Chest Pain Center — The Chest Pain Center at Citizens Medical Center opened in February, 2005 and provides patients with potential life threatening cardiac disease the opportunity for quick evaluation and treatment by the emergency room staff. There are four chest pain beds physically located in the emergency room.

The Society of Chest Pain Centers has granted the designation of Accredited Chest Pain Center to Citizens Medical Center - Victoria, Texas for receiving full accreditation from the Accreditation Review Committee on March 9, 2005. Citizens Medical Center is the 13th accredited Chest Pain Center in Texas and the 106th in the nation.

Heart attacks are the leading cause of death in the United States, with 600,000 dying annually of heart disease. More than five million Americans visit hospitals each year with chest pain. The goal of the Society of Chest Pain Centers is to significantly reduce the mortality rate of these patients by teaching the public to recognize and react to the early symptoms of a possible heart attack, reduce the time that it takes to receive treatment, and increase the accuracy and effectiveness of treatment.

The Chest Pain Center’s protocol driven and systematic approach to patient management allows physicians to reduce time to treatment during the critical early stages of a heart attack, when treatments are most effective, and to better monitor patients when it is not clear whether they are having a coronary event. Such observation helps ensure that a patient is neither sent home too early nor needlessly admitted.

With the rise of Chest Pain Centers comes the need to establish standards designed to improve the consistency and quality of care provided to patients. The Society’s accreditation process insures centers meet or exceed quality of care measures in acute cardiac medicine.

The Chest Pain Center at Citizens Medical Center has demonstrated its expertise and commitment to quality patient care by meeting or exceeding a wide set of stringent criteria and completing on-site evaluations by a review team from the Society of Chest Pain Centers. Key areas in which a Chest Pain Center must demonstrate expertise include:

Integrating the emergency department with the local emergency medical system
Assessing, diagnosing, and treating patients quickly
Effectively treating patients with low risk for acute coronary syndrome and no
assignable cause for their symptoms
Having a functional design that promotes optimal patient care
Ensuring Chest Pain Center personnel competency and training
Maintaining organizational structure and commitment
Continually seeking to improve processes and procedures
Supporting community outreach programs that educate the public to promptly seek
medical care if they display symptoms of a possible heart attack

Admission to the Chest Pain Center
So what is the process? When a patient presents to the emergency room at Citizens Medical Center with chest pain (see list of symptoms below), an EKG is done rapidly. Blood work is drawn, the patient’s history obtained, monitor applied, oxygen applied, and aspirin is given. Depending upon results of the EKG and laboratory work, it is determined by the emergency medicine physician if the patient is actually having a heart attack. If the EKG and laboratory work are not indicative of a heart attack, it may not mean the patient doesn’t have a heart problem. In less than 24 hours, further tests are done and a stress test is performed to determine if a blockage in the coronary artery exists. This process helps determine if a blockage in a cardiac artery exists but is not a heart attack. The process also allows the emergency room physician to determine that it’s safe to discharge a patient because a blockage in the coronary artery is unlikely.

About 70% of chest pain patients show no evidence of heart attack and won’t have to stay at the hospital for two to four days. The challenge is to identify which chest pain patients are experiencing a cardiovascular episode and to rule out the others, saving time and expense while making it easy for patients to determine the answer.

Signs and Symptoms of Cardiac Pain:
Chest discomfort:
Pressure
Squeezing
Heaviness

Symptoms that may occur with or without chest discomfort:
Shortness of breath
Sweating
Nausea / vomiting
Pain in neck, jaw, between shoulder blades
Pain in either arm
Weakness / lightheadedness
Blackouts / syncopal episodes

The elderly, diabetics, and women may not have any chest discomfort at all. Any symptom that only comes on with exercise and is relieved by rest needs to be investigated even if no chest pain or discomfort is present. Remember that the number one killer of Americans, both men and women, is heart disease!

Risk Factors:
Diabetes
High blood pressure - silent killer
High cholesterol: high LDL, low HDL
Smoking
Sedentary lifestyle
Obesity
Elderly > 65 years of age
Hereditary

Most of the risk factors are lifestyle choices. Patients cannot change their genetic makeup, but they can control or modify many of the other risk factors.

About the Society of Chest Pain Centers — The Society of Chest Pain Centers (SCPC) is an international professional society focused on improving care for patients with acute coronary syndromes and related maladies. Established in 1998, the Society is dedicated to patient advocacy and focusing on ischemic heart disease. Central to its mission is the question, “What is right for the patient?” In answer, the Society promotes protocol-based medicine, often delivered through a Chest Pain Center model to address the diagnosis and treatment of acute coronary syndromes, heart failure, and to promote the adoption of process improvement science by healthcare providers. SCPC is headquartered in Columbus, Ohio.

For more information on the Society of Chest Pain Centers visit www.scpcp.org or contact Robert Weisenburger Lipetz, Executive Director at (614)274-9710 or director@scpcp.org.