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Chest Pain Center opens in Tualatin

by: JAIME VALDEZ - Nan Beckwith, a registered nurse in the Legacy Meridian Park Medical Center Chest Pain Center, holds a telemetry cardiac monitor. A week after marking its 40th anniversary, Legacy Meridian Park Medical Center expanded services to respond to the most common cause of mortality for American men and women.

The Chest Pain Center is an eight-bed facility just across the hall from the emergency room, staffed by a full-time cardiac nurse and nurse practitioner and equipped with a full “stress test” room.

The serene wing feels far removed from the hustle and bustle of the emergency department, a haven of sorts for patients concerned about symptoms of heart disease, but who do not appear to be having a heart attack.

After a heart attack has been ruled out through electrocardiogram, or an EKG test, and after blood work shows troponin levels are normal, specialists consider other factors: whether there is a history of cardiac disease in the family, for one.

“Most patients we keep six to eight hours to do the EKG and troponin tests again,” said Carol Palmer, director of patient care services. “Those patients would come into the Chest Pain Center.”

Patients in each room are monitored at all times, and the wing comes equipped with a “crash cart” defibrillator, allowing emergency response if a patient should suffer cardiac arrest while staff is attempting diagnosis.

Although Meridian Park has long considered itself a “virtual chest pain center,” limited resources meant that not every patient concerned about heart attack risks would get a stress test, or the kind of follow-up observation that puts staff at ease.

by: JAIME VALDEZ - Legacy Meridian Park Medical Center Chest Pain Center nurses Nan Beckwith and Kristen Ash adjust a telemetry cardiac monitor.The new center will serve an estimated 700 people each year, Palmer said, and in many cases allow the risk of heart attack to be identified earlier.

“We can say, ‘You’re not having a heart attack,’ and it’s not necessarily fine,” Palmer explained.

After all, chest pain can hint at a host of health risks, such as a blocked artery. And the very term “chest pain” is an oversimplification.

“Chest pain isn’t just your chest hurting,” Palmer said. “Your elbow could hurt, your jaw could hurt, your neck, your shoulder blades — there are so many different ways chest pain presents.”

This is especially true with women.

While heart disease is popularly considered a higher risk to men, fatality rates show it’s an equal-opportunity killer. The differences in symptoms between genders can be explained in part by the fact men tend to suffer blockage in coronary arteries, while in women, the issues tend to be microvascular, according to the American Heart Association — a matter of coronary artery disease versus microvascular disease.

Rapid response, longer observation

Palmer recommends calling 911 at the first signs of concerning pain or sensations.

“The ambulance can start treating you there, and (the emergency response team) can call into us, so we can have a team here waiting when you get here. You really save time,” Palmer said.

“We have every kind of test and treatment available, short of open heart surgery, we can do here,” she said, adding that the catheter lab is just down the hall, allowing for immediate angiogram referrals.

“We want to be able to bring people in so we can provide them with a risk-stratified diagnosis that can say that’s a cardiac condition as opposed to not,” she added.

The center is staffed by telemetry nurses, but lacks the “fast turnover” of the emergency department, instead allowing patients a longer period of rest as their troponin levels are monitored.

From conception to ribbon-cutting, the process took about three years and involved a nearly million-dollar fundraising effort from within the community.

Above all, Palmer considers the center a tremendous public health resource.

“Our aim is that within 12 to 16 hours, we can get you out of here with a diagnosis,” she said.



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