STEMI Release

Hospitals Consider Regional Plan for Heart Attacks

When a blocked artery causes a heart attack, the best treatment is angioplasty

Physicians, EMS paramedics, and hospital staff representing 11 hospitals in northern Michigan recently met for the purpose of saving the lives of more northern Michigan residents who suffer severe heart attacks.

The task force set a goal for developing a regional system for ST segment elevation myocardial infarction or “STEMI”care. Munson Medical Center Cardiologist James Fox said a STEMI is a severe heart attack that results from a blocked artery. More than 400,000 people in the U.S. suffer this kind of heart attack each year. An average of one a day occurs in northern Michigan.

“These are truly deadly heart attacks,” Fox said. “This is a crisis of health care of the first order and represents the number one medical problem for adults in the world.”

Guidelines created by the American Heart Association based on international research findings call for patients who experience a STEMI to be treated through “percutaneous coronary intervention” or PCI within 90 minutes. This involves inserting a catheter with a balloon device into the groin artery and maneuvering it up to the blockage site to remove the blockage.

The American Heart Association has developed a “Mission Lifeline” model for regional care of STEMI patients that provides ideas and resources for implementation of a regional plan.

Munson Medical Center in Traverse City and Northern Michigan Regional Hospital in Petoskey are the only two hospitals with facilities for PCI – also commonly called coronary angioplasty – in the northern Lower Peninsula.

At the meeting in Kalkaska on July 15, about 90 paramedics, physicians, nurses and administrators representing all 11 hospitals in the region evaluated steps to improve care for patients in the area who may experience a STEMI heart attack.

Both Fox and Cardiologist Duane Schuil, M.D., of Northern Michigan Regional Hospital, presented statistics showing improved times between “door to balloon” when patients arrive at their respective hospitals. The focus for a regional approach would require greater support for EMS agencies and paramedics, and the use of 12-lead heart monitors that would show a trained paramedic whether the patient is suffering from a STEMI.

When patients cannot be transported to Petoskey or Traverse City within 90 minutes, the second method of treatment would involve administering “clot-busting” medication called a thrombolytic. This buys time if the patient is unable to receive immediate treatment. Patients still should be transported to have their artery opened even after the 90-minute window.

“Minutes of blockage represent loss of heart muscle,” Fox said.

Meeting participants agreed to return to their hospitals and work out a local plan that will be shared with the other hospitals and agencies at a future meeting.

Participating hospitals included Alpena Regional Medical Center, Charlevoix Area Hospital, Cheboygan Memorial Hospital, Kalkaska Memorial Health Center, Mercy Hospital Cadillac, Mercy Hospital Grayling, Munson Medical Center, Northern Michigan Regional Hospital, Ostego Memorial Hospital in Gaylord, Paul Oliver Memorial Hospital in Frankfort, and West Shore Medical Center in Manistee.

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