Where do broken hearts go?

There are lots of amazing things a person sees in their lifetime. Some are lucky enough to be present when a life is brought into the world, then there are simple things like a stunning view, but few get to see a life saved right in front of their eyes. I was extremely lucky because I saw it more than once, and each time I was left in awe.

Time for a quick physiology lesson – your heart has blood vessels all around it, sometimes cholesterol can build up in these vessels and that constricts the flow of blood, similar to gunk building up in your water pipes at home which result in a blocked sink or washing machine. When this happens to your heart it is known as an MI: a Myocardial Infarction. Infarction meaning an obstruction to oxygen rich blood, causing the death of tissue in that area of the heart. This is a very simple explanation, and there are other causes of narrowing of the blood vessels, but it will hopefully help to make sense of the rest of this post.
Percutaneous Coronary Intervention, or PCI. It’s an instant life saving procedure. Basically, a surgeon places a spring like device, known as a stent, into a narrowed blood vessel then inflates a balloon inside it to open up the spring. Once the balloon is deflated, the spring keeps it’s new, enlarged, state and blood flow is improved.

We were allowed to see that happen, live!

When we received a call to a chest pain we always did a 12 lead ecg. This gave us a rough idea what was going on, but we weren’t cardiologists. If we had suspicions, we had the ability to transmit the ecg to the cardiac dept at the local hospital for examination by someone who knew a whole lot more than us. If they deemed it necessary, they called us to ask for more information and, if they diagnosed a narrowing of an artery, we were diverted to the PCI lab at the hospital. By the time we arrived with the patient the staff were all prepared and ready to go. The patient was transferred to the hospital trolley and wheeled through to the procedures room. The surgeon nearly always asked if we wanted to stay to watch. If circumstances allowed, we’d stay. We would be ushered into a small room, where we could watch proceedings through large windows and on large monitors. These monitors showed the patient’s live ecg, and x-ray type images of the process, again, in real-time.

The surgeon inserts a tube, usually into the femoral artery in the patient’s thigh, then advances it towards the blockage, before inserting and dilating the stent. Watching the almost immediate change in the cardiac rhythm was amazing. To think that, without intervention, the patient may have had a catastrophic cardiac event, possibly with a sad outcome, had this quick and relatively simple procedure not happened. It was real-time lifesaving, and we had been a part of it. Someone was going to live longer. Its a simple thing, with a huge outcome.

We’d head back to our ambulance knowing we’d been part of something amazing, and the effect was (literally) life changing for the patient. It was so quick and routine that sometimes we’d become a bit blazè about it, but we’d remember soon enough how special what had just happened was.

This post gives a very simplistic explanation of the PCI process, I’m no cardiac specialist and this is not about the medical aspects of PCI. The point of this post is purely to explain that, life is valuable, and to see a life undoubtedly saved right in front of you is indescribable.

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