Bob Meares was working in his yard on Labor Day in 2007 when he started feeling tightness in his chest. The 58-year-old Aiken resident knew right away what was happening to him.

"I had a heart attack several years ago so I was pretty sure I was having another one," he said. "I called 911 immediately. The first responders were there within five minutes. When I arrived at Aiken Regional Medical Centers (ARMC), my doctor was already waiting for me."

What Meares may not have realized was that he was in good hands. ARMC is ranked as the top hospital in the Central Savannah River Area (CSRA) and among the top hospitals in the nation for treating heart attack patients.

Prompt Care
The hospital's good results in heart attack care are due, in part, to its participation in the American College of Cardiology's (ACC) Door-to-Balloon (D2B) initiative.

This quality improvement program is designed to reduce the number of minutes that pass between when patients with the most serious type of heart attack arrive at the emergency room (ER) and undergo cardiac catheterization procedures, which open blocked vessels and restore blood flow to the heart.

Studies show that patients who receive treatment at hospitals that comply with these guidelines have a better chance of surviving heart attacks, less permanent damage and fewer longterm complications.

ARMC Initiatives
When ARMC joined the D2B initiative about 18 months ago, staff immediately began evaluating every aspect of the care they provide to heart attack patients.

"People in all areas, including the ER, the cardiac cath lab, imaging, laboratory, hospital operators, quality outcomes and local emergency medical services (EMS), worked together to identify ways we could improve care," said Todd Franke, RT(R), CVT, Manager of Cardiovascular Services at ARMC. "Then we developed new processes and preset orders to make us more efficient so we could provide the high-level services heart attack patients need within the 90-minute goal recommended by the ACC."

"We've made a lot of little changes that saved a minute here and a few minutes there," said Ursula Bethmann, RN, a clinical nurse specialist at the Cardiovascular Institute of Carolina at Aiken Regional. "All the minutes add up and make a major difference when it comes to patient outcomes."

Some of the changes made as part of the D2B program included:

• A new triage protocol that speeds assessment of acute heart attack patients
• Reducing the time it takes to perform initial electrocardiograms (EKGs)
• A new system that allows EMS personnel to transmit EKGs from the field to the hospital
• A new paging system that allows ER doctors to alert cardiologists and cardiac catheterization lab team members simultaneously so they can report quickly to the appropriate area
• A protocol to give aspirin to all heart attack patients unless contraindicated
• Reporting on individual patients' D2B times within 24 to 48 hours

Improved Outcomes
Like all heart attack patients, Meares' chances for surviving his heart attack decreased with every minute that passed.

Fortunately, once Meares arrived at the ER, it took staff just 79 minutes to assess his condition, perform tests to diagnose his heart attack, transport him to the cardiac catheterization lab and perform a procedure to open his blocked vessel.

"Two good things happened that improved Mr. Meares' outcome," said Greg Eaves, MD, an interventional cardiologist at ARMC. "He knew he was having a heart attack so he called for emergency help right away instead of waiting to decide if his symptoms were serious. And he went to a hospital that has a very aggressive and successful D2B program in place so he got to the cath lab very quickly."

Meares recovered fully from his second heart attack and is taking steps to reduce his risk for future heart problems. He's cutting back on fried foods and sweets, drinking more water and exercising. He said he feels very fortunate that he suffered no permanent damage to his heart and doesn't face any long-term cardiac complications.

"I was very pleased with the fast and efficient service," Meares said. "I feel better now than I have for a long time. ARMC has a top-notch heart unit. I can't imagine that people could get better care anywhere else. There's no reason for people to leave the area for heart attack treatment when they can get the help they need right away at ARMC."

Help Us Help You
Staff at Aiken Regional Medical Centers is available 24 hours a day, seven days a week to provide you with prompt and effective heart attack care.

But their efforts can be successful only if you seek care immediately. Call 911 right away if you develop these typical heart attack symptoms:

• Chest pain, pressure or discomfort
• Pain or discomfort in one or both arms or your back, stomach or jaw
• Shortness of breath
• Cold sweats
• Nausea and vomiting
• Light-headedness

Keep Your Heart Healthy
The Cardiovascular Institute of Carolina at Aiken Regional offers comprehensive and advanced cardiac care close to home. To find out more about the Institute's services, please call 803-641-5280.

P.O. Drawer 1117 Aiken, SC 29802