EVERGREEN PARK, Ill., Nov. 17, 2011 — Mention the phrase "door-to-balloon time," and you're likely to get a few blank stares. But not from 67-year-old Judith O'Sullivan of Orland Park.
O'Sullivan not only understands what the phrase means, she knows that it saved her life at Little Company of Mary Hospital and Health Care Centers earlier this year.
Door-to-balloon time is a term coined by the American College of Cardiology (ACC) to describe the time it takes for a hospital to recognize and treat a heart attack patient with balloon angioplasty, stents or both after he or she arrives at the hospital.
The ACC recommends 90 minutes or less. For patients at Little Company of Mary, door-to-balloon time is well below that – 70 minutes or less on average.
O'Sullivan's story begins on a typical workday in early May. She was busy checking in food orders at the local grocery store where she's employed. Out of the blue, O'Sullivan started feeling dizzy and hot.
"It could have been because it was hot that day," she recalls.
As it turns out, that wasn't it at all.
O'Sullivan was having a heart attack. When she tried to sit down on a nearby milk crate, she collapsed. A quick-thinking customer started performing cardiopulmonary resuscitation immediately. Once she was revived, the next thing O'Sullivan remembers is her boss standing over her telling her an ambulance was on the way.
"I didn't believe I was having a heart attack," she explains.
When she arrived in the emergency department at Little Company of Mary, O'Sullivan's heart rate was 20 beats per minute; her blood pressure dangerously low at 60.
"She was in critical condition," explains Dr. Daniel Rowan, board-certified interventional cardiologist and medical director of the hospital's Interventional Cardiology Department and the Cardiac Catheterization Lab. "She was in cardiogenic shock."
Once she entered the hospital's emergency department doors, the clock started ticking on door-to-balloon time. Within moments, O'Sullivan was receiving lifesaving treatment. A 12-lead electrocardiogram (EKG) confirmed the presence of a particular type of heart attack called a STEMI (ST segment elevation myocardial infarction) that requires fast treatment in the Cardiac Catheterization Lab. (A STEMI occurs when a coronary artery is totally occluded by a blood clot.)
"When I first arrived there, they told me her heart was in very poor shape," O'Sullivan's husband Joseph recalls. "I was thinking the worst but hoping for the best. Five minutes later, I was talking to Dr. Rowan. The entire team was very responsive. The doctor was there; the catheterization lab was available."
Within minutes, the busy mother of three adult children and grandmother of two was rushed to the catheterization lab where Dr. Rowan opened up her blocked artery, inserted three stents to keep it open, and put in an intra-aortic balloon pump to lessen the load on her weakened heart. She also received a temporary pacemaker to maintain a normal heart rhythm and special medication to keep her blood pressure at a healthy level.
O'Sullivan remained hospitalized at Little Company of Mary for 15 days before her discharge to home. She has very little recall of her ordeal – especially the first nine days when she was sedated to prevent her from removing her breathing tube.
"Mrs. O'Sullivan's right coronary artery was 100-percent blocked," Dr. Rowan added. "Initially, her heart appeared to be very damaged from the heart attack, but it has made an almost complete recovery. Her recovery is a testament to our team approach. The catheterization staff, along with the Emergency Department, did an outstanding job."
So much so that O'Sullivan returned to work October 1. Though she never had heart symptoms before, O'Sullivan said her mother had coronary bypass surgery several years ago. She also has given up her pack-a-day smoking habit since her heart attack.
"The last time I was at Little Company of Mary was when I had my children," she added. "I'm so grateful to be alive."
"The whole situation was so gloomy and desperate in the first 48 hours," Joseph added. "Miraculously, through it all, she came back to us as the same person she was before her heart attack. I can't say enough about Little Company of Mary. Special prayers of thanks to Dr. Rowan and everyone associated with the Cardiac Catheterization Lab. Also, we would like to especially thank all of the staff of the Intensive Care Unit for all of their help and understanding … not only for Judy but our entire family."
More About Door-to-Balloon Time
"Time is (heart) muscle," Dr. Rowan explains. "The quicker we can open up a blocked artery, the better the chance we have of saving the patient."
According to the American College of Cardiology, patients who do not receive lifesaving heart care within 90 minutes of a STEMI face an increased risk of death within the first year after their heart attack; a weakened heart muscle; and greater complications overall.
"We've been performing cardiac interventions at Little Company of Mary for 11 years," he added.
It began when the hospital joined a registry program with Johns Hopkins' Atlantic Cardiovascular Patient Outcomes Research Team (C-PORT) in 2000. Under the direction of Dr. Rowan, the hospital became the first in Illinois to participate in the registry and has successfully performed numerous angioplasties and stents in emergencies where time is critical.
"We're one of the busiest hospitals in the area that treat patients with STEMIs," he added. "For seven consecutive quarters, our DBT (door-to-balloon time) has been met 100% of the time."
In 2010, the hospital joined the American College of Cardiology Foundation's National Cardiovascular Data Registry (NCDR) to further track and compare our interventional coronary care outcomes with other registry hospitals.
From the beginning, Little Company of Mary has worked hard to maintain its impressive door-to-balloon timeframe.
In fact, in mid-September, The Joint Commission – the national organization that accredits and certifies more than 19,000 health care organizations and facilities in the United States – recognized Little Company of Mary for its superior work in meeting key quality measures – one of which is heart attack treatment.
Little Company of Mary was one of only 18 hospitals in Illinois to be named a "Top Performer on Key Quality Measures," which represents the top 14 percent of all reporting hospitals in the nation.
"STEMI care clearly requires a team effort," adds Ann Miller, DNP, APN/CCNS, Critical Care Clinical Nurse Specialist. "Maintaining our outstanding door-to-balloon times requires expeditious movement of the patient from the emergency department to the catheterization lab. We stay focused on our care and target turnaround times."
The key hospital departments involved in meeting door-to-balloon times include the Emergency Department, Adult Intensive Care Unit's Rapid Response Team, and the Cardiac Catheterization Lab Team.
"Our goal is to have an EKG performed within five minutes of arrival and interpreted immediately by the ED Physician. The Cath Lab team is then paged with a response time of 30 minutes or less," she added. "Everyone is on their toes. At Little Company of Mary, we are ready and waiting. Our turnaround times are ultimately shared with the key hospital departments leaders and staff."
For more information about Little Company of Mary's heart program, visit http://www.lcmh.org. For a referral to a cardiologist, call 1-866-540-LCMH (5264).
Contact:
Kelly Cusack
Little Company of Mary Hospital and Health Care Centers
Tel.: 708.229.5049
E-mail: Email
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