If a patient with a heart attack is treated within 90 minutes, damage to the heart can be minimized (and mortality decreased) by aborting the infarct. After delay, substantial heart damage can occur, minimizing the impact of medical interventions.

Why were Chest Pain Centers Developed?

The concept of Chest Pain Centers in community hospitals was presented in the late 1980s as a strategy to significantly reduce heart attack deaths through the rapid treatment of patients with acute myocardial infarction. Since then, they have evolved to include safe management of low risk patients presenting with acute chest pain.

The number of Chest Pain Centers has grown continuously; it is estimated that there are now as many as 1,500 Chest Pain Centers in the United States. That number continues to grow as the value of such a center is proved in lives saved.

To earn accreditation status, a hospital must meet or exceed a wide set of stringent criteria and an on-site evaluation by a review team from the Society of Chest Pain Centers. Accredited hospitals are committed to providing quality cardiac care to patients and have the resources available to do so.
On February 28, 2009 Forbes became the first hospital in the Pittsburgh region to be named an accredited Chest Pain Center by the Society of Chest Pain Centers. Only nine other hospitals statewide have earned this accreditation.

How is a hospital with a “Chest Pain Center” different from other hospitals?

The Chest Pain Center’s protocol-driven and systematic approach to care allows physicians to reduce time to treatment during the critical early stages of a heart attack, when treatment are most effective and to better monitor patients when it is not clear whether they are having a cardiac event.

How does the doctor determine if I am having a heart attack?

This is determined through a history and physical exam and 12-lead electrocardiogram (EKG). The best treatment for patients experiencing a heart attack is to open the blocked coronary artery in the cardiac catheterization lab as quickly as possible.

If I am not having a heart attack why do I need to be admitted to the hospital?

Some times the coronary artery is only partially blocked and the EKG will look normal even though the heart muscle may not be receiving an adequate blood supply and may be at risk for muscle damage. To detect this muscle damage it is necessary to obtain lab work, called cardiac enzymes, to determine if any heart muscle damage has occurred.

Chest Pain Centers provide a specialized observation setting for low level chest pain patients in which physicians are better able to monitor patients when it is not clear whether they are having a coronary event. Such observation helps ensure that a patient is neither sent home too early nor needlessly occupying a CCU bed.

What type of testing will be done while I am in the Chest Pain Center?

The following lab work will be done:

  • Cardiac enzymes
  • Blood chemistries
  • Complete Blood Count
  • Blood clotting study
  • Fasting Lipid Panel
  • Your doctor may also order one of the following tests to evaluate your heart’s response to exercise
  • Exercise Stress test with nuclear imaging
  • Pharmacologic stress test (for patients who cannot walk on a treadmill)
  • Exercise Stress Echo

Other testing such as a CT scan of the chest and an echocardiogram may also be ordered by your doctor.

For a detailed description of these tests, please refer to end of the booklet.
Additional testing may also be ordered based upon your individual case.

What symptoms should I tell the nurse about?

Please let your nurse know immediately if you have any of the following:

  • Pain, pressure, or discomfort in your arms, back, neck or jaw
  • Nausea or indigestion
  • Chest pressure or pain
  • Shortness of breath

How long can I expect to be in the Chest Pain Center?

Most patients are able to be discharged home within 23 hours of admission after the lab work and stress test are completed and the results have been evaluated by your physician.

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