JoAnn Chapman, 70, was driving from her farm near Doolittle, Missouri, to a friend’s house in Richland when her chest started to hurt.

 Lake Regional Health System is the only hospital between Columbia and Springfield that is a state-designated center for all three time critical diagnoses: trauma, stroke and heart attack. In this special series, learn how Lake Regional’s achievement is saving lives throughout mid-Missouri.

JoAnn Chapman, 70, was driving from her farm near Doolittle, Missouri, to a friend’s house in Richland when her chest started to hurt.

“Tippy, I’ve got that indigestion again,” she told her beagle, riding along with her.

For weeks, Chapman, a retired teacher, had felt tightness and burning in her chest. It would come and go, but this time was worse.

“It was hurting so bad, it was crushing me,” she said.

Time is Muscle

She didn’t know it, but Chapman was having a heart attack. During a heart attack, also called a myocardial infarction, there’s a blockage in blood flow to part of the heart. The amount of damage to the heart muscle — and how quickly it happens — depends on the size and location of the blocked vessel. It also depends on whether the blockage is partial or complete.

“The faster a heart attack patient seeks treatment, the better their chances are for survival and a good recovery,” said Julia Hudler, Lake Regional’s STEMI coordinator. (STEMI stands for “ST segment elevation myocardial infarction,” a particular kind of serious heart attack.) “We say, ‘Time is muscle,’ because the more quickly we restore blood flow, the more heart muscle we can save.”

“Take Her to the Lake”

As Chapman’s pain worsened, she pulled off the road into a parking lot and called her son, Geoff Heavin. Chapman told Heavin she was in Waynesville and something was wrong — she didn’t know what. Then she quit talking.

Heavin is an emergency medical technician paramedic for MU Health Care’s ambulance service. So he knew what to do. He called Pulaski County dispatch and asked them to ping his mother’s phone to find her. Then he took off from Doolittle to Waynesville. When he arrived, his mother had just been loaded into a Mercy Life Line Air Medical Service helicopter. Heavin jumped inside and told them to take her to MU. But the flight nurse, Jennifer Isenburg, told him no, they were going to Lake Regional. Heavin started to argue, but Isenburg pointed to the monitor — which showed Chapman’s heart was in serious trouble — and said: “You know time is muscle. The lake is 15 minutes closer.”

“You’re right,” Heavin said. “Take her to the lake.”

Beating the Clock

Treatment for heart attack requires opening the blocked artery in a cardiac catheterization lab. A doctor threads a thin tube with a tiny balloon through blood vessels to the blockage. The balloon is then inflated to push plaque aside and restore blood flow. “Door-to-balloon” time measures how much time passes between the patient arriving at an emergency department and the care team restoring blood flow. Nationwide, the median door-to-balloon time is 60 minutes.

“We’re proud to have a median door-to-balloon time at Lake Regional of 44 minutes,” Hudler said. “That is better than nine out of 10 hospitals nationwide.”

Chapman’s flight took 18 minutes. When she landed, Lake Regional’s heart attack team met her at the door. Chapman was in cardiogenic shock, which happens when the heart can’t pump enough blood to the body. It is fatal if not treated immediately. The team started her on medications for this life-threatening condition while going to work on finding the cause of her heart attack. Testing revealed the artery on the heart’s right side was completely blocked. Lake Regional Cardiologist Zubair Khan, M.D., FACC, quickly inserted a balloon to open the artery and then placed a stent to hold it open.

Fifteen minutes after her arrival at Lake Regional, Chapman had complete blood flow restored to her heart muscle and her cardiogenic shock started to improve. She went home just two days later, on April 8, 2018, and her heart was back to normal functioning.

“The people and the care were just wonderful,” said Chapman, who is happy to be back home on her farm, where she cares for several rescued dogs and cats. Her son the paramedic agreed she went to the right place.

“I was very impressed with the lake hospital,” Heavin said. “They understand the timeframes that have to be met, and it worked flawlessly.”

Level II STEMI Center

To help heart attack patients receive the best care possible in the shortest amount of time, the State of Missouri has identified hospitals that are well-equipped to treat heart attack. Lake Regional was among the first hospitals to become a Level II STEMI Center this spring.

Because Lake Regional has earned this designation, EMS providers can bring heart attack patients to Lake Regional. In addition, rather than having to transfer heart attack patients on to another care center, Lake Regional can receive transfers from other hospitals.