STEMI/PPCI Awareness: Part 2

Time is Muscle

Since the turn of the century I have had the privelege of discussing heart attack and stroke recognition and management with hundreds of older adults. What I've learned from these discussions is that when it comes to heart attack seniors are burdened with some very realistic fears and a very scary lack of knowledge.

I've also found that filling the knowledge void goes a long way toward reducing the fear. Adult learners want to know the hows and whys and once they do they will buy into the message and be better prepared to act in a way that insures the best possible outcome.

In the vast and evolving universe of Myocardial Infarction (MI) there is one constant that all Cardiologists agree on - "Time is Muscle".

Blood carries oxygen, all human tissue needs oxygen, in the absence of oxygen all human tissue dies. When a person is having a Heart Attack part of their heart muscle is not getting any blood, is therefore not getting any oxygen and is therefore dying. If blood flow is not restored to the affected part of the heart within 90 minutes heart muscle will be dead. The longer it takes to restore blood flow the more heart muscle that dies. The more heart muscle that dies the greater the likelihood of permanent disability or death.

In every community where I teach there is a hospital with a team of interventional cardiologists, working in a cardiac catheterization lab, that specializes in restoring blood flow to the affected part of the heart within 90 minutes thereby minimizing damage and insuring the best possible outcomes for Heart Attack patients. Virtually none of my students know this.

Virtually none of these adult learners know that every ambulance in their community is equipped with an ECG monitor and every paramedic is trained to identify the electronic signature (ST Elevation) of a heart attack that requires direct transport to the cath lab. None of them know that using a personal vehicle to transport a patient to the closest (and often wrong) hospital could result in the 90 minute window being closed and the worst possible outcome.

Governments and health care systems take billions of tax dollars from the people most at risk of morbidity and mortality resulting from Myocardial Infarction and use that money to build state of the art treatment programs; training and equipping paramedics and interventional cardiologists, so that blood flow can be restored to the affected part of the heart effectively solving the age old "Time is Muscle" dilemma. And then the entire system fails to invest one nickel in educating those same taxpayers on how and why to access the progams that they have paid for.