A Race Against Time

Organization: Service: Story Topics:
Heart Disease
Derek Lester, Debra Posey, R.M., Rex Winters, M.D.

When a heart attack strikes, seconds matter—and getting treatment can mean the difference between life and death.

That's why calling 9-1-1 is the best advice for anyone experiencing chest pain or other heart attack symptoms. This allows paramedics to take patients to the best hospital for their condition. Long Beach Memorial's Chest Pain Center, located in the emergency department (ED), is equipped to diagnose and treat cardiac emergencies.

Upon arrival, patients with heart attack symptoms are assessed by a physician in the Chest Pain Center, a facility ranked among the top 3 percent in the nation for heart attack survival. "Having a team of specialized physicians do the initial assessments streamlines the process, ensuring cardiac emergencies are diagnosed and treated quickly," says Gary Moreau, M.D., medical director of emergency services.


Part of the assessment process involves an electro-cardiogram (EKG) to measure the heart's electrical activity. "An EKG is a critical tool to confirm if patients are having a heart attack," says Dr. Moreau. He notes that in Los Angeles County, including the Long Beach Fire Department, paramedic vehicles are equipped with 12-lead EKGs so this test can be performed in the field. An ST-elevation myocardial infarction (STEMI) is the most life-threatening form of heart attack and needs immediate treatment. When a patient suffering a STEMI is identified, paramedics alert Long Beach Memorial, allowing the cardiac care team to prepare for the patient's arrival—saving valuable time.

"A STEMI involves the complete blockage of one of the main arteries supplying blood to the heart," says Rex Winters, M.D., medical director of interventional cardiology. "This can lead to permanent heart damage or death, if not treated promptly." Long Beach Memorial was the first hospital in Long Beach designated as a STEMI receiving center by Los Angeles County Emergency Medical Services.

If the patient has suffered a suspected STEMI, a specialized cardiac treatment team is activated. The group includes chest pain specialists such as interventional cardiologists, cardiac catheterization lab technologists and cardiac care nurses.

"Multiple studies show the best treatment for STEMIs is opening the blocked artery by inflating a surgical balloon and placing a coronary stent at the blockage site—a procedure called balloon angioplasty," says Dr. Winters.

The goal of hospitals around the nation is to perform an angioplasty on patients with blocked coronary arteries within 90 minutes of their arrival in the ED. This is known as the "door-to-balloon" time.

Long Beach Memorial's door-to-balloon time averages 55 to 60 minutes—significantly better than the national average.

Saving Valuable Time

While the cardiac care team, including primary and cardiac care nurses, works with the ED physician to provide care, STEMI team members in the MemorialCare Heart and Vascular Institute prepare the cardiac catheterization lab for balloon angioplasty. During the procedure, the patient may have one or more tiny wire cages called stents placed inside the cleared artery to prop it open permanently.

If the patient's condition requires immediate bypass surgery, Long Beach Memorial is equipped to perform the procedure without delay. After angioplasty or bypass surgery, patients are moved to the Coronary Care Unit, where their condition is monitored by a cardiologist, intensivist and cardiology nurses.

The STEMI panel at Long Beach Memorial is composed of board-certified interventional cardiologists and are supported by nurses, nurse practitioners, coordinators and cardiology fellows.

Featured physician:

Gary P. Moreau, MD

Medical Director, Pediatric Emergency Department at Miller Children's Hospital Long Beach; Program Director, Emergency Medicine, Graduate Medical Education
  • Emergency Medicine