The last thing Daniel Kulick, M.D., wants is for a person with chest pain to tough it out at home.
Get to the hospital emergency room. Best of all, get to Mission Hospital’s emergency room, where a team of coronary care specialists who are part of the Chest Pain Center will determine the cause and danger associated with the pain and provide necessary treatment within minutes.
Too embarrassed to call 911 for fear that your pain might not be a heart attack? “Don’t die of doubt,” advises the American Heart Association.
Whether a person walks in to the ER on his or her own, is driven by a family member or is brought unconscious by ambulance — each patient is treated with the same urgent and complete care.
“If a person is having a heart attack, he or she will go directly to cath lab for stent or angioplasty,” says Dr. Kulick, Director of the Mission Hospital Chest Pain Center.
A stent is a tiny wire mesh that is inserted through a catheter to an artery blocked by plaque; the mesh is then expanded to keep that artery open. Angioplasty is the procedure during which a tiny balloon is inserted through a catheter to a blocked artery, inflated so that blood can flow easily again in that artery, then removed.
Even if chest pain is not a heart attack, it can be a warning of heart disease. The team will keep the patient for observation, to determine just what that warning means. A treadmill test and other tests will help a cardiologist determine the cause of the chest pain and possible treatment.
“There is a long list of causes of chest pain,” says Dr. Kulick, “only a few are dangerous.”
And a heart condition that is not dangerous now, could become dangerous without treatment. To appreciate the value of the Chest Pain Center, it’s helpful to know how far coronary care has come: “In the old days, it was up to the ER doctor to say okay, you’re safe to go home — and occasionally patients would go home and have a heart attack,” says Dr. Kulick.
The Chest Pain Center team works fast — for a good reason: it can save lives. “Our goal is that it takes less than 90 minutes from the time a person walks through our door and to angioplasty or stent,” says Dr. Kulick. “And 95 percent of the time it’s done in that time frame, and this includes patients who are actually having cardiac arrest and have been resuscitated.”
The amount of time it takes for a heart attack patient to get treatment is a major factor in a life or death outcome. Mission Hospital is known in the area for being equipped to receive and treat anyone having a heart attack, fast.
“In Laguna Beach, they keep an ambulance parked there 100 percent of the time,” says Dr. Kulick. “If a patient is diagnosed as having a heart attack, that patient can be put in an ambulance and brought here — and even coming from Laguna we can meet the under 90-minute time.”
Who staffs the chest pain center?
The staff of the Chest Pain Center — nurses, doctors and technicians — meets regularly to make sure that the procedures are working smoothly. “These extraordinarily skilled people meet quarterly to review what we’re doing — the teamwork is phenomenal,” says Dr. Kulick.
What is it like to work with this team? “It’s very gratifying,” says Dr. Kulick. “We used to give heart attack patients morphine, then sit and watch people die. It’s so gratifying that now we can do so much for them.”