24 minutes! They ran out of heart saving acceleration

Mondo Science Updated on 2024-02-01

Changsha Evening News, Changsha, January 10 (Reporter Yang Yunlong, correspondent Tang Siyuan) Acute myocardial infarction is a cardiovascular emergency, and once a patient has an acute myocardial infarction, it may be life-threatening. For patients with acute myocardial infarction, time is myocardium, time is life, and opening the blocked blood vessels in the shortest possible time is the most effective means of rescue. The reporter learned from the Fourth Hospital of Changsha today that the chest pain center of the hospital built a heart-saving "highway", which opened up a "road of life" in only 24 minutes and successfully rescued a patient with acute myocardial infarction.

The man had a sudden acute myocardial infarction, and the heart-saving "highway" was unblocked in 24 minutes

Chest pain is a common but easy to ignore symptoms, there are many causes and diseases that cause chest pain, some chest pain is only a temporary symptom, and some chest pain is a symptom of a fatal disease, Mr. Zhang, a citizen of Changsha, has encountered chest pain that is fatal.

The incident went back to January 5, at about 8 o'clock in the morning, Mr. Zhang suddenly felt chest pain, and after lying down to rest, the symptoms did not improve, and the pain became more and more painful, and he also experienced profuse sweating, nausea and vomiting, and fatigue, so he immediately went to the nearby Changhao Hospital for treatment.

At 9:25 on the same day, Mr. Zhang's first electrocardiogram came out, and the results showed that the ST segment of the anterior lead was elevated. The attending doctor preliminarily diagnosed him with acute myocardial infarction, and immediately gave the patient an oral "one pack of myocardial infarction medicine" after communicating with the patient's family. At 9:28, the attending doctor sent Mr. Zhang's electrocardiogram to the Chest Pain Center of Changsha Fourth Hospital, and briefly described the patient's condition and situation, and prepared to transfer the patient to Changsha Fourth Hospital for **. Through remote consultation and communication, the Chest Pain Center of Changsha Fourth Hospital immediately activated the catheterization laboratory, and a chest pain first aid in a race against time began.

At 10:15 on the same day, the 120 ambulance sent Mr. Zhang to the Fourth Hospital of Changsha City; At 10:19, the patient was taken to the interventional catheterization laboratory. At this time, the interventional team led by Wang Yonghong, deputy director of the first ward of the Department of Cardiovascular Medicine, was already ready and immediately started the operation. At 10:28, the interventional team began to puncture, and the imaging results showed that the patient's anterior descending artery opening and proximal segment were 99% occluded, and the patient was in critical condition. At 10:39, the guidewire passed through the patient's lesion, and the interventional team performed coronary stent implantation after thrombus aspiration.

After 20 minutes of surgery, Mr. Zhang's blocked blood vessel was opened, his chest pain was relieved, his vital signs were stable and he was safely admitted to the ward. The time from the time the patient enters the gate of Changsha Fourth Hospital to the time when the guidewire passes through the lesion is only 24 minutes.

Build a high-risk chest pain first aid network to save lives "all the way to the green light".

Wang Yonghong, deputy director of the first ward of the Department of Cardiovascular Medicine of Changsha Fourth Hospital, said that it took only 24 minutes to open up a "road of life" for patients with acute myocardial infarction, and thanks to the high-risk chest pain emergency network built by the hospital, the D-to-W time was accelerated again. The so-called D-to-W time refers to the time from the time when a patient with acute myocardial infarction enters the gate of a hospital with interventional surgery ability to the time when the guidewire passes through the lesion (the standard requirement of the chest pain center is 90 minutes), which is an important factor in determining the prognosis of patients with acute myocardial infarction.

In general, after 18 minutes of coronary occlusion, subintendent cardiomyocytes begin to die; After 3 hours of occlusion, the necrotic zone expands to two-thirds of the entire layer; Occlusion for 4 to 6 hours can cause transmural myocardial infarction. Therefore, time is of the essence for patients with emergency myocardial infarction.

The traditional mode of myocardial infarction treatment requires a series of complex processes such as pre-hospital first aid, transport, emergency room examination, and then admission to the cardiology ward, where the ward doctor makes a diagnosis, then talks to the family, and enters the catheterization laboratory. Wang Yonghong said that the Department of Cardiovascular Medicine of the Fourth Hospital of Changsha City cooperated with the chest pain emergency department and the interventional department, integrated superior resources to establish a chest pain center, and used the emergency communication platform to open a comprehensive and full-process high-risk chest pain emergency network from pre-hospital emergency to in-hospital diagnosis and treatment, so that the treatment of acute myocardial infarction has formed a complete, fast and efficient chain one-stop service model, which greatly shortens the D-to-W time and enables many high-risk chest pain patients to get a fast and effective **.

In order to better treat patients with high-risk chest pain, the Department of Cardiovascular Medicine of the hospital will actively optimize all links, strengthen regional cooperation with chest pain treatment units and surrounding primary medical institutions, and strive to build a more standard, better and more efficient emergency network system, so as to open up the "first mile" of acute chest pain treatment.

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