On what seemed like a normal work day April 17, Yacolt resident Richard Blake suddenly began experiencing arm pain and indigestion — classic signs of a heart attack.
Blake, an executive chef at ilani at the time, quickly recognized the symptoms and called for paramedics. When first responders asked if he wanted to be taken to Legacy Salmon Creek Medical Center — home to a newly established cardiac program offering a minimally invasive heart procedure — he immediately agreed.
The hospital’s full-scale 24/7 percutaneous coronary intervention program has been open since April 1, allowing more Southwest Washington patients to receive this updated care without having to go to Portland.
“As soon as they rushed me into the hospital, they told me that I had 100 percent blockage in the left side of my heart,” Blake said. “I preferred Salmon Creek, because that’s where I receive primary care. They were very informative. They were very responsive. I’m a person that doesn’t sit around a whole lot, and 53 is relatively young to have a heart attack. I had to change my lifestyle completely.”
Blake has since made a full recovery. The care from the team within Salmon Creek’s Cardiac Services Unit made all the difference, he said.
24/7 care
Percutaneous coronary intervention, or PCI, is a nonsurgical procedure to relieve the narrowing of the coronary artery in the heart and improve blood supply to the surrounding tissue. The procedure is used to place and deploy coronary stents, permanent wire-meshed tubing used to open coronary arteries.
Previously, PeaceHealth Southwest Medical Center was the only hospital in Clark County that could perform this procedure on patients, said Kat Tower, a registered nurse and manager of Legacy’s program.
“Historically, bypass was the way to fix arteries of the heart. Opening the sternum to bypass arteries that are blocked is like a six-month recovery,” Tower said. “The percutaneous approach, which means through the skin, became the most minimally invasive technique, which is what we can now offer.”
Prior to getting a certificate that allows the cardiac services unit to offer this procedure, physicians could take images of the patient but would ultimately have to send them to a different hospital or provider. This could cause stress and fear in patients and their families, Tower said.
In Washington, for a unit to offer percutaneous coronary intervention, the state requires a certificate of need, which is harder for a smaller community hospital to obtain. The initial application process started in 2016 but was unsuccessful, Tower said.
After Legacy reapplied, the state approved the program in March 2021. Over time, it has grown, now offering 24/7 care that starts as early as in the ambulance.
For a patient like Blake — who had a 100 percent blockage, meaning no blood could reach his heart — this procedure would have been the most efficient and least invasive way to save his life.
“To see a patient go from that state of anxiety and fear to complete resolution of all of their symptoms is why we do what we do,” Tower said. “That starts in the emergency room. We can’t get anywhere with a patient physically if we don’t meet their mental and emotional needs as well.”
Communication is key
For patients to make it to the catheterization lab where heart procedures are performed, communication from all parties is key.
Clark County EMS uses the Pulsara system to notify hospitals that a patient is en route, said the agency’s medical director, Marlow Macht.
“We launched this communication system several years ago to streamline and accelerate care for heart attack or stroke patients,” Macht said in a news release. “An electrocardiogram can be performed in the ambulance, and these results and other vitals are directly sent to the hospital before the patient arrives. The cath lab is activated from the field if a procedure is needed. This reduces the time it takes to open an artery and protect the heart muscle from further damage.”
Registered nurse Kayla Kiest-Lundeen has worked within Legacy Salmon Creek’s cardiac services unit for only a year, but she has already noticed how the team works together.
“I came here and shadowed and was like, ‘I’m home,’” Kiest-Lundeen said. “It’s like a symphony: You can hone in on the bass, but when you step back, you hear the actual melody. That’s one thing I saw when I was here: The teamwork is so cohesive. Everyone’s goal is to just take care of the patient most efficiently with the most dignity.”
Legacy Salmon Creek Medical Director Mayank Agrawal said roughly 500 people a year will benefit from an emergency or elective treatment that results in a percutaneous coronary intervention procedure at the hospital.
Now fully recovered, Blake has adopted lifestyle changes to ensure his health, including the way he eats.
“I’m just hoping to maintain it. Just eating healthier, getting exercise, it’s definitely giving me a lot more energy,” Blake said “The follow-up, from the cardiologists to the nurses, they were all very communicative. They were very professional. If they didn’t have the answers, they would get it for us.”
