Emergency heart care

Welcome back. In today's marketplace, being heart smart. Heart attacks are the leading cause of death among both men and women worldwide, so it is important to know the risks and the warning signs. Dr. Jeff Chambers is from Allina's Metropolitan Heart and Vascular Institute at Mercy Hospital. He's here this morning to tell us so much more.

Thank you so much for coming in, Jeff. Really appreciate it. You know, all of us hear about the symptoms, but what if anything were to ever happen to us? You think sometimes it's going to happen to someone older, but if younger, same symptoms, what do we watch out for?

So most people think that the classic symptom is chest pain. Everyone says chest pain. It's really chest pressure, heaviness. The typical symptoms are pain that comes across your chest. In some people, it radiates down the arm, and oftentimes it's associated with shortness of breath.

And the shortness of breath-- describe that.

People feel like they just cannot take a deep breath. And no matter what you do, how you change positions, the feeling will not go away. Women have a little bit different symptoms. A lot of times women will have jaw pain, back pain, or just shortness of breath.

And how do you know the difference between just a regular backache and something that's more serious?

So this is something that generally comes on relatively quickly and doesn't go away. So it's a new or different symptoms. So all of a sudden, boom, something's very different, it's going on. You need to get it evaluated. So if it doesn't go away in 10 or 15 minutes, get it evaluated.

So you call or you get to the hospital as fast as you can. And then that's where you'd step in and you'd evaluate?

Right. So call 911. Don't drive yourself. We've had people who tried to drive themselves to the hospital. That doesn't work out very well. Occasionally, if you're having a heart attack, your heart can stop on the way to the hospital.

Not good.

Not good. And then you might drive off the road and hurt yourself.

Hurt someone else.

Or worse, hurt someone else, exactly.

Right. So when you get in there--

So call 911.

And people say take an aspirin if this is coming on. Is that yes or no?

Yes. If you have it, take an aspirin. Two, three baby aspirins is ideal, or take a regular aspirin. Aspirin is a blood thinner that helps start to break up the blood clot that forms.

And it can't hurt to do that anyway if it's not happening.

Exactly.

So then you get to the hospital, and you decided, yes, somebody is having a heart attack. Oh, no.

So what happens when you have a heart attack is inside your arteries-- arteries are like tubes in the heart, and they have a plaque. Usually the plaque is not totally blocking it off. And one of these plaques breaks open, and then a little blood clot forms right in that spot. And then it blocks off the artery.

A lot of times people will have some warning symptoms where the artery opens or closes. And you may have some warning symptoms. Some people, it just closes right away. So when that happens, get right to the hospital. And then when we see--

We looked just now at a picture of a blood clot?

That was a blood clot. And that's one that I actually removed from somebody's heart at the time of an angioplasty. So if you get to the hospital, are having a heart attack, we'll do an EKG right away. If it shows a heart attack, we zip you right up to the cardiac cath lab, which is a place where we can do an angiogram.

We put an IV in the big artery in the leg, tubes up in the heart. And then we can actually inject X-ray dye and see blockages. This is an angiogram here, and that shows a blockage in the LAD, which is the big artery going down the front part of the heart.

So at that point, we go in first, usually, and have a little tube thing that we can pull out, and we can extract the blood clot. And there is what it looks like after we've removed the blood clot. So now we've opened up the artery and stopped the heart attack. And then we usually finish off by putting a stent in, which will actually stay in there and hold the artery open.

So this is something which is amazing to see. And we can actually show how you would do that.

Yeah. Here's a model of how we would put a stent in. So a stent is a metal tube that's mounted in a balloon. It's actually crimped on a balloon.

What we do is-- this is a model of the arteries-- we put the stent over a little, tiny, tiny wire across, and we feed it to where the blockage is in place. And then we blow up the balloon, like this. Hopefully we can do it here.

So normally, would that expand right in there?

Yep. Normally that would expand right in there. Got a lot of air in this one. Usually a fluid in there, which makes it a lot easier to do.

Oh, OK.

Let me try this.

But it's amazing to me, just the pinpoint. I mean, it's so thin.

Yes, it's so thin.

How it gets in there and just--

Let me put a little more air in there so we can blow it up all the way. And we actually blow it up with a balloon, and we leave it right inside the artery. And it stays in there, has some scaffolding.

And this is done a lot of times right away. Oops, we lost it. So tiny, it just flies out of our hands there. But it's amazing to me that this can be done right as you come in, and they've determined it.

Would you mind holding that for one second? I think we can do it here.

There you go. OK.

So if we blow it up--

And blowing it up, meaning this is going to expand?

Yep. Expands, and then the stent stays right inside the artery. And we can pull it out now.

And now we pull this out.

Yep. And usually the stent stays right inside. I'll pull it out. So there's the balloon blowing up with a stent on top of it.

So that would stay in?

And that stays in the artery. Then we let the balloon down. I'll let you hold this. I'll let the balloon down. Why don't you hold onto that stent piece?

OK.

And I'll take the balloon down. We let the balloon down.

And then this comes out?

That comes out, and there's the stent right there.

And I mean, that is just a tiny, tiny piece. That's amazing.

Yep. It's amazing the stuff we can do.

Yeah, so we hope that people don't have to get to this point. And obviously with lifestyle and all of those things, we can definitely keep from having to do this.

Exactly. Don't smoke. Lower your cholesterol. Treat your blood pressure. Get lots of exercise. Those are all the things you can do to avoid it. Just see your doctor routinely, and that will help prevent developing a heart attack.

Thank you so much. We really appreciate you coming in. For more health advice on your heart and information about Allina's Metropolitan Heart and Vascular Institute at Mercy Hospital, visit allina.com/heart.