Listen to your heart

Posted on January 15, 2013 by durhamregionalhospital

Protect yourself and those you love by becoming familiar with techniques to detect and react to a heart attack.

“The most common signs you may be experiencing a heart attack are pain, discomfort and pressure in your chest,” says Michael Komada, MD, FACC, interventional cardiologist at Durham Regional Hospital. “You may also experience shortness of breath, nausea, a sense of clamminess or jaw discomfort.”

In addition to the classic symptoms, there are other, less common signs that may indicate you are experiencing a cardiac issue, such as feelings of indigestion, fatigue or muscle strain.

“Anybody who develops new symptoms of indigestion or muscle strain in the chest region should have it checked out to make sure it’s not an indication of heart disease,” Dr. Komada says.

What to Do When You Expect the Worst

“If you believe you are experiencing a heart attack, the smartest move is to call 911,” says Dr. Komada. “Taking an aspirin is usually a good idea, but the sooner you connect with emergency medical technicians [EMT] by calling 911 the faster the award-winning cardiac care team at Durham Regional can begin coordinating your treatment and recovery.”

Recent advancements in emergency response technology allow some rescue squads to conduct electrocardiograms on the spot, and early coordination allows admitted patients with blockages to be treated more efficiently. At Durham Regional, cardiac care is highly orchestrated from the moment the EMTs reach you until the day you go home.

To learn more about cardiac care services offered at Durham Regional, visit durhamregional.org/heart.

________________________________________

Don’t be a bystander when minutes count!

Saturday, February 9 at 10 am
First Level Classroom at Durham Regional Hospital
Join us for bystander CPR training as well as a panel discussion on heart attack and stroke, warning signs, symptoms and prevention tips. The panel will include Eric Moore, MD, cardiologist with Triangle Heart Associates; Michael Komada, MD, interventional cardiologist with Triangle Heart Associates and Nada El Husseini, MD, Duke neurologist.

To register, visit durhamregional.org/events or call 919-403-4DRH.

Durham Regional recognized for heart attack care

Posted on November 29, 2012 by durhamregionalhospital

Durham Regional Hospital has received the American College of Cardiology Foundation’s NCDR ACTION Registry–Get With The Guidelines Platinum Performance Achievement Award for 2012–one of only 164 hospitals nationwide to do so. The award recognizes Durham Regional’s commitment and success in implementing a higher standard of care for heart attack patients, and signifies the hospital has reached an aggressive goal of treating these patients to standard levels of care as outlined by the American College of Cardiology/American Heart Association clinical guidelines and recommendations.

To receive the Platinum Performance Achievement Award, Durham Regional consistently followed the treatment guidelines in the ACTION Registry–GWTG Premier for eight consecutive quarters and met a performance standard of 90 percent for specific performance measures. Following these treatment guidelines increases adherence to ACC/AHA clinical guideline recommendations, monitors drug safety and improves the overall quality of care provided to ST-elevation myocardial infarction (STEMI) and non-ST-elevation myocardial infarction (NSTEMI) patients.

“Durham Regional is proud to offer excellent care for heart emergencies,” says Michael Komada, MD, board certified interventional cardiologist. “Our multidisciplinary team comes together after caring for every patient to evaluate our performance and see if there are any areas for improvement. The fact that we are nationally recognized every year, but continue to work on ways we can improve, shows how committed we are to delivering the absolute best possible outcomes for our patients.”

ACTION Registry–GWTG is a partnership between the American College of Cardiology Foundation and the American Heart Association with support from the American College of Emergency Physicians, Society of Chest Pain Centers and the Society of Hospital Medicine. ACTION Registry–GWTG empowers healthcare teams to consistently treat heart attack patients according to the most current, science-based guidelines and establishes a national standard for understanding and improving the quality, safety and outcomes of care provided for patients with coronary artery disease, specifically high-risk STEMI and NSTEMI patients.

In 2011, Durham Regional received the ACTION Registry–GWTG Gold Performance Achievement Award. Gold represented eight consecutive quarters of following treatment guidelines and reaching a performance standard of 85 percent for specific performance measures. This year, by receiving Platinum, Durham Regional achieved the same goals, but met a performance standard of 90 percent.

What does smoking do to the body?

Posted on October 9, 2012 by durhamregionalhospital

Joanne Carey
Cardiovascular Registries Coordinator

For decades, we’ve heard concerns about the effects of cigarette smoking on the heart and lungs. We’ve read frightening statistics that smoking claims more than 440,000 people annually. But how do cigarettes actually damage the body, and is that damage limited to the heart and lungs?

Every cell and all tissues of the body need oxygen as a fuel source. We get this from the air we breathe into our lungs, which is pumped by our heart throughoutthe body. Inhaling smoke from cigarettes increases blood carbon monoxide which decreases the amount of available oxygen to circulate to tissues. As a result, tissues are less able to function over time and, for another example, bones can fracture due to the decreased oxygen supply.

Nicotine in cigarettes increases blood pressure and triggers the release of hormones (catecholamines) that raise the heart rate about 20 beats per minute. You may have noticed when you climb stairs or run, your heart rate and blood pressure increase to meet these extra temporary demands on the body; then they slow to your normal rate after the exertion is over. But the increased heart rate and blood pressure due to nicotine end up overworking the heart and blood vessels.

Nicotine in the blood vessels is like a clamp that makes it harder for blood to circulate. This vasoconstriction contributes to the blood vessel walls not being as elastic so the heart has to work harder to push blood around, raising blood pressure over time. As the chemicals in cigarettes circulate in the body, they roughen blood vessel walls. Instead of a smooth interior surface, this roughened area makes it easier for sticky red blood cells to latch on. This area where blood flow is decreased is an ideal place for clots to form, which could cause a heart attack or stroke.

In addition

Smoking prematurely ages the skin by wearing away proteins and depleting vitamin A. This can cause tiny lines around the lips and eyes and contributes to skin becoming dry and leathery.
Nicotine is an appetite suppressant and, for some, smoking between meals replaces a snack. The nicotine raises blood sugar and blood fat levels, which tricks the body into thinking it has eaten more than it actually has. This affects your body’s ability to get the nutrients it needs.
Smoking reduces resistance to the bacteria that cause stomach ulcers. It also impacts the stomach’s ability to neutralize acid after a meal. This damages the lining of the stomach and can lead to hard-to-treat ulcers.
Smokers have a 40 percent higher rate of cataracts due to smoke irritating the eyes and from the chemicals in cigarettes entering the lungs and circulating to the eyes through the blood stream.
Smoking damages the lining of the lungs over time. Coughing is a natural response to clear irritants from the lungs. The long-term build-up of these irritants contributes to a “smoker’s cough,” makes a cold harder to get over and can lead to chronic lung diseases such as emphysema.
More than 40 chemicals in tobacco have been shown to cause cancer, especially in the lungs, mouth and throat.

The overall health of the individual, genetic tendencies inherited from both parents, quantity of cigarettes smoked or exposed to and other factors regarding nutrition in one’s diet and amount of exercise affect how the body responds over time to the extra burden cigarettes place on the body.

The good news is the body usually responds favorably when a person stops smoking. Within a few days, many positive effects—such as eliminating the nicotine chemicals from the blood supply through the kidneys, feeling less anxious, improved blood oxygen levels as well as heart rate and blood pressure normalization—can be felt. It may take months or years to feel the maximum effects on one’s heart and lungs (and this can vary by the individual), but over time ex-smokers usually feel more energetic, sleep better and enjoy the taste of food again.

Stopping smoking is one of the hardest habits to break but also has some of the most significant rewards. Talk with your caregiver at Durham Regional about smoking cessation help.

Visit durhamregional.org to find a physician who’s right for you.

A look at Durham Regional’s Cath Lab and cardiac care

Posted on September 13, 2012 by durhamregionalhospital

Joanne Carey
Cardiovascular Registries Coordinator

When EMS brings a patient to our Emergency Department with concerns for a heart attack, or acute myocardial infarction, the doctors and nurses spring into action. An electrocardiogram (ECG) is taken of the heart to see the heart rhythm. This test is key to determining how severe the heart attack is and its location in the heart. The care team also draws several tubes of blood and notes blood pressure and pulse.

Based on the ECG, the patient may transfer to our Cardiac Catheterization (Cath) Lab, where a cardiologist and staff insert a catheter into the blocked heart artery through the large artery in the groin area. This allows a small sterile balloon to be inserted into the area of blockage and then inflated to improve the flow of oxygen rich blood. The doctor may also place a sterile stent, a small mesh of wire similar to scaffolding, that will keep the newly inflated artery propped open. The goal is to increase blood flow into the affected area of the heart in less than 90 minutes, at which point the heart muscle can begin to die from lack of oxygen. The damaged area then begins to heal into scar tissue.

While at Durham Regional, patients discuss with their doctor factors that contributed to heart disease, such as blood pressure, cholesterol, exercise levels, smoking and weight. Doctors may recommend lifestyle changes to improve the patient’s health; new medicines to help the heart pump more effectively, lower cholesterol and decrease blood pressure or a combination of lifestyle changes and medications.

Patients are discharged to home usually in two to three days. After a few weeks, they can enter a cardiac rehabilitation program to learn about nutrition, methods to stop smoking and exercise to improve heart health. These programs are supervised by trained cardiac rehab nurses and therapists.

Durham Regional’s Cardiac Cath Lab is available 24/7 for heart emergencies, and we have an accredited cardiac rehab program to guide your recovery. Our cardiology team has consistently been recognized by the American Heart Association and American College of Cardiology Foundation for sustained excellence in meeting guidelines for acute myocardial infarction timeliness and therapies.

To learn more about our heart services, visit durhamregional.org/heart.

Durham Regional receives award for heart attack care

Posted on August 20, 2012 by durhamregionalhospital

Michael Komada, MD
Cardiologist

At Durham Regional, we are dedicated to providing timely, expert care to heart attack patients. This takes a team and great collaboration across many departments within the hospital, as well as with local EMS and other facilities.

Durham Regional recently received the American Heart Association’s Mission: Lifeline Silver Receiving Quality Achievement Award. This award recognizes the hospital’s commitment and success in implementing an exceptional standard of care for heart attack patients.

We are excited to be recognized for this achievement, and I am proud of our dedication to continuous improvement in cardiac care.

Each year in the United States, nearly 300,000 people have a STEMI, or ST-segment elevation myocardial infarction, the most severe form of heart attack. A STEMI occurs when a blood clot completely blocks an artery to the heart. To prevent death, it’s critical to immediately restore blood flow, either by surgically opening the blocked vessel or by giving clot-busting medication.

Hospitals involved in Mission: Lifeline are part of a system that makes sure STEMI patients get the right care they need as quickly as possible. Mission: Lifeline focuses on improving the system of care for these patients and at the same time improving care for all heart attack patients.

As a “STEMI Receiving Hospital,” Durham Regional meets high standards of performance in quick and appropriate treatment of STEMI patients to open the blocked artery. Before discharge, patients start aggressive risk-reduction therapies such as cholesterol-lowering drugs, aspirin, ACE inhibitors and beta-blockers, and they receive smoking cessation counseling if needed. Hospitals must adhere to these guidelines-based measures at a set level for a designated period of time to be eligible for the achievement awards.

In 2011, Durham Regional received the Bronze Quality Achievement Award. Bronze represented one quarter of meeting or exceeding quality measures. By receiving Silver, Durham Regional achieved four quarters (or one year) of consecutively meeting all the goals outlined by the American Heart Association with the focus on first medical contact to angioplasty in less than 90 minutes.

For information about our heart services, visit durhamregional.org/heart.

Get well and improve your health after a heart attack

Posted on July 25, 2012 by durhamregionalhospital

Joanne Carey, MHA, RN, RHIA
Cardiovascular Registries Coordinator

Heart attack treatments have changed dramatically from the times when doctors prescribed long bed rest and keeping noise levels to almost whisper levels. Research shows the heart muscle is resilient and, with guided therapy, can remodel itself to be stronger and continue working effectively.

After a few weeks of rest following a heart attack, patients enter a cardiac rehabilitation program to learn about nutrition, ways to stop smoking and exercises to improve heart health. These programs can help reduce the risk of future heart attacks and improve health through a new understanding of food and nutrition, exercise and weight reduction. Patients also gain confidence in their abilities.

But cardiac rehab is not limited to those who have had a heart attack. This kind of therapy is also excellent for patients with other types of coronary disease and certain types of heart surgery, including coronary artery bypass grafting or valve replacement surgery. Patients who have received a stent for a coronary artery blockage are also eligible.

At Durham Regional, our accredited cardiac rehabilitation program helps guide our heart attack patients’ recovery. Under the supervision of experienced cardiologists, trained cardiac rehab nurses and therapists work closely with the primary care physician to review the patient’s needs and goals. Then our team tailors a program to meet those needs through walking, stationary bike riding and arm exercises to increase endurance and strength.

To learn more about the cardiac rehabilitation programs at Durham Regional Hospital, visit durhamregional.org/wellness or call the Wellness Institute at 919-470-8151. We look forward to helping you improve your health!

What is a heart attack?

Posted on June 27, 2012 by durhamregionalhospital

Joanne Carey, MHA, RN, RHIA
Cardiovascular Registries Coordinator

This week long-time game show host, Alex Trebek, found his heart health in jeopardy. Trebek is recovering in a Los Angeles hospital after a heart attack, but what is a heart attack?

A heart attack, also known as a myocardial infarction or MI, occurs when oxygen-rich blood that normally circulates with each heartbeat is blocked from reaching all parts of the heart muscle. The “attack” is acute pain caused by a blood clot or fatty deposits building over time and blocking blood flow. The pain is sometimes described as an elephant on the chest, though it may be more subtle, such as shoulder or neck pain that radiates down the arms.

If you’re experiencing any of the following symptoms, you may be having a heart attack.

Chest discomfort, such as a pressure sensation, squeezing, fullness or pain
Shortness of breath
A cold sweat
Nausea

What can you do if you think you or someone you love is having a heart attack? Call 911 immediately so your local emergency medical services team (EMS) can transport you to a hospital like Durham Regional with a 24/7 Cardiac Catheterization Laboratory.

Note: Not all chest pain is a heart attack, but it is important to be mindful of changes to your health and seek assistance.