Just before 7 a.m. on Wednesday, Aug. 26, a Villa Rica resident and her “daughter” approached the triage desk in the emergency department at Tanner Medical Center/Villa Rica.
“I’ve been having some chest pain,” the patient said. “I think I need to see a doctor.”
Within seconds, the patient was in a wheelchair, rolling through the double doors of the emergency department toward an exam room. Staff from throughout the facility lined the corridor to watch. This wasn’t a typical visit; it was a drill. The patient was Shirley Marchman, a Villa Rica city councilwoman, and her “daughter” was a Tanner employee. And everyone was watching to make sure that the patient could walk in, be evaluated for a heart attack and be brought to the hospital’s catheterization lab for a procedure that could save her life.
The procedure is percutaneous coronary intervention, or PCI. It’s also called angioplasty. During a heart attack, an artery that supplies the heart with blood becomes blocked, leaving the heart deprived of oxygen.
It allows an interventional cardiologist to use a small balloon on the end of a catheter, threaded through a patient’s arteries to the site of a blockage, to clear the blockage and quickly restore blood flow to the heart. Performed fast enough, PCI can save heart tissue and lower the risk of long-term damage to the heart, since heart tissue that dies due to lack of oxygen does not come back.
The service has been available for several years at Tanner Medical Center/Carrollton, performed on an elective basis as a way to clear blocked arteries detected before a heart attack, as well as in urgent cases when a heart attack is occurring and the PCI needs to be performed right away.
Expanding the service to Tanner Medical Center/Villa Rica means access to life-saving PCI will be faster for residents in Carroll, Douglas and Paulding counties.
“Use of the program will grow as familiarity grows,” said Shazib Khawaja, MD, a board-certified interventional cardiologist and vascular medicine specialist with Tanner Heart & Vascular Specialists and medical operations leader for heart care at Tanner Health System. “We’re going to be reaching people now in Douglas County and Paulding County who may never have considered this an option in Villa Rica.”
In the emergency department Wednesday morning, an electrocardiogram (ECG) was taken and evaluated by Justin DeWillers, MD, a board-certified emergency medicine physician with Carrollton Emergency Physicians. At 6:57 a.m., on Dr. DeWillers’ order, a heart alert was paged. Upstairs, staff began rushing to prepare the catheterization lab for the patient. Dr. DeWillers called Dr. Khawaja, the interventional cardiologist on call, to debrief him on the patient.
As staff rushed around the emergency department to prepare the patient to be moved to the cath lab, nurses and the physician spoke to Marchman. She was told she was having a heart attack. She was told a cardiologist was being brought in to care for her. She was told they were going to relieve her symptoms as quickly as they could.
Dr. Khawaja came into the emergency department exam room and spoke to Marchman and her daughter. He looked over the ECG and told them he thought she needed a PCI, and if that’s OK with them, he was ready to do it now. Marchman was rolled in the exam room bed from the emergency department into an elevator, escorted by staff from the catheterization lab, some of whom darted from the elevator and up the stairs to make sure treatment wasn’t delayed.
A little after 7 a.m., Dr. Khawaja asked Marchman if she felt better. The procedure was complete and her heart was getting the oxygen-rich blood it needed to survive. She said she felt much better and was moved to the intensive care unit for close observation as she recovered.
At Tanner Medical Center/Carrollton, the heart alert process is down to a science, helping the facility post door-to-balloon times — time from which a patient arrives at the hospital door with a heart attack until the blockage is cleared with the balloon catheter — much faster than the national average. Dr. Khawaja said they would continue refining the process at Tanner Medical Center/Villa Rica.
“We’re going to find ways to shave off a minute here and a minute there,” he said. “We’re always looking to unblock the artery as quickly — and as safely — as possible.”
The PCI program at Tanner Medical Center/Villa Rica launches Aug. 31.
And if there was any question as to whether Tanner needed two PCI locations, the answer came in the Villa Rica emergency department that morning. Even as Dr. Khawaja discussed the PCI with Marchman, he received a call that another patient had arrived at Tanner Medical Center/Carrollton with chest pain.
It was going to be a busy day saving hearts in west Georgia.
More information about PCI and Tanner’s other cardiac services is available online at www.TannerHeartCare.org.