SOUTHEAST MISSOURI HOSPITAL OPENS CHEST PAIN CENTER

Clyde Harvel remembers the pain. "My heart felt like it was trying to come out of my chest.

"It felt like somebody was kicking me and I was feeling it inside," said the 37-year-old Anna, Ill., man. "It was a real jarring thing. It was scary."

Harvel said he awoke with the severe chest pain around 3:30 a.m. on Jan. 11. He ended up in Southeast Missouri Hospital's new Chest Pain Center and a day later he underwent triple bypass surgery.

"I don't think I could have gone anywhere else in the country and gotten any better care," said a recuperating Harvel in a telephone interview from his home Tuesday afternoon.

Hospital officials officially announced the opening of the Chest Pain Center at a press conference Tuesday morning, although the center began operating on Jan. 5.

It consists of a two-bed Chest Pain Center within the emergency services department; a 19-bed Chest Pain Observation Unit on the hospital's second floor; and a public education program to encourage people to recognize early warning symptoms of a possible heart attack and seek immediate medical attention.

During its first month, the Chest Pain Center saw 80 patients, including Harvel. Eighteen patients were admitted to the Chest Pain Observation Unit, officials said.

Harvel said that when he awoke with the chest pain, his first thought was that it was heartburn. "I just refused to believe that I was having any kind of heart problems, although that was in the back of my mind."

It wasn't until 4 or 4:30 a.m. that he thought about going to the hospital. Harvel's wife drove him to Southeast Missouri Hospital.

Harvel said he was lucky. "I had no damage to my heart." A mental health technician, Harvel said he expects to go back to work in mid-April.

James Wente, administrator of Southeast Missouri Hospital, said the center, designed to provide early intervention in heart attack cases, is "a natural extension" of Southeast's 10-year-old heart program. The hospital began doing bypass surgery in 1984.

To date, over 2,200 open heart procedures have been done at the hospital, including about 300 last year, said Wente.

He said the new Chest Pain Center "reaffirms the commitment that Southeast has to reducing heart attack deaths by bringing together staff, equipment and treatment protocols and making them available to patients on a pathway of care that will meet their individual needs.

"The key is early intervention," said Wente.

Persons suffering from chest pains are first seen in the center by emergency services nurses, who are specially trained in cardiac care.

Dr. Michael Kolda, chief of emergency services at Southeast, said that when a patient enters the center, EKG and laboratory tests are run, and IVs may be started.

A specialized team decides, after conferring with the patient's attending physician, what type of medical care is needed.

In some cases, patients would be admitted to one of Southeast's two cardiovascular laboratories for procedures such as balloon or laser angioplasty.

Others may be admitted to the coronary care unit or require bypass surgery.

Where warranted, patients are sent to the Chest Pain Observation Unit for additional testing and careful observation for up to 23 hours, Kolda said.

"The Chest Pain Center removes chest pain patients from the mainstream emergency department," explained Kolda, "and provides immediate triage, evaluation and treatment."

Hospital officials said the center is patterned after successful chest pain facilities in Long Beach, Calif., and Baltimore.

The first chest pain emergency room in the nation was established in 1981 at St. Agnes Hospital in Baltimore.

Southeast Hospital officials stressed the importance of educating the public to the warning signs of a heart attack.

"Education is really the key to this program and its success," said Linda Heitman, clinical nurse specialist and coordinator of the hospital's Regional Heart Center.

"We want to teach the public that chest pain is a warning sign," said Heitman.

Symptoms of a heart attack include a squeezing pain, pressure or tightness in the chest.

"One of the main problems in heart attacks is people tend to deny their symptoms," said Kolda.

The average heart attack victim waits three hours before getting medical care, said Dr. William LaFoe, chairman of Southeast's cardiovascular services committee.

Prompt treatment is critical in heart attack cases, he said. "Early intervention minimizes damage. Most heart attacks are caused by a blood clot and when a blood clot blocks a coronary artery, an area of heart muscle is destroyed."

How fast circulation can be restored determines whether or not the patient recovers, he said.

This year, an estimated 1.5 million Americans will suffer a heart attack, and about one third of them will die, hospital officials said.

LaFoe said that nationwide 23 percent of heart attack victims die before they reach the hospital. The longer the wait, the greater the risk, he said.