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Winter 2007

UCLA Designated Center for Heart Attacks

Time and technology are keys to surviving a heart attack. The faster patients reach a full-service hospital with a complete range of cardiac care equipment and capabilities, the more likely they will survive and return to health, work and family. heart attacks

The Los Angeles County Department of Health Services has certified the emergency rooms at UCLA’s Westwood and Santa Monica hospitals as receiving centers, or target hospitals, for victims of high-risk ST-elevation myocardial infarctions (STEMI).

A STEMI occurs when blood flow to a region of the heart is blocked by a sudden tear in a plaque in a heart artery, leading to formation of a blood clot that blocks blood flow to the heart muscle fed by that artery. Elevations of the ST segments of an electrocardiogram tell paramedics and doctors that a significant part of the heart muscle is not getting blood flow.

“Time is of the essence. Once the heart muscle is starved of oxygen and other nutrients it begins dying,” says Richard J. Shemin, M.D., chief of cardiothoracic surgery at UCLA. “The sooner you recognize the symptoms and get the vessel open, the sooner you’re able to restore full blood flow to the heart, minimize damage and reduce the risk of death.”

When county paramedics identify STEMI victims through a field electrocardiogram, they are trained to bring those patients directly to the nearest STEMI receiving center. STEMI receiving centers have at-theready cardiac catheterization teams and full percutaneous cardiac intervention (PCI) capability necessary to quickly clear the blockage. “In treating STEMI, we use a balloon to open the artery, and then we place a stent in the artery to keep it from collapsing again," explains Larry Yeatman, M.D., director of Adult Cardiac Catheterization Laboratories at UCLA hospitals in Westwood and Santa Monica.

The goal is to open the artery within 90 minutes of the onset of symptoms. Dr. Shemin notes, “Our emergency teams are trained to move these patients rapidly through the system so that our average door-to-balloon time is better than the standard for STEMI certification.”

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