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SAINT RAPHAEL’S MEETS EXCELLENCE STANDARDS CARING FOR HEART ATTACK PATIENTS

March 24, 1997

SAINT RAPHAEL’S MEETS EXCELLENCE STANDARDS CARING FOR HEART ATTACK PATIENTS

NEW HAVEN, Conn. — The Hospital of Saint Raphael continues to be in the range of excellence in care for treating heart attack patients, according to new data released today by the Connecticut Hospital Association (CHA). The data document statewide hospital success rates in treating heart attack patients during the study period of Oct. 1, 1994 to Sept. 30, 1995.

“Saint Raphael’s heart attack survival rate during that time was 90.3 percent,” says Peter Herbert, M.D., chair of the Department of Medicine for the 500-bed community teaching hospital. CHA’s data indicate Saint Raphael’s mortality rate for the study period was 9.7 percent. “For many years, Saint Raphael’s has consistently done well, with a steady decline in the AMI (acute myocardial infarction, or heart attack) mortality rates,” says Herbert.

A leading provider of full-service cardiac care in Connecticut, Saint Raphael’s treats between 400 to 450 heart attack patients each year. In addition, the Hospital performs more than 1,000 open heart cases, 1,100 angioplasties and over 2,600 cardiac catheterizations.

The Hospital of Saint Raphael also offers a comprehensive range of cardiac services, from diagnostic tests to treatment to cardiac rehab and support groups. It was the first community hospital in Connecticut to open a coronary care unit and one of the first in New England to perform open heart surgery. Saint Raphael’s also has the state’s largest dedicated cardiothoracic intensive care unit.

A more aggressive approach
Saint Raphael physicians credit the Hospital of Saint Raphael’s aggressive approach to treating heart attack patients for the positive heart attack survival data.

“We took a hard look at well-established treatments for heart attack patients, like the use of aspirin and beta blockers,” says Herbert. “And we’ve dramatically improved our use of them. For instance, everyone who comes into our Emergency Department with chest pain is given aspirin, and very few leave here without being put on beta blockers.” According to Herbert, aspirin and a blood thinner called heparin are the mainstays of treatment for patients with unstable angina because they stop the formation of blood clots which can trigger heart attacks.

Philip Fazzone, M.D., chief of Cardiology, agrees the approach is working. “We renovated our cardiac cath labs with the newest technology for imaging coronary arteries,” he says. “We have the ability to treat heart attack patients in our cath labs 24 hours a day.

“Saint Raphael’s also is performing more therapeutic cardiology, such as angioplasties, as a primary treatment to open blocked arteries,” says Fazzone. “This approach has been shown to improve survival odds, salvage more heart muscle and allow the patient to go home sooner.

“Statistics now show that if we achieve good blood flow in a blocked artery by doing an angioplasty at the time of the heart attack, we can safely send the patient home after just three days and monitor his or her care on an outpatient basis,” says Fazzone.

Time is of the essence
Quick treatment of a heart attack is key to survival,” says Herbert. “But a lot depends on the patient. If he or she knows the warning signs of a heart attack and gets to an emergency room quickly, the survival odds are highest. Aspirin, beta blockers and thrombolysis drugs — also known as ‘clot-busters’ — are extremely effective when given to heart attack patients early,” he says. “The longer a patient waits to get medical attention, the less likely the drugs will do any good. Otherwise, we can save a good portion of the heart. Our statistics support this.”

“Education is very important,” emphasizes Fazzone. “People are more tuned in to the urgency of seeking immediate treatment for heart attack, thus improving their odds of survival. And there’s so much we can do to help them once they get here. By seeking prompt medical attention, heart attack patients can be treated sooner, helping to salvage more of the heart muscle and therefore improving the quality of life once the patient leaves the hospital.”

The sequence of events
“It’s very important for people to know the warning signs of a heart attack,” says Herbert. These include pain in the chest, jaw and/or left arm, sometimes with sweating or an upset stomach.

According to Herbert, anyone experiencing these symptoms should go to the emergency room right away.

Herbert notes that patients who get to the hospital within three hours of experiencing any symptoms present the best opportunity for successful treatment. “Within 12 hours of the onset of symptoms is essential and six hours is good, but within three hours seems to make the most difference for survival,” he adds.

The patient, after initial treatment in the Emergency Department, is admitted to the Hospital’s coronary care unit for observation. Once stabilized, the patient then receives a stress test to determine if the heart is in danger of additional damage. If this danger exists, a cardiac catheterization procedure, followed by surgery or angioplasty, may be recommended.

Technological advances coupled with education
“The addition of coronary care units (CCU) to hospitals is probably one of the biggest factors in improving heart attack survival rates,” says Fazzone. “Prior to the CCU, 30 percent of patients who reached the hospital would die — 15 percent because they were not adequately monitored, and 15 percent because of heart muscle damage and failure. Coronary care units give us the ability to more closely monitor cardiac cases and improve survival rates. Advances in technology and medical therapies to restore blood flow to the heart have further improved survival rates.”

Herbert agrees, adding, “Technological advances coupled with a greater public awareness about the urgency of seeking immediate care have made a big difference in improving survival rates for heart attack patients.”

For nine decades, the Hospital of Saint Raphael — and later the Saint Raphael Healthcare System — has embraced the greater New Haven community by offering quality healthcare services, pioneering state-of-the-art medical treatment and innovative community-based outreach programs. This year, Saint Raphael’s is proud to commemorate the 90th anniversary of its presence in New Haven.

For an interview with a cardiac expert, call Sandy St. Pierre, (203) 789-3507.

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