Sometimes a STEMI heart attack can do everything right
(recognize the symptoms and immediately activate 9-1-1), but without a STEMI system of care in place, things can go horribly wrong. But when a STEMI system is established, even if the patient fails to act appropriate, the system can save him or her. The following true stories of STEMI patients illustrate just that.
Without a STEMI System of Care
Edward Smith was 37 years old and married to his high school sweetheart, Kathy, who was a cardiac care unit (CCU) nurse. They were the parents of two small children: Allison and Josh.
Ed had been experiencing chest pain and shortness of breath. Over the weekend, he and Kathy had gone to a special event and spent time with friends. They enjoyed being with their children, too, and were teaching little Josh how to skip.
Monday morning, the family had breakfast together, and the kids were off to school. Ed had an appointment with his doctor for a stress test to determine the cause of the symptoms he had been experiencing. In the middle of the test Ed began having a heart attack. Kathy immediately recognized what was happening and began performing CPR on Ed.
9-1-1 was promptly notified, and Ed was taken to the closest community hospital, which did not have the capability to administer percutaneous coronary interfusion (PCI), the surgical means of restoring blood flow to the heart and the preferred method of treating a STEMI attack. Ed was given clot-busting drugs instead.
Ed died that afternoon in the community hospital while his children were at school. If Ed had been taken to a PCI-capable hospital that could have performed emergency angioplasty, he would still be here today.
The Smiths did everything right, but there was not a STEMI system of care in place to make sure Ed got the life-saving treatment he needed quickly.
With a STEMI System of Care
It was an ordinary Thursday afternoon, and Dale Baldelli was working. His wife, Karla, picked up their two boys (2-year-old Rafe and 12-year-old Roman) from school, and the three of them stopped at the grocery store on the way home.
While in the market, Dale called Karla's mobile phone five times, but she did not hear the phone ring. It wasn't until she got to her car that she noticed Dale had been trying to reach her, so she called him back. While Dale answered the phone, he was unable to clearly communicate. For some strange reason, Karla asked if he was having chest pains. When he said yes, she asked if he had notified 9-1-1, to which he said no. Karla hung up on Dale and called 9-1-1 from her car.
When EMS arrived at their home, they had a 12-lead electrocardiogram (ECG). While the Baldelli's lived less than two miles from the local community hospital, it was not equipped to administer PCI. When EMS diagnosed Dale was having a STEMI attack, they advised Karla that Dale needed to be taken directly to a PCI-capable hospital farther away so he could get the preferred treatment in a timely fashion.
The STEMI-receiving hospital was notified by EMS that they were en route with Dale. The cardiac team met the ambulance as it pulled up, taking Dale directly to the cath lab and bypassing the emergency room. Within approximately 45 minutes, Dale received angioplasty. He recovered in the intensive care unit for three days, then at home for a week before he could return to work.
Dale's heart attack occurred two years ago, and he is doing great. He's still around to watch his boys grow up. Rafe is now in kindergarten, and Roman just started high school. Their dad never misses an event.
The Difference a STEMI System Makes
These two men had very different outcomes following their heart attacks because of the presence or absence of a STEMI system of care. Ed did everything right, but there was not a system in place to ensure he got the treatment he needed in time. Dale did everything wrong by not calling 9-1-1, but a STEMI system of care was in place to save him. It allowed medical professionals to make appropriate decisions and provide proper and immediate care.
Mission: Lifeline wants to see STEMI systems of care established across this country so every patient receives the lifesaving care they deserve when they need it.