Earlier treatment for patients with blood clots in the heart

The annual 2,000-3,000 Danes suffering a large blood clot in the heart are today receiving the correct specialist treatment much quicker, which increases their chances of surviving the dreaded condition significantly, compared with just ten years ago.

The reason for this is the introduction of ambulance helicopters and ambulances with better examination equipment and that patients are today transported directly to the large heart centres, for example at Rigshospitalet, instead of having to first visit an accident and emergency department at the local hospital, which was usual practice at the turn of the millennium.

On 1 June 2011, Rigshospitalet took over Gentofte Hospital's catchment area for treatment of large blood clots in the heart with balloon angioplasty. At the same time the acute service grew from having to deal with a catchment population of 1.6 million to 2.6 million people.

Treatment of large blood clots in the heart with balloon angioplasty requires rapid life-saving response and highly specialised treatment in an efficient, streamlined organisation. Every minute counts for acute, critically ill heart patients because the heart tissue rapidly deteriorates and the risk of death or disability increases considerably if treatment is delayed.

Doubling the number of patient admissions with acute myocardial infarcation (AMI) who have received balloon treatment (percutaneous coronary intervention, PCI) has been a huge organisational challenge. Despite the large increase in the number of acute patients, they are receiving treatment more quickly. The time lag up to treatment has dropped by 22%. According to Søren Boesgaard, Head of Department at the Department of Cardiology at Rigshospitalet, time is crucial and an important, internationally acknowledged indicator of the quality of treatment of large blood clots in the heart because mortality is greatest in the first hours. Treatment courses for heart patients have fallen by an average 82 minutes.
 
Today 75% of all patients come directly to Rigshospitalet because they, or others ring the emergency services and are diagnosed in the ambulance via direct tele-medical contact to Rigshospitalet. This means that a medical decision regarding whether the patient should be transported to Rigshospitalet can actually be made in transit , instead of at the local accident and emergency department as previously. The full effect of the ambulance helicopter and the short transport time is also important. In addition both physicians and nurses at the Cardiology Laboratory and Coronary Department  have shown great flexibility in managing the large number of acute patients.