September 23, 2022

Time Is Heart

Marco Spaziano, MD, MSc

It’s 4:00 AM. You are suddenly awoken by a strong pressure in your chest. You’ve never felt this before, or certainly not this intense. You start to sweat and are having trouble breathing. Your loved one calls 911. The paramedics arrive, quickly take your vital signs, and perform an electrocardiogram; they suspect you’re having a heart attack, a big one. Start the clock.

Why? Because you’re possibly having a major heart attack, clinically described as a ST-Elevation Myocardial Infarction (STEMI), meaning one of the three principal arteries that supply your heart’s muscle is totally occluded. Your heart, the muscle that circulates oxygenated blood throughout your entire body, is inadequately fueled and actively suffering. Time is muscle.

Over 800,000 Americans have a heart attack every year- the leading cause of death globally. Every minute a principal coronary artery remains acutely blocked directly increases mortality. For patients in whom the culprit artery is opened within 90 minutes, the risk of death is as low as 4%. However, in those for whom it takes over 90 minutes to unblock the culprit artery, the risk of death increases to over 12%. And in those with a delay of over 150 minutes, the risk of death is as high as 20%. That's one in five patients. The sooner we unblock that artery, the sooner we’re able to restore blood flow to the part of your heart that is suffering, and the higher the likelihood that region can remain viable cardiac tissue rather than irreversible scar. Time is heart.

Scholz et al. EHJ. 2018;36(13):1065-74

What you may or may not be surprised to learn is that until now, healthcare systems across North America haven’t actually had a fully integrated infrastructure to coordinate the timely care necessary for saving lives. Instead, healthcare professionals including paramedics, emergency physicians, interventional cardiologists, nurses, and technologists, have had no choice but to rely on legacy systems like pagers, paper, fax machines, and text messaging, to coordinate logistically complex, time-sensitive, and life-saving care.

Major heart attacks can occur at any time of day, and with both patients and healthcare providers being at home from the moment of symptom onset, the challenge is one of speed and coordination. The diagnosis needs to be validated, the intervention team needs to be mobilized, and the patient needs to be transported to an intervention-capable center for advanced cardiac care. Only once entering the operating room and identifying and unblocking the culprit artery, can you finally stop the clock.

At Stenoa, we’re building the first cloud-based platform for mission critical care coordination, secure communication, and real-time analytics of heart attacks, the leading cause of death globally. By building intelligent and intuitive care coordination software for when it matters most, we’re empowering care providers to optimize their operational efficiency, and that time is heart.