EMERGENCY patients taken to The Essex Cardiothoracic Centre (CTC) after a heart attack have one of the highest chances in the country of making a good recovery.
About 30,000 people in Britain have a cardiac arrest outside hospital every year and their chances of making it alive to an emergency department are around 50/50. If they do, their chances of making a full recovery without damage to the brain or other organs will depend on the quality of treatment they receive.
Dr John Davies, cardiology consultant at the specialist heart centre, explains: “Data at the CTC shows a particularly high survival rate, given the severity the patients’ conditions. We think this is due to teamwork, rapid treatment and management of the
heart disease and the effects that cardiac arrest has on other organs. We believe that this can only be provided at centres like ours where the facilities and expertise are available round the clock, every day of the year.”
Noel Watson, divisional head of nursing and quality (interim), at the CTC recently organised a study day to share knowledge with other cardiac clinical staff from hospitals in London and East Anglia. In one of the presentations, Dr Davies told delegates that 20 years ago he could never have imagined the improvements that would be made in the treatment of hospital cardiac arrests (OHCA).
He said: “Such progress is a shining example of teamwork – what we refer to as the ‘chain of survival’ for patients. The first link in the chain may be a bystander who knows how to administer chest compressions and rescue breaths (CPR) until another ‘link’ arrives – the paramedic team.
“In hospital, the patient will then be treated by doctors, nurses and therapists from nearly 20 different disciplines, including cardiology, radiography, neurology, renal, intensive care, physiotherapy, cardiac rehab, to name a few. Along with these clinical specialists, follow-up care from The CTC’s psychological support service, patient’s GP and their family, are all essential elements of the chain of survival.”
Emergency patients treated at the Essex CTC also benefit from the latest techniques and equipment, including state-of-the-art cath labs where imaging, tests and cardiology procedures are carried out. And the specialist centre is one of only two in Britain to offer a treatment called therapeutic hypothermia (TH), where the patient is rapidly cooled before the artery is opened by cardiologists.
Dr Thomas Keeble, interventional cardiology specialist registrar, explains: “Clinical trials show that if the patient is cooled after a heart attack, there is a significant reduction in the physical or neurological (brain) damage caused to them.
“When an artery is blocked the surrounding heart muscle dies. When we open up the artery, the muscle that has died is further damaged by the rapid reflow of blood – about half the injury to the heart following a cardiac arrest is caused by this.
“By cooling the patient before we open the artery, we can significantly reduce this damage. It’s essential to do this quickly – we begin TH on the patient immediately on their arrival and in most cases, get their body temperature down to the target 33 degrees while they are still in the cath lab.”
One patient who has made a full recovery after a heart attack in April this year was a guest speaker at The CTC study day.
Gary Parker, 55, told the audience: “I used to be fit and healthy – I played rugby – but as I got older I became more sedentary, ate the wrong food and my weight went up.”
He doesn’t remember anything about the massive cardiac arrest he had on 16 April this year, but that day he collapsed in the car park of Rayleigh station. Luckily for Gary, two people in the vicinity knew how to administer CPR, and an air ambulance arrived rapidly and took him to The Essex CTC.
The team immediately began cooling Gary’s body, he was taken to the cath lab for a cardiology procedure to open a blocked artery and then transferred to intensive care where he spent a week.
His wife Angie recalled: “It was one of the scariest things I’ve ever experienced, seeing someone you love in intensive care on breathing apparatus. But the staff were fantastic – they told me he was extremely ill but made sure I understood everything they were doing for him – until I realised the reason for the cooling I wanted to warm him up!
“I was worried he might not know me, but when the sedation was turned off he woke up in two minutes and said ‘I love you Angie’.
Gary added: “The CTC staff were absolutely fantastic and the treatment and support with rehabilitation has been second to none. I had five stents fitted but the only pain I felt afterwards was from the CPR and that was certainly worth it to still be here.”
Gary and Angie, who live in Rayleigh, say they are now making the most of every day, and have set up an independent fostering business together. They got married in July with two special guests of honour – the man and woman who administered CPR on Gary on that fateful day in April.