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Home > Heart Care > Care for Heart Attack

Care for Heart Attack

Making News—Why was Richard Silverman’s name in USA TODAY? After his wife Janet called 911, he received care at Lehigh Valley Hospital, the nation's second best hospital for heart attack care. His blocked artery was opened in 24 minutes.

If you’re having a heart attack (myocardial infarction), U.S. Centers for Medicare and Medicaid Services "Hospital Compare" data shows that Lehigh Valley Hospital consistently ranks in the top 1 percent in the nation for heart attack survival. Our heart attack survival rate is high because you receive care fast. The faster you get care, the less damage is done to your heart. That’s why it’s so important to know the symptoms of a heart attack and call 9-1-1 if someone is experiencing them. The symptoms include:

  • Chest discomfort or pain that lasts more than a few minutes
  • Discomfort or pain in one or both arms, the back, neck, jaw or stomach
  • Shortness of breath with or without chest discomfort
  • Cold sweats
  • Nausea
  • Lightheadedness
 
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Our fast heart attack care program (MI Alert for Heart Attacks) saves lives and limits the amount of damage done to your heart. We educated area paramedics and EMTs to diagnose heart attacks in the field. If you’re having a heart attack, they will start treatment immediately and call ahead to our ER to ensure we’re ready when you arrive. When you arrive, a procedure performed in our cardiac catheterization lab (angioplasty) can open your blocked arteries within 90 minutes, the "gold standard" for heart attack care.

If our heart team determines you need bypass surgery, you’ll be in the right place. We are the fifth largest heart program in Pennsylvania. Lehigh Valley Hospital is also cited as a "high performer" in cardiology and heart surgery by U.S. News & World Report.

If you live outside the Lehigh Valley, we still can help. We’ve partnered with hospitals in Hazleton, Lehighton, Palmerton, Pottsville, Sellersville and Ashland. Our experienced MedEvac helicopter flight crew, along with local ambulance crews, ensure people experiencing heart attack symptoms in these communities get to our hospital as soon as possible.

When you call 9-1-1, be clear and direct. Say, “I think I’m having a heart attack.” Then, chew and swallow an aspirin. Remember, if you’re experiencing symptoms, don’t wait! Call 9-1-1 to get to Lehigh Valley Health Network’s ER for fast heart attack care.

If a serious heart attack stops the heart from sending oxygen to the brain, we can provide lifesaving care. We are one of six major U.S. heart centers collaborating to produce data about the use of therapeutic hypothermia. This leading-edge technology lowers the body’s core temperature to 91 degrees, slowing metabolism and preventing dangerous swelling, giving you a better chance to heal.

To learn how we created one of the nation's best hospitals for heart attack care, click here.

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Follow-up Care

After you receive treatment, we’ll remain by your side. We offer these services to ensure your optimal health: 

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This page last updated 11/22/11 10:40 AM

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Lehigh Valley Health Network has three Magnet-designated hospitals, including Lehigh Valley Hospital-Cedar Crest and Lehigh Valley Hospital-17th Street, both in Allentown, Pa., and Lehigh Valley Hospital-Muhlenberg in Bethlehem, Pa.. The health network is also comprised of labs, health centers, physician practices, home care, hospice and pharmacies, and serves the Pennsylvania communities of Easton, Doylestown, Quakertown, Hazleton, Lehighton, Perkasie, Pottstown, Pottsville, Reading, Scranton, Wilkes Barre, Stroudsburg, and the Poconos and also Phillipsburg and Flemington, N.J., and western New Jersey. Lehigh Valley Health Network has also been recognized by US News & World Report as one of America's Best Hospitals and by the American Nurses Credentialing Center as a Magnet hospital for excellence in nursing care. You don't have to travel to Philadelphia or New York for quality health care.

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HON

He Received a Life-Saving Stent

He’s up and running again - Carbon County residents like Ron Butz of Lehighton, Pa., go to Lehighton’s Gnaden Huetten Memorial Hospital, have access to “gold standard” heart attack care-an angioplasty and stent within 90 minutes of coming to the emergency room-through a partnership with Lehigh Valley Health Network.

When Ronald Butz of Lehighton, Pa., came to his local emergency room with a heart attack, the doctors there knew what to do. “You need to open the blocked artery as quickly as possible to prevent death or permanent damage to the heart,” says Frank Penater, M.D., emergency physician at Gnaden Huetten Memorial Hospital. Penater and his team transferred Butz to Lehigh Valley Health Network, their heart care partner, where cardiologist Raymond Durkin, M.D., opened the artery with a balloon angioplasty and stent.

Butz enjoyed a full recovery. Today he’s among the millions of people with one or more arteries held open by stents—small, expandable wire mesh tubes. Used more often now than coronary bypass surgery, stents offer a faster and less painful recovery, says cardiologist John Mannisi, M.D., of the health network.

How stents work

First, cardiologists do a cardiac catheterization, a test in which a catheter (tiny hollow tube) is guided through a vein or artery into the heart. Dye is injected to reveal a moving image of blood flow to and from the heart.

“It gives us a blueprint of the arteries, including the severity of the blockage and the exact diameter of the artery we need to open,” Mannisi says. “This is important because stents come in different sizes and are fitted just as shoes are fitted. There is a size for everyone except those with naturally very small arteries.”

Cardiologists then guide a tiny balloon and stent through the catheter and into the artery. They inflate the balloon to open the artery, place the stent as a scaffold to hold the artery open, then remove the balloon. In the past, the patient might need a repeat procedure because scar tissue forming over the stent re-narrowed the artery. The drug-coated stents now in use prevent this in most cases, Mannisi says.

Today, stents also are used to prevent strokes in high-risk patients. They’re placed in the carotid arteries, the blood vessels on either side of the neck that carry blood to the face and brain.

Life Saved in 24 Minutes

MI Alert for Heart Attack Minutes matter —Janet Silverman’s 9-1-1 call ensured her husband, Richard, of South Whitehall Township, Pa., received fast heart attack care from paramedics and our heart care team. In only 24 minutes, his blocked artery was repaired.

When Richard Silverman of South Whitehall Township, Pa., starting having chest discomfort, he thought it was acid reflux. “I took an antacid tablet and expected it to work right away,” the 62-year-old man says. But things got worse quickly. Soon he was in pain and drenched with sweat.

Silverman’s wife, Janet, realized something was seriously wrong. Despite her husband’s protest, she called 9-1-1. An ambulance arrived within minutes. Having received education from Lehigh Valley Health Network on how to use a 12-lead EKG, paramedics determined that Silverman was having a heart attack and started treatment.

In the ambulance, a paramedic called ahead to Lehigh Valley Hospital-Cedar Crest and spoke to emergency physician Marna Greenberg, D.O. After hearing the paramedic’s report, she activated the Alert which triggered emergency and heart specialists to prepare for Silverman’s arrival, saving precious minutes.

The heart attack was confirmed in the emergency room, and Silverman was rushed to the cardiac catheterization lab. Caregivers there were ready. Nainesh Patel, M.D., found that his heart’s “widow maker” artery was completely blocked. He opened it with a tiny balloon and inserted two metal stents to hold the artery open. This life-saving treatment took only 24 minutes from the time Silverman came through the emergency room doors. The national “gold standard” for this procedure is 90 minutes.

Silverman is grateful to his wife for calling 9-1-1, and the paramedics and health network staff for their quick and competent treatment which undoubtedly saved his life. “They were all wonderful and very professional,” he says.

He wants people to know that the best thing they can do when having chest discomfort or pain is to call 9-1-1. “Even if it’s not the classic chest-crushing symptom, you’re better off getting it checked out,” he says. Thanks to the health network's MI Alert for Heart Attacks, he’s alive and able to offer this advice.

The Race of His Life

Patric Hettman of East Stroudsburg Lifesaving flight —During the MedEvac flight from Pocono Raceway to Lehigh Valley Health Network, Patric Hettman’s heart stopped four times. But before the Pocono 500 was over, an angioplasty and stent saved the East Stroudsburg man's life.

On the morning of the Pocono 500, the smell of gasoline, exhaust and burnt rubber filled the air on Pocono Raceway’s infield. However, it wasn’t strong enough to mask the aroma of freshly brewed coffee inside Patric Hettman’s camper. The East Stroudsburg man was just about to join his wife for a cup we he began experiencing heartburn. “I waited for it to pass, but it didn’t,” the 52-year-old says. “I began sweating and lied down, but couldn’t get comfortable.”

Hettman’s wife, a registered nurse, recognized the symptoms. “She noticed I had trouble using my hands and had me chew an aspirin,” Hettman says. When his hands and arms went numb, friends in a neighboring RV notified security personnel. They took Hettman to the infield hospital, operated by caregivers from Lehigh Valley Health Network’s emergency room (ER).

An EKG showed he was having a heart attack. John McCarthy, D.O., initiated an MI Alert for Heart Attacks, our award-winning program that opens blocked heart vessels within 90 minutes, saving heart muscle. “They said MedEvac was taking off in two minutes to bring me to Lehigh Valley Hospital-Cedar Crest,” Hettman recalls. Because the health network has been providing medical service at the Raceway since 2004, MedEvac was nearby.

During the 15-minute flight, Hettman’s heart stopped four times, meaning his artery was severely blocked. Every time, flight nurse Judy Gagnon, R.N., shocked him back to life and assured him he would be OK. A former emergency medical technician, Hettman says, “I remember looking at the monitor and seeing my heart rate over 215. I knew it wasn’t good.”

After his heart stopped and was shocked yet again in the ER, Hettman was taken to the cardiac catheterization lab, where cardiologist Bryan Kluck, D.O., found the blocked artery. He opened it with a device that breaks up and sucks out plaque. Two stents were put in to help the artery stay open.

“I remember waking up in my room and watching the end of the race on TV,” Hettman says. Denny Hamlin took the checkered flag to win the Pocono 500, but Hettman says, “We were both winners that day.”

Three days later, Hettman was well enough to go home. “If it wasn’t for the speed and professional competence of everyone involved—and if I were at home instead of at the raceway—I probably wouldn’t be here today,” he says. “Thank God for Lehigh Valley Health Network.”

He Had Chest Pain



Life-saving care – As part of our fast action heart attack program (MI Alert for Heart Attacks), we educated local EMTs like (l-r) Anthony Ripa and Jeff Phy to diagnose a heart attack in the field. It’s why Daniel Sachs of Drums, Pa., (center) had his blocked artery opened in only 78 minutes.

Sweaty, woozy and experiencing chest pain, Daniel Sachs knew something was wrong. The 78-year-old man dialed 9-1-1. In minutes, paramedic Jeff Phy and emergency medical technician (EMT) Anthony Ripa arrived at his home near Hazleton, Pa., and made arrangements for Sach to be taken to Lehigh Valley Health Network, an accredited Chest Pain Center.

A new piece of equipment in their ambulance and education they received from the health network’s Emergency Medicine Institute (EMI) ensured they were prepared to provide the best care. “We’re teaching EMTs to diagnose a heart attack in the field so patients get the care they need quickly,” says EMI program coordinator Alan Heckman.

The education is part of the health network's MI Alert for Heart Attacks program. Its goal is to open a patient’s blocked heart vessels within 90 minutes of arrival at the emergency room (ER).

Phy and Ripa used a 12-lead EKG (electrocardiogram) to determine if Sachs was having a heart attack. Formerly, patients wouldn’t receive this test until they arrived at the hospital. “EMI taught us to operate the 12-lead EKG, interpret the data and communicate our findings to a physician,” Phy says.

Suspecting a heart attack, they radioed Hazleton General Hospital (HGH), the health network’s heart attack care partner. The ED physician there agreed with the diagnosis and activated an Alert.

With the Alert initiated, several things happened simultaneously. Phy and Ripa began treatment and rushed Sachs to HGH; a MedEvac helicopter was dispatched to transport him to Lehigh Valley Hospital-Cedar Crest (one of the health network’s three accredited Chest Pain Centers); and our cardiac catheterization lab was prepped for his arrival. “When everything happens at once, valuable minutes are saved,” says MI Alert coordinator Orlando Rivera, R.N.

Only 78 minutes after the Alert was initiated in a community an hour’s drive away, Sachs’ blocked artery was repaired. He offers good advice to people having chest pain. “Call 9-1-1 to get to the Lehigh Valley Health Network in a hurry,” he says.

Blood Pressure Medication

About Our Expert

Matthew Schumaecker, M.D., is a cardiologist with Lehigh Valley Health Network.

Q: I have high blood pressure. Do I start with one medication or a combination?

A: Most people start on one medication, often a diuretic. But many individuals may need to be treated more aggressively with a combination of drugs. Which combinations work best for high-risk patients is the subject of ongoing investigation.

Q: What medications are available, and what do they do?

A: There are dozens of combination medications, but most drugs for hypertension fall into four general categories:

Q: Why start with a diuretic?

A: Any of these drugs might be effective as an initial therapy. But the Joint National Committee for the Prevention, Detection, Evaluation and Treatment of High Blood Pressure (JNC) recommends starting with diuretics. They have relatively few side effects, they're less expensive for the patient, and about half of people with hypertension who take them are able to bring blood pressure down to a target range of at least 130/90 (or, ideally, 120/80) without needing another medication.

Q: When might other drugs be added to my treatment?

A: If a diuretic alone doesn't bring your blood pressure down enough, it's generally better to add a different medication than increase the dose of the diuretic. Hypertension has a lot of possible causes, and those related to blood volume-which diuretics address-may not be the only ones at work. Adding a different medication attacks the problem in a new way. Many combination treatments are already formulated together so you can take them in one pill instead of two.

Q: What combinations are usually used?

A: People already on a diuretic can be given an ACE inhibitor or a beta blocker as a second drug. It depends on other conditions you may have. ACE inhibitors, for example, help to protect your kidneys if you have diabetes. Different combinations allow treatment to be tailored to your individual condition, so it's important to follow your doctor's advice.

Q: How do these drugs affect my risk for having a heart attack or stroke?

A: It's been clearly shown that people who control blood pressure with medication are less likely to suffer heart attacks, strokes and death than people with uncontrolled blood pressure. For a lot of people, reducing risks comes from lowering blood pressure alone. But many of these drugs have biochemical actions that also help the heart directly by relaxing it or helping on some other front.

Q: What are the risks of these medications?

A: One risk they all share is bringing blood pressure too low, so tell your doctor if you feel side effects like dizziness. Controlling your blood pressure is like getting the right temperature in a bathtub-you might need some trial and error to find what's right for you. Other side effects depend on the medication. For example, diuretics may reduce levels of potassium in the blood, ACE inhibitors may cause kidney problems in certain patients, beta blockers can make the heart beat too slowly and calcium channel blockers may cause swelling in the legs.

Q: What else can I do to lower my risks from high blood pressure?

A: First, if you smoke, quit. Second, don't drink more than two alcoholic drinks a day if you're male; one if you're female. Third, exercise regularly and eat a varied, heart-healthy diet and small amounts of fat, especially saturated animal fat. Moderate, healthy lifestyle measures like these can be powerful, without the side effects of medication.