A fast and efficient response to chest pain
Some people pass off chest pain as nothing more than indigestion or heartburn. However, chest pain — pressure in the center of the chest that may spread to the shoulders, neck or arms — can be a sign of a heart attack and should be evaluated immediately. By ignoring symptoms, patients can put themselves at risk for heart damage or worse.
A quick diagnosis can save a heart
"Patients who receive treatment within 60 minutes of first feeling chest pain can minimize damage to the heart," says Virtua cardiologist Robert Singer, MD. That's why Virtua has established Chest Pain Centers (CPC) within each hospital. The emergency room staff follows protocols to make a timely diagnosis in the critical early stage when treatments are most effective. So, any patient entering the emergency room with chest pain receives immediate attention.
Making the diagnosis
Diagnosing chest pain begins with a review of a patient's medical history, a physical examination, an electrocardiogram (EKG) and a blood test. The EKG shows abnormalities caused by damage to the heart, while a blood test detects abnormal levels of enzymes in the blood.
The results of these tests help doctors diagnose whether the chest pain is being caused by angina, a heart attack or something else.
After testing is complete, physicians monitor patients — even if their pain does not appear to be related to the heart. This gives the staff more time to observe the patient, perform more diagnostic tests and start treatment as early as necessary. And it gives the patient some peace of mind.
Treating chest pain
Treatment for patients with chest pain may include cardiac catheterization, angioplasty or stents. "Cardiac catheterization (or cardiac cath) may be performed during or after a heart attack to evaluate a patient's heart and arteries to determine if there's damage," says Virtua interventional cardiologist Randy Mintz, MD. "A cardiac cath involves inserting a long, narrow tube, called a catheter, into a blood vessel in the patient's arm or leg, and guiding it to the heart with the aid of a special x-ray machine." The cardiologist then injects a special dye into the arteries that allows the doctor to see how the heart and arteries are functioning.
Angioplasty may be used to open narrowed or blocked arteries. Dr. Mintz continues: "During this procedure, a cardiologist inserts a balloon-tipped catheter into the blocked artery. The small balloon is inflated to open the blockage which increases blood flow in the artery."
For some patients, stents may be used together with angioplasty. A stent is a small, wire-mesh tube that is inserted into the site where the balloon was inflated. Once in place, the stent expands and keeps the artery open.
"If a blockage in the arteries connected to the heart muscle can be cleared quickly enough — within the first few hours of the onset of the attack — permanent damage can be minimized," says Virtua cardiologist Mark Finch, MD.
Virtua's Chest Pain Centers save lives
Dr. Singer describes the CPC and the protocols for diagnosing chest pain as a "needed piece in the puzzle" when dealing with heart problems. "Most importantly, it allows us to provide patients with a quick diagnosis so we can determine the next step in providing care for the patient," says Dr. Mintz.
The CPC broadens Virtua's cardiac capabilities which include cardiac cath labs, cardiac rehabilitation and the use of General Electric MUSE — a fully digital, wireless system that transmits and stores a patient's electrocardiogram (EKG) data for immediate retrieval anytime, anywhere.
For an appointment with a Virtua cardiologist, call 1-888-Virtua-3
Since this article was published, Virtua Marlton was the first hospital in Burlington, Camden and Gloucester Counties to be fully accredited as a Chest Pain Center by the Society of Chest Pain Centers (SCPC). To earn this designation, facilities must provide the highest level of quality care to patients in emergency situations and meet national guidelines on a consistent basis. These guidelines have been established by leaders in cardiovascular and emergency medicine.
Mark Finch, MD, is a fellow of the American College of Cardiology and received his medical degree from Cornell University. He completed a residency in internal medicine at Mount Sinai Medical Center in New York City and a fellowship in cardiovascular diseases at the Long Island Jewish Medical Center. He is board certified in echocardiography, nuclear cardiology and cardiovascular diseases.
Randy Mintz, MD, a fellow of the American College of Cardiology, received his medical degree from the UMDMJ-Robert Wood Johnson School of Medicine. He is a board-certified interventional cardiologist with over a decade of training. Dr. Mintz completed a cardiology fellowship at the Medical College of Pennsylvania.
Robert Singer, MD, is board certified in internal medicine and cardiology and completed a fellowship in cardiology at Hahnemann University Hospital. He received his medical degree from the State University of New York Health Science Center at Brooklyn and completed a residency in internal medicine at the Albert Einstein College of Medicine at Bronx Municipal Hospital Center.