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Cardiovascular emergency care

Minneapolis Heart Institute® created the first comprehensive cardiovascular emergency center capable of immediately triaging and treating all forms of cardiovascular emergencies, not just acute myocardial infarctions or heart attacks. Modeled after Level One trauma programs and based on Minneapolis Heart Institute®’s first-in-the-nation ST-segment elevation myocardial infarction (STEMI) transfer program, the Cardiovascular Emergency Center is ready for any cardiovascular emergency including cardiac arrest, ascending aortic dissection, abdominal aortic aneurysm (AAA), critical limb ischemia, STEMI, non-STEMI/unstable angina and cardiogenic shock.

The Cardiovascular Emergency Center is made possible because of the depth and breadth of services available at Minneapolis Heart Institute® and features a board-certified cardiologist inhouse 24/7. Emergency teams are always ready and provide the most advanced therapies available, such as therapeutic hypothermia and all forms of cardiovascular surgery including ventricular assist devices (VADs). Minneapolis Heart Institute®’s Cardiovascular Emergency Center is the most comprehensive program of its kind in the nation.

Level One Heart Attack Program

When a patient is diagnosed with STEMI, the goal is to open the blocked artery within 90 minutes or less, from the time the patient arrives at a community emergency department to the start of life-saving percutaneous coronary intervention (PCI) at Abbott Northwestern Hospital. This is achieved through a standardized process with statewide emergency care providers who stabilize the patient and begin adjunctive therapies even before the patient arrives in Minneapolis. When a Level One emergency is declared, all systems and personnel are set in motion, communication is frequent and thorough, and the patient is transported directly to a waiting, expert PCI team—anytime, day or night.

Therapeutic Hypothermia (Cool It)

Minneapolis Heart Institute® pioneered the collaborative “Cool It” protocol and was the first to simultaneously combine transport, emergency angioplasty and cooling. The core body temperature of a patient resuscitated after cardiac arrest is cooled to 33° C to reduce the risk of permanent neurological damage.

Aortic Dissection

In 2005, Minneapolis Heart Institute® created a multidisciplinary aortic dissection program to aid in the emergency room recognition, triage and surgical treatment of these critically ill patients. Through regular updates to the regional network partners, the time to diagnosis this condition has been cut by 43 percent (or by 4.5 hours at community  hospitals) and the time to surgical treatment has been cut in half. For a condition with a 1 percent per hour mortality rate, this has dramatically improved care. On a local level, the multidisciplinary team of cardiologists, cardiac and vascular surgeons, emergency room physicians, radiologists and cardiac anesthesiologists meets regularly to review cases and treatment times to continue to improve care. Care protocols for patients with suspected and confirmed aortic dissection are available. Patients are encouraged to return to the aortic dissection clinic for regular follow-up care that includes complex imaging studies.

Critical Limb Ischemia

Peripheral arterial disease can manifest as critical limb ischemia. Prompt diagnosis and treatment are mandatory to prevent limb loss. Treatment algorithms are designed to help referring clinicians diagnose critical limb ischemia (and all other cardiovascular emergencies) and facilitate transfer. Emergent endovascular and surgical therapies are provided by the Minneapolis Heart Institute® vascular surgery team.

Ruptured Aortic Aneurysm

Minneapolis Heart Institute® vascular surgeons adapted the Level One Heart Attack protocol to ensure faster diagnosis and emergency treatment of thoracic and abdominal aortic aneurysms. As a result, time from diagnosis to intervention dropped by more than an hour. Combined with increased use of endovascular therapy, survival outcomes improved from 69 percent to 89 percent for these historically deadly vascular emergencies2.

Non-STEMI and Unstable Angina

Minneapolis Heart Institute® at Abbott Northwestern Hospital is Minnesota’s first Accredited Chest Pain Center, as designated by the Society of Chest Pain Centers. The Chest Pain Program applies protocol-based care to reduce variations in treatment and create a more efficient and effective way to treat patients with all types of acute coronary syndromes, not just STEMI. One of the first multi-hospital initiatives for this condition nationwide, the program clearly identifies which patients need to be transferred to Abbott Northwestern and which can safely remain in their communities for testing and follow-up.