Many attorneys are baby boomers who are at risk for a heart attack. What are your odds of surviving a heart attack?

There is always room for learning. Although I’m a seasoned ER doctor, I came across something the other day to which I had not given any thought.

There are two types of heart attacks. One is called a “STEMI,” the other is a “non-STEMI”. If you have a STEMI, it shows up on the EKG, and you will do better. You will have an increased chance of living and being healthy. Your odds are better if you are able to get a cardiac catheterization within 90 minutes, maybe 120 minutes, but not much longer. With this procedure, sooner is better.

If you’re over 50, and—like most readers of this blog—have some reasonable idea of what might be expected with a heart attack, what happens if you go to a small community hospital? They see you; they treat you; they stabilize you to the extent they can, and they transfer you to a large center where they do cardiac catheterizations, and they do them 24/7.
Will you be there in time?

Unfortunately, the answer is likely, “No.” According to recent articles in the American Journal of Cardiology, only 10% of patients with a STEMI who are transferred to a center have the catheterization in the optimal time frame. The average time is 149 minutes.

Why are your odds so poor? The hospital from which you are being transferred has to find a hospital willing to take you (usually not hard), and stabilize you, and get an ambulance to get you there. You lose time.
What happens if you initially go to the larger center? Almost every patient with a STEMI gets a cardiac catheterization within the optimal time frame.

Here is what you should remember:
If you’re at home, and you or your loved one has chest pain that might be related to cardiac disease, what do you do? Your safest transportation is an ambulance. The crew may—or may not—insist on taking you to the closest hospital.

Never take a car ride to where you want to go. You could pass out at the wheel. Even if someone else drives you, the car ride can be dangerous. There is no cardiac monitor, no cardiac medications, nothing. However, you may be able to get to the larger center in the proper time frame—if you can get there alive.

One of the greatest dangers right after a heart attack is that your heart goes into an abnormal rhythm that does not sustain life. If you’re with paramedics, they “shock” you out of that rhythm. If your wife or husband is driving you in the family car . . . that is not an option.

For now, if you develop chest pain, first chew four baby aspirin or one whole adult aspirin. After that, you need to decide on your own.

About the Author
Dean Dobkin, M.D., is a practicing emergency physician at the Philadelphia Veterans Affairs Medical Center. He testifies as an expert witness in emergency medical care. Contact him through ml@medleague.com.