Peter Franklin, a radiologist from Boston, was vacationing with his wife Kathleen in Marathon when he felt his first chest pains. Alarmed, the couple went to the closest hospital for a checkup and from there to Mount Sinai Heart Institute.
But that ambulance trip to Miami Beach was only the beginning of his roller-coaster journey to health.
While in the cardiac catheterization lab, Franklin, 63, went into severe cardiac arrest and was without oxygen for almost 15 minutes. He was lucky, though. The quick action by the cardiologists at Mount Sinai saved his life.
“If I had not been in this hospital with these doctors, I would not be having this conversation right now,” said Franklin, from his hospital bed weeks later. “Essentially I should have died right there on the table.”
Added Kathleen: “He’s completely and miraculously intact, but it was a real wake-up call.”
Franklin’s story of cheating death is a perfect example of how far medical treatment of heart attacks has come. Ultimately, however, it is also the story of how seeking help quickly can make all the difference.
“Minutes count,” said Dr. Nirat Beohar, director of the Mount Sinai cardiac catheterization lab and one of two doctors who, along with five nurses and five technicians, worked on Franklin. “We see enough of these that we are very attuned to what we must do.”
Franklin went into cardiac arrest on the table, just as Beohar had noticed that Franklin’s left anterior descending coronary artery was completely blocked. Immediately, the medical team dilated his artery and placed a stent to preserve it. With an AngioJet, a high-powered vacuum, they sucked up the clot. They also used a pump to help stabilize blood flow to the heart.
Once Franklin was stabilized, the team froze the patient to 34 degrees Fahrenheit for 24 hours to preserve brain function and stop the body’s normal inflammatory response. Later, Franklin was slowly “warmed.” Eventually he was able to respond to commands and after six days moved to a regular room.
“If all these pieces hadn’t come together in quick succession,” Beohar said, “he might not have been telling this story.”
Dr. Yvonne Johnson, emergency director of the Heart Attack Unit at South Miami Hospital and co-medical director of the hospital’s Emergency Center, says South Floridians are fortunate when it comes to treatment for heart attacks. Ten Miami-Dade hospitals and six fire-rescue departments are part of a STEMI network that, since 2007, has committed to getting heart attack victims to a cardiac cat lab in 90 minutes. Broward has a similar network.
Such speedy response time, as exemplified in Franklin’s case, can make the difference between life and death, recovery or irreparable loss of heart muscle.
“As an E.R. physician, what I’ve seen in the past 20 years is amazing,” Johnson said. “What we are able to do, the kind of care we can give, makes all the difference.”
New guidelines for treating STEMIs — the acronym for ST Segment Elevation Myocardial Infarction, or the most severe type of heart attack — were updated in December by the American Heart Association and the American College of Cardiology. The guidelines, last published in 2009, detail the best treatment plan that doctors should follow.