DASH saves lives of heart patients

Seven's On Call with Dr. Jay Adlersberg
December 4, 2007 9:00:00 PM PST
Everyone knows time is of the essence in a medical emergency. And now, there's a new push to get heart attack patients help even faster.Seven's On Call with Dr. Jay Adlersberg.

How fast a heart attack patient gets from the emergency room to the cardiac cath lab can mean the difference between life and death. Now ,there's a national campaign by a group of heart doctors to cut that time way down.

The cath lab is where doctors do angioplasty, which means putting in stents, or tiny metal coils to hold open a blocked heart artery. A balloon expands the stent. Now, there's a new push to shorten the time from the ER door to the balloon.

"We find that we can save lives if we open up arteries as soon as possible," said Dr. John Fox, of Beth Israel Medical Center.

Door-to-balloon time is reduced at this hospital because of a program called DASH, which stands for Direct Angioplasty Saves Heart. It begins in the ER, where patients with chest pain get an immediate EKG.

"The technician who does the EKG has the responsibility of handing it to a physician, who can read it," Dr. Daniel Waxman said.

If it shows signs of a heart attack, the doctor dials 77 to call the DASH operator.

Seconds later, beepers beep with the DASH message and designated nurses, technicians and senior balloon cardiologists are on their way to the hospital. The patient gets fast-tracked through registration and is quickly on the way to the cath lab. Staff can arrive within 30 minutes, day or night.

The American College of Cardiology says the door-to-balloon time should be less than 90 minutes for 70 percent of patients with heart attacks.

Since March of this year, when DASH began, the percentage at Beth Israel has gone from 50 percent to the goal of 70 percent.

Just ask David Katz, who was rushed there with chest pressure and a narrowed heart artery. DASH may have prevented a heart attack.

"It was like a well-oiled machine," he said. "Everybody knew their role. It was almost like a ballet. It was choreographed. When I was in this room looking up at the ceiling, and all of the sudden I felt the release of that pressure. It's a new life, you know?"

Other hospitals have similar programs. One expert at NYU says on occasion, patients are not operated on arrival at the cath lab because doctors find the problem is not a heart attack. But those false alarms are far outweighed by the number of lives saved on others.