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(Rick Egan | The Salt Lake Tribune) Allan Wilson enjoys gardening around his Holladay home, Friday, June 20, 2014
Too many Utah heart attack patients skip the ambulance
Emergency » Better chance for survival and reducing heart damage are two reasons to call an ambulance.
First Published Jul 06 2014 01:01 am • Last Updated Jul 06 2014 12:43 pm

In his 69 years, Allan Wilson has made more than a few trips to the hospital.

The Postal Service retiree always drove himself, even in emergencies, rationalizing that it’s quicker, more convenient and less expensive. But he wasn’t given a choice last fall when his wife summoned an ambulance to a shop in Park City after he started talking nonsensically, his speech slurred — and her fast thinking probably saved his life.

At a glance

Ignoring the signs

In a 2005 survey, 92 percent of Americans recognized chest pain as a symptom of a heart attack. Only 27 percent were aware of all major symptoms and knew to call 911.

» About 47 percent of sudden cardiac deaths occur outside a hospital, suggesting many don’t act on early warning signs.

Source: Centers for Disease Control and Prevention

Got symptoms? Don’t drive

Three of four Utahns having a heart attack skip calling an ambulance, according to 2013 data from MountainStar’s urban hospitals. The percentage of heart attack patients arriving by private vehicle:

» St. Mark’s Hospital in Salt Lake City, 80 percent. 

» Timpanogos Regional in Orem, 96 percent.

» Brigham City Community Hospital, 82 percent.

» Mountain View Hospital in Payson, 76 percent.

»   Lone Peak Hospital in Draper, 77 percent.

» Lakeview Hospital in Bountiful, 66 percent.

» Ogden Regional Medical Center, 64 percent.

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"I was having a stroke, which they were able to treat en route," said the Holladay resident. "And when I got to the hospital they were ready for me. They found a blocked artery in my left ventricle, the main one that feeds the heart, and whisked me into surgery."

Wilson is an anomaly.

Three of four Utahns having a heart attack arrive at an emergency room in private vehicles, according to data from MountainStar’s urban hospitals. In rural areas the rate is probably higher.

It’s a national problem, dubbed "the Achilles’ heel" of efforts to combat heart disease in the United States, said Scott Hacking, a cardiovascular specialist at St. Mark’s Hospital in Salt Lake City.

According to the Centers for Disease Control and Prevention, 720,000 Americans have a heart attack each year and about 30 percent die, largely because they didn’t get help on time.

A national initiative shaved an average of 16 minutes off the time it takes to clear a blocked artery with a medical balloon once patients arrive at the hospital, according to a 2013 study in the New England Journal of Medicine. Ninety percent of heart patients are now treated within the recommended 90-minute time frame, and many are treated in 30 minutes or less.

But that same study found cardiac death rates remain unchanged — even though patients with shorter door-to-balloon times were more likely to survive.

"Since 2005 door-to-balloon times have progressively improved, but it seems we have reached a nadir," Hacking said. "What’s not changing is symptom-to-balloon time."


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The need for speed » The door-to-balloon initiative exemplifies the limits of medicine.

It made the health system more efficient and effective, but there’s a limit to what doctors and hospitals can do when so much of a person’s health hinges on personal decisions.

With heart attacks, timing is everything. The longer the heart is deprived of oxygen, the more muscle is lost.

Patients fare best when they get to a hospital within the "golden hour" after symptoms start. But ,on average, it takes two to four hours for patients to arrive, said Michelle Pola, a chest pain center coordinator at St. Mark’s.

Tips for surviving a heart attack aren’t complicated: recognize the symptoms, dial 911 and chew an aspirin while waiting for an ambulance to arrive.

But many patients don’t recognize the symptoms, or they downplay and deny them.

Others lose precious tissue-saving minutes behind the wheel of a car — endangering themselves and others should they arrest and lose consciousness while driving.

"Even if you have a family member drive, what can that person do if you arrest?" said Pola. "Heart tissue doesn’t regenerate. If you wait too long, you might survive, but you’ll probably wind up with damage to the heart."

Women tend to take even longer than men to get to a hospital, and once they arrive it takes longer to diagnose and treat them, studies show.

This cuts against the common understanding of women as the decision-makers in family health care.

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