Destination Critical


In case of a serious heart attack, getting to the right hospital is key for survival. Heart attack is the leading cause of death for adults in the United States and in Santa Barbara County.


Someone who suffers a heart attack often can survive-if they get the help they need in time. But it's not enough just to get to any hospital right away. In the most serious case of heart attack, it's crucial to go where specialized treatment is available immediately.



Members of the cardiac care team: Afsaneh Kalantarirad, CRT; Gary Tarter, RN; Sheila Fink, RN; Krista Johnson, CRT; Mark Gonzales, CRT; Thomas Watson, MD, Joseph Aragon, MD; Debra Powell, CRT.


A heart attack strikes when the flow of blood to the heart is cut off, usually from clogged arteries. Lack of blood flow starts to damage the heart muscle right away.


"During a heart attack, time is muscle," said Dr. Tom Watson, medical director of the cardiac catheterization laboratory at Santa Barbara Cottage Hospital. "The longer the artery is blocked, the greater the amount of heart muscle damage. That increases the chances of disability and even death."


The most serious form of heart attack is an "S-T Elevation Myocardial Infarction," or STEMI. In this situation a heart artery is completely blocked with no flow to a portion of the heart muscle.


Santa Barbara County recently created a new Comprehensive Cardiac Care System to assure that ambulances will transport people with a STEMI to one of two hospitals in the county. The key to this system is connecting people to treatment within 90 minutes of the emergency call to 9-1-1.


Santa Barbara Cottage Hospital is one of the two designated STEMI Receiving Centers. This means it is able to perform a procedure known as cardiac catheterization (also called percutaneous coronary intervention) to open blocked arteries and restore blood flow to the heart.


Symptoms of STEMI:

• Chest pain or pressure

• Pain (of sudden or gradual onset)
  that builds to a severe discomfort

• Difficulty breathing

• Pain that spreads to shoulders, arm,
  neck or jaw

• Nausea and/or sweating


Learn more about:

Heart Attack symptoms, risk,

   and treatment >>

STEMI systems of care >>



Cottage has fulfilled specific standards, including having the required equipment and staff to provide rapid intervention and care, and has created procedures and quality improvement processes to earn the designation.


Marian Medical Center also has been given this designation to serve the northern Santa Barbara County area.


The goal of the new Comprehensive Cardiac Care System is to open closed coronary heart arteries within 90 minutes of the first medical contact.


Before this system was created, paramedics would transport heart attack patients to the nearest hospital. This would lead to delay if the patient had to be transferred to a facility that provided STEMI treatment. The time lost would lead to more heart damage.


Now, paramedics can perform an EKG when they arrive at the patient's side, and if it is a serious heart attack, the patient is taken directly to a STEMI Receiving Center.


"We are definitely seeing decreased times from first medical contact to artery opening as a direct result of this new county heart attack program," Dr. Watson said.


Dr. Joseph Aragon, medical director of Cottage's structural heart disease program, adds that even heart attack sufferers from the Santa Ynez Valley have been able to begin treatment at SBCH in under 60 minutes when triaged by ambulance.


"EKGs are read in the field, so when patients arrive at Santa Barbara Cottage Hospital the cath lab team is here and ready to get the artery open to relieve symptoms," Dr. Aragon explained.


"This new system makes it possible to transport patients really fast to where they need to be," he added. "They come in here early enough and we can get the clot out before it causes more damage."




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 Mar 2011