Interventional Cardiology is a specialized branch of cardiology that treats
coronary artery disease with balloon angioplasty and stenting. When an
artery that supplies blood to the heart is blocked, an interventional
cardiologist threads a small, flexible tube called a catheter with a deflated
balloon on the tip to the blockage. At that point, the balloon is inflated,
pushing open the blockage. A stent is then inserted to prop the artery
open, restoring blood flow to the heart.
Lucky to Be Alive
Despite a history of heart disease in his family, 64-year-old Thurmont
native Ted Ridenour had always enjoyed good health. His own risk factors
for heart attack were low, and the former construction supervisor was
enjoying an active lifestyle in retirement.
All that changed last December when Ted experienced a serious cardiac event
called an “ST segment elevation myocardial infarction,” or
STEMI. A STEMI is a particularly serious type of heart attack in which
a coronary artery has become completely blocked and a large part of the
heart muscle is unable to receive blood.
Ted recounts that he and his wife, Kay, were out Christmas shopping when
he began to feel nauseated and short of breath. After getting home, his
symptoms initially subsided but returned hours later with a vengeance.
Kay called 9-1-1, and within moments EMS had arrived to take Ted to FMH.
Ted has little memory of that ambulance ride down Route 15, but what happened
on the way to the hospital very likely saved his life. As soon as EMS
personnel recognized that he was having a heart attack, they called the
FMH Emergency Department from the field. This activated the Code Heart
team as early as possible, putting everything in place to begin the emergency
procedure immediately upon Ted’s arrival at FMH.
However, before the procedure could begin, Ted’s heart stopped completely.
The team shocked his heart repeatedly to restore a rhythm, and because
he was already in the cardiac catheterization procedure room, they were
in a position to implant an emergency pacemaker and cardiac pump to keep
his heart functioning. After he was stabilized sufficiently, the team
opened a complete blockage in Ted’s right artery, restoring blood
flow to his heart. Three days later, he was resting and recovering at
home with very little damage to his heart muscle.
Time is Muscle
During a heart attack like the one Ted Ridenour had, there is a blockage
in one of the arteries that carries oxygen-rich blood to the heart, causing
life-threatening rhythms, muscle damage, and death. The faster that blockage
can be opened up, the better the patient’s chances are for survival
and less permanent damage to the heart muscle.
The amount of time between a patient’s arrival at the hospital and
the completion of the procedure that opens up the blockage and restores
blood flow is called the “door-to-balloon” time. The American
College of Cardiology recommends a door-to-balloon time of less than 90
minutes. FMH is currently beating that metric with a median door-to-balloon
time of 53 minutes, and achieves the 90-minute benchmark 100 percent of the time.
According to Dr. David Brill, co-director of the hospital’s Interventional
Cardiology program, the collaboration among EMS, the hospital’s
Emergency Department and the FMH Interventional Cardiology team has helped
earn FMH some of the highest quality metrics not only in the state, but
in the nation.
“FMH has been ahead of the curve every step of the way with regard
to reducing door-to-balloon times,” said Dr. Brill, “and the
pre-activation of the Code Heart team by EMS from the field has been at
the center of that. There’s no doubt about it: time is muscle, and
the speed and efficiency with which the FMH team is able to open up a
blockage and restore blood flow to the heart is reducing muscle damage
and saving lives.”
Pictured left to right: (front row) Frederick EMS Chief Mike Cole, Interventional
Cardiology Supervisor Anne Morton, Erin Shover, Cody Humburg, Nicole Myers,
Ann Marie Bowins, Catalina Alvear, Mr. Ridenour, Sue Calhoun, and Maggie
Ramkissoon. (back row) Program Director Kristen Fletcher, Shawn Kocher,
Jim Varley, Wendy Cordell, Janet Custer, Laura Trumpower, Ronna Dixon,
Dr. Chao-Wei Hwang, Jeff Garling, and Mike Marchone. Not pictured: Kristin
Deely, Kristen Pickett, Sarah Breeden, Nancy Thrasher, Amanda Little,
Ron Bugbee, and Amy Gordon.