PORT ST. LUCIE, FL – Patients having one of the most serious types of heart attack can now get around-the-clock emergency treatment at Cleveland Clinic Tradition Hospital, which launched a new STEMI protocol in October.
STEMI, or ST-elevation myocardial infarction, is a heart attack caused by a complete blockage of one of the heart’s arteries. Dr. Jaime Lewellyn, medical director of interventional cardiology at Cleveland Clinic Martin Health, said speed matters because the heart muscle is starved of oxygen.
“The heart muscle is without oxygen, which is why it’s so important that we open it up quickly,” Lewellyn said.
The hospital expanded its cardiac catheterization lab and added specialized staff, Lewellyn said. Cardiac cath labs are where doctors open blocked arteries, often by placing stents.
“Now we’re able to provide coverage 24-7 for anyone who’s having a heart attack,” she said. “We have all of those capabilities here at Tradition Hospital,” including placing stents and providing added support for critically ill patients.
The process starts in the field. Local EMS crews can run an electrocardiogram, or ECG, on a patient to determine whether a heart attack is under way. Hospital officials said those ECGs can be sent directly to the emergency department, so clinicians can confirm a STEMI and activate the cardiac response team quickly.
When a crew identifies a heart attack, Lewellyn said, paramedics contact the emergency room physician, who triggers what the hospital calls a cardiac alert.
“It informs the interventional cardiologist like myself, our cath lab team and our nursing leadership to help facilitate getting that cath lab ready,” she said.
The patient is checked in at the emergency room and then taken directly upstairs to the cath lab, where doctors open the blocked artery.
The first minutes can feel overwhelming for patients and families, Lewellyn said, as the team prepares the patient for the procedure with an ID band, IVs and other steps.
After the procedure, patients typically spend one night in the intensive care unit before moving to a regular floor bed. Without complications, which she said is the case for most STEMI patients, they go home in about two days.
Lewellyn said treatment has improved significantly over the years. Wires and stents have been used for years, but newer devices can now support a weakened heart while it recovers.
“We’re seeing that people are doing better as far as recovery,” she said. “We have better technology, shorter hospital stays and better medications to prevent recurrent future heart attacks or problems with the stent.”
Tradition’s cath lab handled five STEMI cases in its first month, Lewellyn said. She expects that number to climb as the Treasure Coast’s seasonal population grows.
“With the population being older in the Port St. Lucie Tradition area, we do see a fairly high volume of heart attacks throughout all the different facilities,” she said.
Patients with severe blockages or complications will be stabilized and transferred to cardiothoracic surgeons at Cleveland Clinic Martin North in Stuart, who can perform coronary artery bypass grafting, or CABG. That surgery creates a new route for blood to get around a blockage.
“Patients who require cardiac surgery or need extended mechanical support or heart transplantation consideration can be rapidly transferred to the appropriate Cleveland Clinic facility, while many patients will be able to receive lifesaving STEMI intervention at Tradition Hospital,” said Dr. Jerry D. Estep, interim vice chief of the Heart, Vascular and Thoracic Institute at Cleveland Clinic Florida.
Dr. Chirag Choudhary, vice president and chief medical officer of Cleveland Clinic Tradition, North and South hospitals, said the program is meant to bring timely care closer to home.
“When someone is having a heart attack, every minute counts,” Choudhary said.
For patients heading home, Lewellyn said, a heart attack often changes how they live. That means eating heart-healthy by cutting back on saturated fats and processed foods, and slowly building activity back up.
“We really want our cardiac patients to do around 150 minutes of cardio every week,” she said.
Patients are referred to cardiac rehab to rebuild endurance. Doctors also prescribe cholesterol medications to stabilize plaque and lower the risk of future heart attacks, and they urge patients who smoke to quit.
Lewellyn said she is glad to offer the service locally.
“I think this is exciting that we get to offer this to the community. I think it’s a great resource, and I’m very excited to be a part of it,” she said.