Imagine: You are playing a weekly pick-up basketball game with friends. You are in great shape — trim, fit and competitive. But suddenly, you’re short of breath. You sit on the sideline, something you’re not known to do. Your friends take notice. When they ask what’s wrong, you say, “Call 911.” You don’t remember anything else until you wake up three weeks later in the cardiovascular intensive care unit (CICU).
John Harrity suffered a complex heart attack. The 50-year-old Washington lawyer, husband and father of two, was rushed to Inova Fairfax Hospital, where he had a second cardiac arrest. His condition deteriorated into cardiogenic shock, an often fatal condition that can quickly progress to multi-organ failure. His heart was unable to pump enough blood to meet his body’s needs. Timely decision-making and intervention were critical to survival. Nationwide, half of all patients who experience cardiogenic shock die – a rate that has held steady for nearly two decades. It is the most common cause of in-hospital mortality following a heart attack.
Fortunately for John, improving those outcomes has been a major focus at Inova Heart and Vascular Institute, where a new model of care is saving lives. IHVI’s multidisciplinary Shock Team unites specialists from interventional cardiology, cardiovascular surgery, advanced heart failure and critical care to quickly gather information and recommend the best treatment for these critically ill patients.
John was successfully resuscitated, and the team performed several procedures to treat his multiple emergency heart issues.
While recovering in the CICU, things again took a turn for the worse. John experienced a lung hemorrhage and acute respiratory failure. As a result, he was placed on extracorporeal membrane oxygenation (ECMO). This machine provides cardiac and respiratory support to people whose heart and lungs are unable to sustain life. It was touch and go, but eventually he started to stabilize. About two weeks later, he was weaned off ECMO.
John spent eight weeks in the CICU. He recalls having trouble with mobility and getting his strength back. With perseverance, he was soon able to walk short distances and accomplish the tasks his nurses asked him to do. Just a short time later, he was working out, gaining back weight and getting back to his fit and trim self. Four and a half months after that fateful basketball game, he returned to work.
Inova’s standardized, team-based approach has dramatically improved outcomes for patients like John, with results that have garnered national attention. Only two years after deploying its Shock Team, Inova’s 30-day cardiogenic shock survival rate rose to 70 percent or more, far above the national average.
“Our Shock Team algorithm is both a new approach and a practical one,” says Behnam Tehrani, Medical Director of Cardiac Catheterization at IHVI’s Inova Fairfax Medical Campus. “In our initial analysis, we found factors such as fractured care, late detection, impaired access and practice variations contributed to high cardiogenic shock mortality rates. By using a coordinated team approach with a standard algorithm, we became the first medical center in the country to report these amazing results.”