Within 61 minutes of arriving at the Nethercutt Emergency Room at Santa Monica-UCLA Medical Center following a heart attack last October, Jay Smith was recovering in the intensive care unit. A cardiac catheterization team had quickly unblocked an artery in his heart and had inserted a stent that kept the artery open. Smith, a Pacific Palisades resident, certainly benefited from the fact that SM/UCLA is designated as a special receiving center for heart-attack patients. The designation came from the Department of Health Services and Los Angeles County Emergency Medical Services Agency after the hospital met established criteria for best practices in heart-attack care. The center has a 24-hour cardiac catheterization team. In retrospect, the 69-year-old Smith said he should have left for the hospital sooner that nearly fatal day last October. He woke at 4 a.m. and felt tightness in his chest, but after going to the bathroom, decided it wasn’t that serious and went back to bed. The semi-retired toy inventor awakened two hours later and the tightness in his chest was still there. Smith got up and looked up his symptoms on Web MD on the Internet. He found that it could either be an allergy or coronary artery disease. Deciding it wasn’t either, he returned to bed, sleeping until 8 a.m. When he awoke, the tightness was finally gone, and he went to exercise at the Bel-Air Bay Club. As soon as he started, the tight feeling returned, and he walked home and told his wife, Susan. She insisted that he visit the family doctor, Richard Kennedy, who is located about 10 blocks from the Santa Monica-UCLA Medical Center. Smith wasn’t in a hurry. ‘I showered and changed,’ he said. ‘The tightness was there, but it wasn’t a real pain.’ He explained that the pain felt more like a muscle soreness that comes when one has exercised too much. At the doctor’s office, he was given an EKG and Kennedy asked Smith to tell him on a scale of 1 to 10 how much his chest hurt. ‘One,’ Smith remembers telling his doctor and noted, ‘it was hardly noticeable.’ However, based on the test results, Kennedy told him he was having a heart attack and sent him to the emergency room. ‘They were like an army on me,’ Smith said, recalling how doctors inserted a catheter into a groin artery and snaked it to the heart, breaking up the blockage. ‘I was partially conscious during the procedure,’ he said, ‘but it didn’t hurt.’ Afterwards, Smith spent two days in the intensive care unit, and an additional day in the hospital. ‘I got in early enough [for treatment] so that I felt pretty good,’ he said. Afterwards an echocardiogram determined that Smith had ‘dodged a bullet,’ meaning that he had been treated fast enough that there was no damage to the heart muscle. He was later told by doctors that with heart attacks ‘minutes are muscle,’ which means the faster the blockage is dealt with, the less damage is done to the heart muscle. Smith urges others who feel something strange in their chest not to wait like he did, but to call paramedics immediately or go straight to an ER. ‘You’re way ahead of the game getting in there quickly,’ he said. If he could do the day over, which he now describes ‘like a bad day at the office,’ Smith would have called the paramedics while still at the gym. ‘The goal is to get the patient’s blocked vessel open within 90 minutes of the first electrocardiogram indicating a heart attack,’ said Dr. Wally Ghurabi, the medical director at the Nethercutt Center. ‘Paramedics who perform the EKG in the field can transmit the results to our center, where our emergency physicians can then activate our Cath Lab before the patient arrives.’ Smith and his wife have two grown children: Stephanie, who is a documentary film director, and Spencer, who manages the open checks division of Hanover Media Insight Services.
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