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MICHIGAN CARDIOLOGY
Leading the way as one of the top Michigan cardiology and Michigan heart care hospitals with a full array of cardiac treatments and programs that set new standards for heart care every day, that's the St. Joseph Mercy Oakland way. From heart valve replacement to coronary artery bypass, our doctors are at the forefront of heart procedures and treatments.

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OF THE MEDICAL REPORT
Michele DeGregorio, MD
St. Joseph Mercy Oakland
Cardiologist
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THE FACTS ABOUT Emergency Angioplasty

Background

During a heart attack, oxygen-rich blood is cut off to a part of the heart muscle, usually by a clot in a coronary artery. Unless the blockage is quickly removed, that part of the heart muscle dies.

Podcast Posted: 08/10/2007
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Emergency angioplasty has been shown to be the most effective way to treat this condition. The procedure is accomplished by inserting a thin plastic tube (called a catheter) into a large blood vessel, usually in the groin. A small amount of dye is then injected into the catheter — making the arteries visible on x-rays.

A second catheter is then threaded into the blocked heart artery. This catheter has a balloon on its tip, which is repeatedly inflated and deflated to open the blockage. Once the blockage is cleared, a small wire mesh tube (called a stent), is placed inside the artery to help keep it open.



Emergency angioplasty, which is done with local anesthesia, is also commonly used in less time-sensitive situations to open narrowed arteries in patients with atherosclerosis. “It’s a count down from the moment the chest pain begins,” says Michele DeGregorio, MD and SJMO cardiologist. “We aim for between 60-90 minutes from the time a patient comes in the door of the Emergency Room to the time blood flow to the artery is re-established. The efficiency of our system is very impressive, and the skill and expertise of our interventional cardiologists is truly extraordinary.”

The consensus among cardiologists is that emergency angioplasty is the preferred treatment for an acute heart attack. However, this procedure is only available at 20-25 percent of all hospitals due to the necessity for sophisticated personnel and equipment. When angioplasty is not available, doctors often use thrombolytic drugs — also called clot-busters — to dissolve the blood clot.

ADVANTAGES
According to DeGregorio, MD, the advantages of using emergency angioplasty instead of clot-busting drugs for a heart attack include: 1) a higher level of assurance that the artery will open promptly; 2) a lower risk of major bleeding, especially into the brain; 3) the ability to simultaneously assess the status of all other arteries of the heart; and 4) a shorter hospital stay — which reduces costs and minimizes the chances of infection and other complications. “Having a very precise idea of what is going on in the heart by using the x-rays taken during this procedure allows us to make better treatment decisions,” says DeGregorio, MD.

CAUTIONS
Emergency angioplasty isn’t the best option for everyone. Sometimes specific blockages are better treated through other means, including bypass surgery. Regardless of the treatment, when it comes to a heart attack, remember that timing is paramount.

REFERRAL
Please call the SJMO physician referral line at 800.372.6094 to find an SJMO cardiologist near you.

 

THE MEDICAL REPORT LIBRARY:

MICHIGAN CARDIOLOGY
 
 
Coronary Artery Bypass (CABG)
James Caralis, DO
Posted: 08/10/2007
Carotid Artery Disease
Nishit Choksi, MD
Posted: 05/09/2008
Emergency Angioplasty
Michele DeGregorio, MD
Posted: 08/10/2007
Why Minutes Count
Michele DeGregorio, MD
Posted: 08/10/2007
Heart Failure
Nitin Doshi, MD
Posted: 08/10/2007
Life After a Heart Attack
Willam Gordon, MD
Posted: 08/10/2007
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