Help is a heartbeat away
Local hospitals partner to treat heart attacks on the spot

By Penny Richards
MethuenLife Writer

Heart-attack patients in the Merrimack Valley now have rapid access to angioplasty, an emergency procedure known to save lives in times of heart attack. That means patients have a better chance of surviving a heart attack than ever before.
Caritas Holy Family Hospital in Methuen and Lawrence General Hospital have established a Joint Primary Angioplasty Program for patients suffering from a heart attack.
The program is led by Dr. Sunit Muhkerjee, interventional cardiologist at Holy Family Hospital and Lawrence General Hospital, assisted by Dr. Jeffrey Popma, interventional cardiologist, and Dr. Seth Bilazarian from Pentucket Medical Associates. Popma also oversees the cardiac catheterization lab at Caritas St. Elizabeth's Hospital in Boston.
These experienced interventional cardiologists and a team of specially trained staff perform primary angioplasty in the cardiac catheterization laboratories at both hospitals on alternating weekdays. During off-hours and weekends, the team is dispatched to whichever hospital is closest to the patient.
"Our ability to treat patients locally, rather than having to be transported miles away, can mean the difference between life and death for some heart-attack patients," said Muhkerjee. "We believe this therapy will save lives and help prevent repeat heart attacks."
Locally, the team is already saving lives. At press time, some 50 procedures had been performed since the program began last summer.
A heart attack occurs when blood flow is reduced or restricted due to a blockage in a coronary artery. Primary (or emergency) angioplasty is a life-saving procedure designed to open clogged arteries. It involves passing a tiny balloon in the affected artery and inflating it to push aside the material that is blocking the artery, thus allowing the blood to flow freely.
“In the past when these patients came in, we had to fly them to Boston (for the procedure),” says Muhkerjee. “That, of course, would add time and the longer someone is suffering from a heart attack, the more the damage that is being done to the heart. We’re able to save an hour, maybe two hours, and that translates to a lot more heart muscle that we’re saving.”
In the United States, approximately 200,000 people a year have heart attacks caused by blockages in arteries that supply the heart muscle with blood. According to the American Heart Association, primary angioplasty can cut a patient's risk of dying by 40 percent but only if it is done within 90 minutes of the patient's arrival at the hospital. This "door-to-balloon" time window is critical.
The procedure
Dr. Muhkerjee described the angioplasty procedure.
The patient is sedated, and a guide wire in inserted into an artery in the arm or heart and run through the body to the heart or the affected area. A catheter is run over the wire to the affected area, and the wire is removed.
A tiny deflated balloon is fed through the catheter to the site of the blockage. The balloon is expanded, compressing the blockage against the walls of the artery. A stent — a tiny tube — may be inserted to help keep the artery open following the angioplasty.
Most people recover from angioplasty quickly and return to work about a week after being sent home. With a heart attack, a patient may be out of work for four to six weeks, depending on the severity of the event.
Even with angioplasty and a stent, a blockage can return. That’s why it’s so important to make lifestyle changes to reduce the chance of another coronary event.
Before the local program
Dr. Jeffrey Popma explained how patients were treated before the local angioplasty program started and the difference in treatment under the new program.
A patient would call for an ambulance and one would be dispatched. When the emergency medical technicians (EMTs) arrived, the patient would be evaluated and taken to the nearest hospital. On arrival, the patient would have an EKG and the emergency room physician would evaluate whether the patient was having a heart attack.
The emergency room doctor would consult with a cardiologist (perhaps have to fax test results if that doctor was not in the hospital). At some point along the way, someone would determine that the patient needed angioplasty treatment.
The patient would be transported to the nearest facility that could perform the procedure, and often times would have to be taken by medical helicopter to a Boston hospital.
Treatment today
Here’s how a typical heart-attack call is handled, with the Joint Primary Angioplasty Program in place.
The EMTs are called to a patient’s home. Through incredible and intense training of local EMTs, they are able to interpret, with a high degree of accuracy, that a patient is having a hart attack while still at the patient’s home. They contact the nearest hospital (Lawrence General or Holy Family). That call activates the cardiologist and the cardiac catheterization lab team.
Often times the cath lab is ready when the patient arrives at the hospital. This saves 30 to 40 minutes in evaluation time.
The result, Dr. Popma says, can be a life saved.