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St. Clair Hospital Opens Third Cardiac Cath Lab
By Nancy Kennedy

One of the Pittsburgh regions's most highly ranked centers for the treatment of heart attacks has recently enhanced its services, giving it even greater capabilities for efficient, accurate diagnosis and the most advanced emergency cardiac care available anywhere. St. Clair Hospital has expanded its Cardiac Catheterization Lab, adding an entirely new third room, along with cutting-edge technologies.

Shawn Balaschak, RN, BSN, MSM, Manager of the Cardiac and Electrophysiology Lab at Mt. Lebanon-based St. Clair, says the addition of the electrophysiology studies, which examine the heart's electrical conduction system, increased the Cath Lab's volume and necessitated the construction of the additional room. "An electrophysiology study is a longer and somewhat more complicated procedure," he explains. "It's an essential aspect of our program as we continue to offer the most advanced diagnostic and therapeutic technology. The new room includes a 54-inch large screen, high-definition imaging monitor."

When a person has a heart attack, the blood flow from one of the coronary arteries to the heart itself is blocked, depriving the heart muscle of vital oxygen. The primary goal of treatment is to expedite care in order to minimize damage to the heart muscle, which can be irreparable. Ideally, this takes place in a series of precise, well-orchestrated increments that begins in the community and progresses through the Emergency Medical System (EMS), the Emergency Department and then the Cath Lab. Time is of the essence: state-of-the-art cardiovascular emergency care is designed to reduce the timeline in which intervention occurs; the longer the interval between onset and treatment, the greater the risk of damaged heart muscle.

"When a person begins experiencing chest pain or other symptoms suggestive of a heart attack, it's critically important to call 911 immediately and get the ball rolling," says Balaschak. "The EMS first responders will send an EKG (a tracing of the heart's electrical pattern, an integral aspect of diagnosis) to the Emergency Department, who will notify the Cath Lab team that the patient is en route. Once the patient arrives, a quick assessment takes place in the ED and if that is positive for a heart attack, then the patient goes straight to the Cath Lab. As soon as the patient is on the table, we access the femoral artery or radial artery and inject dye into the coronary arteries so that we can identify which blood vessel is blocked. We then restore blood flow with a balloon, which inflates and dilates the artery, and sometimes place a stent, a small mesh tube that prevents the re-opened artery from collapsing. The patient is admitted and monitored for 24 hours and then discharged with follow-up care."

This procedure is known as balloon angioplasty, and a hospital's success in treating heart attack patients is measured in part by so-called "door-to-balloon" time – the amount of time it takes to treat a heart attack patient from the moment he or she arrives at the Emergency Department door to the time the balloon is inserted to unblock the obstructed coronary artery. Reducing door-to-balloon time has been an objective of a national collaborative of health care organizations concerned with cardiovascular health, and St. Clair Hospital has not only met the national guidelines but also exceeded them. In fact, St. Clair consistently ranks first in the Pittsburgh region in its door-to-balloon time rate and is among the best-performing hospitals in the nation in this regard.

St. Clair's new Cardiac Cath room opened on October 26. It will enhance the hospital's cardiac emergency care and provide greater space for the more than 2,000 procedures that the busy lab performs annually. Balaschak and his team of critical care- trained registered nurses, x-ray technicians, and unit directors, are excited about the expansion of the space and services.

"We see patients ranging in age from their 30s to their 90s," Balaschak says, "and in addition to treating emergency patients, we treat both inpatients and outpatients. The Cath Lab performs catheterizations, pacemaker insertions, diagnostic angiograms, stent insertions and many other procedures. Our team is part of a larger team that includes the emergency medical technicians, emergency department physicians and nurses, and the staff of the cardiac care unit. Each member of the team knows their role and carries it out so that we can deliver the highest quality care and services to our patients."

Balaschak is a graduate of Carlow University's School of Nursing and is a veteran employee of St. Clair Hospital. He has been with the Cath Lab for 14 years and still finds it challenging, educational and satisfying. "In health care, most problems are long term and take time to resolve. In the Cath Lab, we are able to 'fix' people immediately after an acute heart attack, within minutes. That's a rare opportunity to really make a difference in somebody's life."

For more information about St. Clair Hospital's cardiovascular services, visit www.stclair.org.

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