Emergency Cardiac and Cerebrovascular Care Services
The Paradise Valley Hospital Emergency Department features certified, advanced care for cardiac and cerebrovascular medical emergencies like severe heart attack and stroke. This means our teams of highly qualified emergency care physicians, nurses, and EMTs are specifically trained to quickly and effectively care for patients who are experiencing stroke or severe heart attack—conditions that require immediate treatment in order to be effective.
Successful treatment for stroke or heart attack also requires care from other hospital departments, such as radiology, pharmacy, and the cardiac catheterization laboratory. Paradise Valley Hospital’s advanced certifications mean that all of these different disciplines have been trained to work in conjunction with the Emergency Department in a tightly choreographed manner to deliver prompt and effective care, while remaining compassionate and patient-centered.
Certified Advanced Primary Stroke Center
The emergency department at Paradise Valley Hospital has been certified by the County of San Diego as a Primary Stroke Center. This means that we maintain the highest levels of prompt, quality care for the treatment of stroke where every second matters. After a rigorous onsite review in October 2018 Joint Commission experts evaluated our compliance with stroke-care standards and requirements, including program management, the delivery of clinical care, and performance improvement. We have been recognized by the American Heart Association/American Stroke Association with “Gold Plus” awards for the treatment of stroke and heart failure.
Designated STEMI Severe Heart Attack Receiving Center
As a San Diego County-designated severe heart attack (STEMI) receiving center, Paradise Valley Hospital emergency physicians and nurses coordinate with emergency response personnel to begin life-saving cardiac care before the patient even gets here.
“STEMI” is an acronym for ST-elevation myocardial infarction, a severe type of heart attack where there is a complete blockage in one of the coronary arteries, resulting in a stoppage of blood to a part of the heart. The longer that blood is blocked from reaching the heart, the greater damage is done.
This special designation as a certified STEMI receiving center is only given to hospitals that have proven their staff can meet stringent standards for cardiac care. Working seamlessly together, the Paradise Valley Hospital emergency and cardiac catheterization lab teams ensure patients receive an interventional procedure, such as balloon angioplasty, within 90 minutes or less of arriving at the emergency department. This time frame achieves the best outcomes for heart attack patients.
What is Stroke?
A stroke, sometimes called a brain attack, occurs when something blocks the blood supply to part of the brain or when a blood vessel in the brain bursts. The three most common types of strokes are ischemic, hemorrhagic, andtransient ischemic. An ischemic stroke occurs when a blood vessel in the brain is blocked by a clot, restricting blood flow and causing rapid brain cell damage. 87% of all strokes are ischemic. Hemorrhagic stroke occurs when a weakened blood vessel in the brain bursts, causing bleeding that increases pressure in the skull that damages the brain and destroys brain cells. These types of strokes are often caused by high blood pressure, aneurysms, or vascular malformations. Symptoms of hemorrhagic strokes often include sudden, severe “thunderclap” headaches, nausea, weakness, and altered consciousness.
Transient ischemic attacks (TIAs) are often called “mini-strokes.” They occur when blood flow to the brain is temporarily blocked, usually by a small clot. Unlike a full stroke, the blockage clears quickly on its own, so symptoms last only a short time. The symptoms of a TIA mimic a stroke; there are weakness, speech problems, numbness, and vision changes. But these symptoms usually last minutes to an hour, and always last less than 24 hours. Because symptoms of a TIA stop by themselves, this may lead the person who suffered a TIA to ignore the attack. But this would be dangerous because 10-15% of people who suffer a TIA will suffer a full stroke within three months. The highest risk of a full stroke is 48 hours after suffering a TIA.
Immediate Treatment is Key
Successfully surviving stroke is dependent on how quickly the patient receives care. So, it is important to recognize the symptoms of stroke and get the person to an emergency room as soon as possible. You can spot the symptoms of stroke by utilizing the BEFAST system. BEFAST is an acronym for:
B – Balance: watch for a sudden loss of balance.
E – Eyes: check for blurred or lost vision.
F – Face: look for an uneven smile.
A – Arm: check for weakness in one arm.
S – Speech: listen for slurred speech.
T – Time: call 9-1-1 immediately.
Calling an ambulance means that medical staff can begin life-saving treatment on the way to the emergency room. Stroke patients who are taken to the hospital in an ambulance may get diagnosed and treated more quickly than people who do not arrive in an ambulance.
Treating Strokes
Treating Ischemic Stroke
If you get to the hospital within 3-4.5 hours of the first symptoms or an ischemic stroke, you may get a type of medicine called a thrombolytic (a “clot-busting” drug) to break up blood clots.
Treating Hemorrhagic Stroke
Other medicines, surgery, or procedures may be needed to stop the bleeding from hemorrhagic stroke and save brain tissue.
Treating Transient Ischemic Attack (TIA)
Transient ischemic strokes are treated with anti-platelet drugs to prevent clotting if there is no atrial fibrillation, or rapid, irregular heart rhythm. Sometimes dual antiplatelet therapy (DAPT) is administered for a period of 21-90 days. DATP combines aspirin with other anti-platelet drugs for greater efficacy. Statins can also be prescribed to lower cholesterol and stabilize plaque.
Post-stroke Recovery: Stroke Rehabilitation
A rehabilitation care plan may include working with speech, physical, and occupational therapists.
- Speech therapy helps people who have problems producing or understanding speech.
- Physical therapy uses exercises to help you relearn movement and coordination skills you may have lost because of the stroke.
- Occupational therapy focuses on improving daily activities such as eating, drinking, dressing, bathing, reading, and writing.
What You Can Do to Help Prevent Strokes
Stop smoking!
Smoking increases your risk of stroke. Paradise Valley Hospital has a very effective smoking cessation program that can help you kick this habit. Contact our Center for Health Promotion at (619) 470-4346 to lean more.
Choose healthy foods and drink
Choosing healthy meal and snack options can help you prevent stroke. Be sure to eat plenty of fresh fruits and vegetables.
Eating foods low in saturated fats, trans fats, and cholesterol and high in fiber can help prevent high cholesterol. Limiting salt (sodium) in your diet can also lower your blood pressure. High cholesterol and high blood pressure increase your chances of suffering a stroke.
Maintain a healthy weight
Talk with your healthcare team about treatment options. Your doctor may recommend certain lifestyle changes, such as getting more physical activity or choosing to eat healthier food. These actions will help keep your weight under control and help lower your risk for stroke.
Treat heart disease
If you have certain heart conditions such as coronary artery disease or atrial fibrillation (irregular heartbeat), your healthcare team may recommend medical treatment or surgery. Taking care of heart problems can help prevent stroke.
Take your medicine
If you take medicine to treat heart disease, high cholesterol, high blood pressure, or diabetes, follow your doctor’s instructions carefully. Always ask questions if you don’t understand something. Never stop taking your medicine without first talking to your doctor or pharmacist.
What is a “STEMI” Severe Heart Attack?
A heart attack occurs when the blood flow that brings oxygen to the heart is reduced or cut off. If blood flow is reduced or stopped for too long, the heart muscle begins to die. This happens when coronary arteries that supply the heart muscle with blood flow become narrowed from plaque—a buildup of fat, cholesterol and other substances. This slow process is known as atherosclerosis.
Another way that blood flow to the heart can be blocked is when plaque within a heart artery breaks. A blood clot can form around the plaque, and this clot can grow large enough to block blood flow through the artery to the heart muscle. About every 40 seconds, someone in the United States has a heart attack.
A STEMI, “ST-elevation myocardial infarction,” is a complete blockage in a coronary artery. This is opposed to other forms of heart attack where there is partial arterial blockage, or where the blood flow is slowed. A STEMI heart attack is the most severe form of heart attack.
The Heart: The Pivotal Engine of the Body
The heart is the central hub of your cardiovascular system. Its primary role is to ensure that oxygenated blood reaches your brain, muscles, and vital organs. Without a high-functioning heart, the rest of the body begins to suffer from a lack of resources.
However, the heart is more than just a pump. It is deeply integrated with your nervous system and metabolic health. Chronic stress, poor sleep, and inflammation can all place an undue burden on this muscle. When you prioritize heart health, you aren’t just protecting one organ; you are supporting your cognitive function, your physical endurance, and your emotional resilience.
Common Warning Signs: Listen to Your Body
Gaining clarity on your health means learning to listen to these warning signs before they become an emergency.
Common red flags include:
- Shortness of Breath: Finding yourself winded during activities that used to be easy.
- Chest Discomfort: This may not always be sharp pain; it can feel like pressure, squeezing, or fullness.
- Persistent Fatigue: Feeling exhausted even after a full night’s sleep.
- Palpitations: The sensation that your heart is skipping a beat, fluttering, or beating too hard.
- Dizziness or Lightheadedness: Often an indicator of blood pressure fluctuations or circulation issues.
Tips for a Heart-Healthy Diet to Help Prevent Heart Attack
When it comes to functional medicine, food is information. What you eat tells your heart whether to promote inflammation or promote healing. To cultivate a healthy heart, focus on nutrient density and balance.
- Prioritize Healthy Fats: Try integrating Omega-3 rich sources like wild-caught salmon, walnuts, and flaxseeds, which help reduce arterial inflammation.
- Fiber is Fundamental: Soluble fiber found in oats, beans, and berries helps sweep excess cholesterol out of the body.
- Color Your Plate: The antioxidants in brightly colored vegetables (like leafy greens, beets, and bell peppers) protect your blood vessels from oxidative stress.
Take the Next Step Toward Heart Clarity
Heart health is not a one-size-fits-all journey. Your genetics, your environment, and your lifestyle all play a role in how your cardiovascular system functions.
Take care of your heart’s future. Paradise Valley Hospital’s Center for Health Promotion offers free health education classes and screenings to help you make lifestyle choices to help you develop and maintain a strong, healthy heart.