Quality Indicators for Treating Heart Attack
Each year close to one million people suffer a heart attack
(also known as an acute myocardial infarction or AMI). A heart attack
occurs when an area of heart muscle dies or is permanently damaged
because of an inadequate supply of oxygen to that area.
Below
you will find the best medical practices for treating a heart attack,
as outlined by the federal government. A best medical practice is a
treatment that has been proven to provide the best results for most
patients. According to guidelines set at the federal level, hospital
medical staff should provide the following treatments to incoming heart
attack patients:
This chart tracks the response rate of physicians practicing at Carle Foundation Hospital:
Percent of Heart Attack Victims Given Aspirin on Arrival.
Why is this Important?
The heart is a muscle that gets oxygen through blood vessels. Sometimes blood clots can block these blood vessels, and the heart can’t get enough oxygen. This can cause a heart attack. Chewing an aspirin as soon as symptoms of a heart attack begin may help reduce the severity of the attack. This chart shows the percent of heart attack patients who were given (or took) aspirin within 24 hours of arrival at the hospital.
Higher percentages are better.
Percent of Heart Attack Victims Given Aspirin at Discharge.
Why is this Important?
Blood clots can block blood vessels. Aspirin can help prevent blood clots from forming or help dissolve blood clots that have formed. Following a heart attack, continued use of aspirin may help reduce the risk of another heart attack. Aspirin can have side effects like stomach inflammation, bleeding, or allergic reactions. Talk to your health care provider before using aspirin on a regular basis to make sure it’s safe for you.
Higher percentages are better.
Percent of Heart Attack Victims Given ACE Inhibitors or ARB for Left Ventricular Systolic Dysfunction (LVSD).
Why is this Important?
ACE (angiotensin converting enzyme) inhibitors and ARBs (angiotensin receptor blockers) are medicines used to treat patients with heart failure and are particularly beneficial in those patients with heart failure and decreased function of the left side of the heart. Early treatment with ACE inhibitors and ARBs in patients who have heart failure symptoms or decreased heart function after a heart attack can also reduce their risk of death from future heart attacks. ACE inhibitors and ARBs work by limiting the effects of a hormone that narrows blood vessels, and may thus lower blood pressure and reduce the work the heart has to perform. Since the ways in which these two kinds of drugs work are different, your doctor will decide which drug is most appropriate for you. If you have a heart attack and/or heart failure, you should get a prescription for ACE inhibitors or ARBs if you have decreased heart function before you leave the hospital.
Percent of Heart Attack Patients Given Smoking Cessation Advice/Counseling.
Why is this Important?
Smoking increases your risk for developing blood clots and heart disease that can result in a heart attack, heart failure or stroke. Smoking causes your arteries to thicken and your blood vessels to narrow. Fat and plaque stick to the walls of your arteries, which makes it harder for blood to flow. Reduced blood flow to your heart may result in chest pain, high blood pressure, and an increased heart rate. Smoking is also linked to lung disease and cancer, and can cause premature death. It is important that you get information to help you quit smoking before you leave the hospital. Quitting may help prevent another heart attack.
Higher percentages are better.
Percent of Heart Attack Patients Given Beta Blocker on Arrival
Why is this Important?
Beta blockers are a type of medicine that is used to lower blood pressure, treat chest pain (angina) and heart failure, and to help prevent a heart attack. Beta blockers relieve the stress on the heart by slowing the heart rate and reducing the force with which the heart muscle contracts (to pump blood). Most heart attack patients should be given a beta blocker within 24 hours of arriving at the hospital.
Higher percentages are better.
Percent of Heart Attack Patients Given Beta Blocker at Discharge.
Why is this Important?
Beta blockers are a type of medicine that is used to lower blood pressure, treat chest pain (angina) and heart failure, and to help prevent a heart attack. Beta blockers relieve the stress on your heart by slowing the heart rate and reducing the force with which your heart muscles contract to pump blood. They also help keep blood vessels from constricting in your heart, brain, and body. If you have a heart attack, you should get a prescription for a beta blocker before you leave the hospital.
Higher percentages are better.
Percent of Heart Attack Patients Given Fibrinolytic Medication Within 30 Minutes of Arrival.
Why is this Important?
The heart is a muscle that gets oxygen through blood vessels. Sometimes blood clots can block these blood vessels and the heart can’t get enough oxygen. This can cause a heart attack. Fibrinolytic drugs are medicines that can help dissolve blood clots in blood vessels and improve blood flow to your heart. You should get them within 30 minutes of arrival at the hospital.
Higher percentages are better.
Percent of Heart Attack Patients Given PCI Within 90 Minutes of Arrival.
Why is this Important?
The heart is a muscle that gets oxygen through blood vessels. Sometimes blood clots can block these blood vessels, and the heart can’t get enough oxygen. This can cause a heart attack. Percutaneous Coronary Interventions (PCI) are procedures that are among the most effective ways to open blocked blood vessels and help prevent further heart
muscle damage. A PCI is performed by a doctor to open the blockage and increase blood flow in blocked blood vessels. Improving blood flow to your heart as quickly as possible lessens the damage to your heart muscle. It also can increase your chances of surviving a heart attack. There are three procedures commonly described by the term PCI.
These procedures all involve a catheter (a flexible tube) that is inserted, often through your leg, and guided through the blood vessels to the blockage. The three procedures are:
- Angioplasty - a balloon is inflated to open the blood vessel.
- Stenting - a small wire tube called a stent is placed in the blood vessel to hold it open.
- Atherectomy - a blade or laser cuts through and removes the blockage.
Higher percentages are better.