Don’t waste time, Doctors say

Heart attack to hospital takes 5 hours in Mumbai

Doctors To Try & Cut Down Time Taken In City [Adapted from a front page article dated May 25 2014 : The Times of India (Mumbai)]

With three million cases every year, heart attack may be the commonest grave ailment in India. But Indians seem to be dimly aware of its calling card—be it the sudden pain in the chest, upper back or jaw—and often don’t react appropriately. A shocking 95% of heart attack patients take public transport to reach hospital. And, many of them reach after six hours—or over 380 minutes—of the first symptoms, found an all-India study.

Cardiologist Dr Prafulla Kerkar, who heads KEM Hospital’s cardiology department, said barely 10% of heart

attack patients in the city reach the hospital within the golden hour. The golden hour is the crucial period in which medical treatment can prevent permanent damage to the heart’s muscles.

“A study among 350 of our heart attack patients showed that 10% reached the hospital 12 hours after the attack. By this time, the advantages of restoring blood flow are lost,” said Dr Kerkar. The majority of the patients took a median time of five hours, which is twice as long as it takes in the West.

It is to reduce this time lag between the appearance of symptoms and hospitalization that a handful of cardiologists have come together to form a not-forprofit organization called STEMI India.

Three years ago, STEMI India brought together doctors, hospitals and ambulance providers in Coimbatore and Chennai to spread awareness about heart attacks and ensure that patients got treated within the golden hour. They have succeeded in reducing the average symptom-to-hospitalization time to less than three hours or 170 minutes so far.

Next weekend, the STEMI India group of which Dr Kerkar is a member will hold its first training programme in Mumbai at Powai. “Over 800 doctors from Maharashtra, Goa, Gujarat and Madhya Pradesh will attend it,” said course director Dr Rajesh Rajani, cardiologist from Hinduja Hospital, Mahim.

“The message is that the longer you take to report to a hospital after a heart attack, the higher the chance that you are left a cardiac cripple who may well need repeated hospitalizations later on,” added Dr Rajani. It is now well established that patients who are given immediate medical treatment–say, a blood thinner or clot buster–may not suffer any long-term effects of a heart attack.
Many hospitals and nursing homes in Mumbai, though, still don’t give a clot-buster to a patient who comes in with suspected heart attack, say doctors. “They refer the patient to a bigger hospital without even providing streptokinase injection that can dissolve blood clots that caused the heart attack,” said Dr Kerkar. Ashok Hospital is one of the few Hospitals that give this vital clot busting drug, and Dr. S. P. Mathew encourages other Hospitals around to do the same.