Heart Attack? Doctors Soon May Have an App for That

There are apps that turn your smartphone into a metal detector, a musical instrument and a GPS system, and now there’s an app that may help doctors save your life if you’re having a heart attack.

The app, which was designed by engineers and critical care physicians, helps doctors rapidly diagnose certain kinds of severe heart attacks, called STEMIs, before patients get to the hospital.

The app currently is in the experimental stage, but it has undergone field testing.

In a STEMI heart attack, which stands for ST segment elevated myocardial infarction, a clot completely blocks blood flow to the heart. About a quarter of a million people have STEMIs each year in the United States.

These kinds of heart attacks create a unique pattern of pulses when doctors hook up patients to an electrocardiogram, or EKG, machine, which measures the heart’s electrical activity.

The problem is that doctors need to see the EKG reading, which is called a tracing, to properly diagnose the attack and quickly assemble the team of specialists that is needed to clear the clot.

There are proprietary systems that use EKG machines hooked up to modems to send images back to hospital computers, but those systems are expensive and not all hospitals and EMS systems can afford them.

As an alternative, paramedics can use their smartphones in the field to snap a picture of the tracing and send it to a doctor at the hospital via email.

But as anyone who has ever tried to email a picture from their phone knows, it’s far from foolproof. Large, high-quality images — the kind doctors need to see — can take several minutes to send and receive.

To address the issue, Dr. David Burt, an associate professor of emergency medicine at the University of Virginia, challenged a class of systems engineering students to develop an app that could shrink images to make them faster to send, but still maintain the clarity needed for diagnoses.

“It’s very easy to use,” Burt said. “You hold it over the EKG tracing, you snap a picture.” Hitting a button sends the image. When it’s finished, the app shakes and makes noise to alert senders to the successful transmission.

“It’s very simple but we want it to be very rugged, so that it’s kind of like a hammer — it always works,” he said. He also wants to offer the app at no cost to doctors and hospitals.

So far, Burt said, they have tested the app more than 1,500 times using different wireless carriers in a city.

They also have pitted the app against the alternative method of using an iPhone to email a picture. In that study, the app consistently sent images within four to six seconds. Emailed images could take nearly two minutes to go through. The app failed less than 1 percent of the time, while the emailed images flopped between 3 percent and 71 percent of the time, according to the study.

The study is scheduled for presentation Friday at an American Heart Association meeting in Baltimore. Studies presented at medical conferences are considered preliminary because they haven’t yet undergone the scrutiny required for publication in a peer-reviewed journal.

Dr. Iltifat Husain, founder of the iMedicalApps website, which keeps up with news about technology in medicine, said he was impressed by the app, but also by how thoroughly the team has been testing it. Husain estimates that less than 1 percent of apps that are developed for doctors are field tested to see if they actually work.

“Something like this would have to be tested before it was put to use because of how critical the information is that you’re relaying,” said Husain, who was not involved in the research.

Husain, who also is an emergency medicine resident at Wake Forest University in Winston-Salem, N.C., said the time the app shaves off image transmission could be critical.

“The longer you wait, the more heart muscle dies, so every minute counts,” he said. “Actually, every second counts.”

Surviving a STEMI depends on how quickly doctors can restore blood flow, which often is done by snaking a catheter up to the heart and using a small balloon to clear the clot.

“We’ll get an EKG reading and the ER physician will activate the cath lab. Once you activate it, a huge team has to be assembled,” Husain said. “If it’s overnight, people are sometimes coming in from home. If you can get someone coming in from home five minutes faster, I think it’s a big deal.”

More information

For more about heart attacks, head to the U.S. National Heart, Lung, and Blood Institute.

SOURCES: David Burt, M.D., associate professor of emergency medicine, University of Virginia, Charlottesville; Iltifat Husain, M.D., second-year emergency medicine resident, Wake Forest Baptist Health System, Winston-Salem, N.C., and founder, iMedicalApps website; May 17, 2013, presentation, American Heart Association meeting, Baltimore

Read more at http://www.philly.com

Monday – Five Weeks Post-op

day-mon

Today went pretty well.  DH did some computer work with an employee.  After about 2 hours, DH rested his eyes for a bit while the other guy finished up.

I took the opportunity to go out to do some grocery shopping.  Exciting stuff!

A few phone calls, then DH napped some more – a bit of computer and you know the rest!

Girl Scout Thin Mint cookies

Girl Scout Thin Mint cookies (Photo credit: Wikipedia)

Sometime before this adventure started, DH had ordered 2 boxes of Girl Scout cookies.

Those arrived this evening and DH said he’d have “just one”.

I didn’t check how many he had but I saw that 4 (the typical serving size for Thin Mints) is 125 mg of sodium.  Possible trouble looming.

Maybe I’ll have to sacrifice myself and eat them all first 🙂

day-tues

Today was a pretty good day.  DH actually did some more work got a testimony ready to file, then some napping.  He went out with a friend to meet some others and actually had half a cup of coffee for the first time since surgery.

While he was out, I went to bell rehearsal to sub for someone else.  A very odd feeling to be subbing in my own group but they’re getting ready for a festival and someone has to ring my position – and it can’t be me.  I won’t be able to be away overnight for a while.

It was nice to be back, even briefly 🙂

day-wed

Up early in the morning for the stress test on the treadmill at the cardiologist.  I dropped DH off at the front door.  By the time I’d parked and gotten upstairs, he was already hooked up to the monitors but they wouldn’t let me go in.

Apparently, he passed with flying colors, all the way up to a 7% grade so he can start cardiac rehab as soon as we can get it set up!

On the way home, we saw my mom out walking so pulled over to say hello.  She was on her way to the library.  She had an appointment with her oncologist next Wednesday and she had been dithering about changing that in case DH’s rehab was on Wednesday mornings.  I told her not to change it – she might change TO the rehab date.  As it turned out, the oncologist had cancelled her.  Problem solved.

We decided to be brave and went to Bob Evans for breakfast.  DH did fairly ok with veggie omelet, egg beaters, fruit plate and dry whole wheat toast.  Another step in getting out into the real world again…

day-thurs

Last night didn’t go well.  I tossed and turned all night.  DH started trying to sleep in our room and went to the recliner about 1:00am, then back to the room about 4:00am.  About 8:00am he was in the recliner again so I guess he didn’t sleep well, either.

The day was like most days – a lot of napping and working.

DH called rehab and he can’t start for 2 weeks.  A bit disappointing 😦

I cleaned out our pantry and got rid of all the canned foods with sodium in them.  I took some to my mom, then took the rest to church to send to Western Fairfax Christian Ministries.

I went to church choir.  They’re getting ready for Holy Week and Easter so there’s lots of new music to learn.  I’m starting to feel less mole-like.

day-fri

Another lazy day.  We were going to go to the mall to walk but work and naps got in the way.

DH is sitting in his recliner listening to some app that will teach him Spanish.

Our son came home and DH actually went with me to Union Station to pick him up from the train.  I parked as close as I could so it was a short walk to the escalator, then another walk, another escalator and a longer walk.

DH was hungry so we went to get some Jamba Juice.  Even though the store was open, they said that they were cleaning up and closed.  DH went into Starbucks against my better judgement and got some kind of strawberry muffin thing.

On the way home, he wanted to go to McDonalds so I went through the drive-through and got 3 shamrock shakes, a grilled chicken sandwich for DH and a quarter pounder, no cheese for me.

Going out into the world is going to wreck all my careful food planning over the last 4 weeks!

day-sat
I woke up at 4:00am with a raging headache, possibly from that shamrock shake.  I’m not used to all that sugar any more 😦  It’s too bad – that’s about the only thing I really like(d) at Mickey D’s.  Oh, well.

At 11 we had our first Mended Hearts meeting.  That went pretty well.  I actually talked some – DH, of course, talked more.  I found it ironic that the snacks included no coffee but the raffle gift was a coffee cup.  HMMM…

It was good listening to other patients and caregivers talking about some of the issues we’ve gone through.

day-sun

 

Today was a take-it-easy day, a bit of TV, napping and playing piano duets with our son.  At night, we took him back to the train station.  Later, DH said that his chest was hurting a bit, probably from so much walking in the train today and Friday and the walking through the parking garage and hospital on Saturday.

Hopefully, a little Tylenol will help.

Next report next Monday…

Salt and Battery

Sorry for the pun-ny title again!  Like our new diet, this post is really low/no salt.  It’s just a followup on our Monday car adventures and has nothing to do with heart stuff so feel free to stop here.


My plan had been to get contact AAA on Tuesday for either a jumpstart or tow but it was one of those icy/cold/freezing rain days so I put it off until Wednesday.  I didn’t really have anywhere to go, anyway.

Wednesday morning, I tried my car again, just in case.  Nothing.  I tried DH’s car, too.  If his worked, I might follow the tow truck and use that.  Nothing for his, either.  It hadn’t been driven since it came home from the ER.  <sigh>

I used my AAA app to contact them and sat in the car to wait.  I didn’t want to rile Mimi up any more than necessary. Joe, the Advanced Automotive driver dispatched by AAA called DH about 15 minutes later to say that he was about 2 minutes away.  I’m not sure why he didn’t call me, though.

He took a look under the hood and asked me the usual questions if I’d left the lights on (DUH), had been listening to the car radio while waiting, etc.  I have way too much experience from living in Milwaukee to run down a battery like that.

He gave it a short boost and the car started.  Hooray!  He asked me to turn it off and start it again.  Nothing.  Another jump and another start.  He checked the alternator.  That was fine.

He had three options: tow the car to a mechanic, get a jump start and drive to a mechanic or he could replace the battery for $125.  A no-brainer, I chose replace the battery.  He said it would be about 30 minutes, so I went back inside.

After about 10 minutes, he knocked on the door – and riled up the dog, just what I was trying to avoid – and said he’d never replaced the battery on a Cruiser.  To do so, he’d have to remove the air filter and several hoses.

I went out and took a look.  The hoses looked fairly important so I told him I’d go with the second option – jumpstart and drive to the mechanic. I was very impressed with his honesty.

I finally got to Fair Oaks Chantilly Chrysler without incident, checked in and hunkered down with my iPad and coffee.  90 minutes later, they told me everything had checked out and they had a new battery.  Their’s was only $120 – unfortunately, all the other electrical checking was another $175 😦  Still worth it to have a car that starts.

A quick stop at Walmart for essential dog food and home to find DH napping.  Time for a nap myself!