Akron General is Summit County's only Accredited Chest Pain Center. That means our Heart & Vascular Center and Emergency Medicine Service meet the high quality standards as set forth by the Society of Chest Pain Centers and Providers.

Compare Akron General with National Standards:

Myocardial Infarction
Aspirin Upon Admission
Beta Blocker Upon Admission
Aspirin at Discharge
Beta Blocker at Discharge
ACE Inhibitors or ARBs for LVSD
Accredited Chest Pain Center
Smoking Cessation
Availability of PTCA
Inpatient Mortality
Average Length of Stay
Physician Board Certification

1. Aspirin on Admission
To work properly, the heart muscle requires constant oxygen and nutrients, which travel through blood vessels. A narrowed blood vessel of the heart (coronary artery) diminishes the oxygen and nutrient delivery to the heart. If a blood clot forms in a coronary artery it can cut off the oxygen supply completely and cause a heart attack or myocardial infarction. Aspirin helps to prevent blood clot formation.

Multiple research studies over the past ten years provide strong evidence that aspirin and certain platelet inhibitors (drugs that keep blood platelets from sticking together) decreases the risk of re-closing a narrowed artery (restenosis) and death after a heart attack.

According to the Joint Commission , persons with a suspected heart attack should receive aspirin within 24 hours before or after hospital arrival.

A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines found Class I evidence (highest level of scientific support) for giving aspirin as soon as possible for a confirmed or strongly suspected heart attack (Circulation, September, 2000: 102 (10); 1193-1209). Individuals who are at increased risk for bleeding, however, may not be candidates for aspirin therapy because aspirin thins the blood, further increasing the risk of bleeding.

Unless otherwise contraindicated, the protocol at Akron General Medical Center includes the administration of aspirin to heart attack patients upon arrival to the hospital.

2. Beta Blocker on Admission
Beta blockers are a group of medications that block the stress hormone adrenaline, creating health benefits for heart attack survivors by blocking the harmful effects of adrenaline and slowing the pulse rate. Multiple studies show that early use of this medication consistently reduces the risk of death and decreases damage to the heart muscle. (Circulation, May, 2005:111 (20):2699-2710).

There are many different types of beta blockers. Your physician will prescribe one that will best suit your needs. Beta blockers are not for everyone, however. Some heart attack survivors may not receive a beta blocker due to other health conditions such as lung disease or slow pulse rate.

Unless otherwise contraindicated, the protocol at Akron General Medical Center includes the administration of beta blockers to patients with heart attacks upon arrival to the hospital.

From September of 2005 - September 2006, 95% percent of heart attack survivors at Akron General Medical Center received a beta blocker (medication that blocks the stress hormone adrenaline) within 24 hours of arrival unless otherwise contraindicated.

3. Aspirin at Discharge
According to the US Preventive Services Task Force, aspirin is recommended to decrease the incidence (frequency of new cases) of heart disease in adults who have risk factors for heart disease. Individuals who are at increased risk for bleeding, however, may not be candidates for aspirin therapy because aspirin thins the blood, further increasing the risk of bleeding.

The American College of Cardiology/American Heart Association Task Force on Practice Guidelines found Class I evidence (highest level of scientific support) for taking aspirin indefinitely after a heart attack. (Circulation, September, 2000: 102 (10); 1193-1209).

Evidence for this guideline has existed since the mid to late 1990s and has been further supported by subsequent research. "Long-term aspirin therapy confers conclusive net benefits on risk of subsequent MI [myocardial infarction], stroke, and vascular death among patients with a wide range of prior manifestations of cardiovascular disease" (Circulation, October 21, 1997: 96(8); 2751-2753).

Unless otherwise contraindicated, the protocol at Akron General Medical Center includes prescribing daily aspirin for heart attack survivors after Hospital discharge.

In 2006, ninety-five (95%) of heart attack survivors at Akron General Medical Center received a prescription for daily aspirin after hospital discharge unless otherwise contraindicated.

4. Beta Blocker at Discharge
For heart attack survivors, starting beta blockers (group of medications that block the stress hormone adrenaline) at or before Hospitals discharge has been shown to reduce death and disability. (American Heart Journal, December, 2004: 148 (6); 944-50).

At Akron General Medical Center 94% percent of heart attack survivors received a prescription for a beta blocker (group of medications that block the stress hormone adrenaline) at discharge in 2006 unless otherwise contraindicated.

5. Angiotensin Converting Enzyme (ACE) Inhibitor or Angiotensin Receptor Blocker (ARB) for Left Ventricular Systolic Dysfunction
The left ventricle is the part of the heart that holds and pumps blood to other vital organs. A measure called the left ventricular ejection fraction or LVEF is used to check for damage due to heart attacks and other conditions. The LVEF value for a person with no heart damage is usually around 60 percent or greater. Systolic dysfunction (condition that causes reduced pumping ability of the heart's left lower ventricle) represents reduced pumping ability of the heart.

Angiotensin converting enzyme (ACEI) inhibitors are a group of medications that relax blood vessels and make it easier for the heart muscle to pump blood to vital organs. Angiotensin receptor blockers (ARB) are a similar group of medications, and both are recommended by the Joint Commission as important tools for reducing mortality in heart attack survivors who have left ventricular systolic dysfunction (LVSD).

A Scientific Statement from the American Heart Association Council on Clinical Cardiology Research indicates those heart attack survivors who have LVEF systolic dysfunction should be placed on an angiotensin converting enzyme inhibitor (ACEI) or an angiotensin receptor blocker (ARB). This medication reduces the chance of death and reduces disease symptoms after a heart attack. (Circulation, May 24, 2005: 111 (20); 2699-2710)

In 2006 85% of eligible heart attack survivors at Akron General Medical Center received a discharge prescription for an angiotensin converting enzyme inhibitor (ACEI) or angiotensin receptor blocker (ARB) medication (two groups of medications that relax blood vessels).

6. Accredited Chest Pain Center
The Society of Chest Pain Centers (SCPC) promotes the use of clinical practices that have been tested through research. These clinical practices support optimal care of patients experiencing chest pain. According to the SCPC, observation of carefully-selected emergency patients has been extensively studied and shown to provide improved health care outcomes, including:

Chest Pain Centers follow research tested protocols to deliver care to patients with chest pain. Chest pain care often begins in an emergency department but may also include additional service areas such as cardiac catheterization, radiology, or surgery. According to the Society of Chest Pain Centers, to earn Accredited Chest Pain Center status, a facility successfully completes the Society's formal process in the following eight (8) key areas:

1. Emergency Department (ED) Integration with the Emergency Medical System (EMS): A formal relationship between the ED and the local EMS that links the care processes for patients with symptoms of possible Acute Coronary Syndromes (ACS). Heart attack is one type of acute coronary syndrome.
2. Emergency Assessment of Patients with Symptoms of ACS. Timely Diagnosis and Treatment of ACS: a program to minimize delays in starting therapy for heart attack.
3. Patients with Low Risk for ACS and No Assignable Cause for their Symptoms: ED or Hospitals observation program that monitors and evaluates low-risk patients to avoid inadvertently releasing patients with AMI (heart attack) or unstable angina (chest pain).
4. Functional Facility Design: an ED Chest Pain care. It includes appropriate cardiovascular monitoring equipment.
5. Personnel, Competencies, and Training: Physicians and nursing staff in contact with patients with symptoms of ACS require certain core competencies and training. Leadership and management may require additional core competencies and training.
6. Process Improvement Orientation: Chest Pain Unit management structure based on continuous quality improvement program principles to ensure quality patient care and proper utilization of ED resources.
7. Organizational Structure and Commitment: The facility's administration, medical staff, and multidisciplinary committee must make a commitment to the establishment and support of a Chest Pain Center.
8. Community Outreach Program: An ED or Hospitals -based community outreach program that educates the public to promptly seek medical care if they have symptoms of an AMI (heart attack), such as chest pain, chest discomfort, shortness of breath, diaphoresis, syncope, and risk factors for coronary artery disease, particularly smoking.

Akron General Medical Center's Chest Pain Center is accredited by the Society of Chest Pain Centers.

7. Smoking Cessation
Smoking is a modifiable risk factor for heart disease. National guidelines strongly recommend smoking counseling to help heart attack survivors to quit smoking (National Cancer Institute (NCI) Prevention and Cessation of Cigarette Smoking: Control of Tobacco Use). Tobacco Cessation Guidelines from the United States Department of Health and Human Services (DHS) provide helpful tips on smoking cessation for patients.

At Akron General Medical Center, in 2006, 98% of eligible heart attack survivors received referrals for smoking cessation counseling prior to discharge.

8. Availability of Percutaneous Transluminal Coronary Angioplasty (PTCA)
Percutaneous transluminal coronary angioplasty (PTCA) is performed to open blocked coronary arteries caused by coronary artery disease (CAD) and to restore arterial blood flow to the heart tissue without open-heart surgery. The term percutaneous coronary intervention (PCI) is a more general term that includes additional artery opening procedures and devices.

Certain patients will benefit from rapid reperfusion (re-entry of blood into area where flow has been reduced) through the use of percutaneous transluminal coronary angioplasty (PTCA). PTCA is a procedure that uses a balloon tipped catheter-tube, which is inserted into a leg artery and then advanced to the heart in order to open blocked arteries that cause heart attacks. According to The American College of Cardiology (ACC) and American Heart Association (AHA) Guidelines for The Management of Patients with Acute Myocardial Infarction, PTCA may be used as an alternative to thrombolytic therapy (medication that disrupts blood clot formation) in patients where this medication is contraindicated. PTCA may also be used in addition to thrombolytic therapy.

At Akron General Medical Center, percutaneous transluminal coronary angioplasty (PTCA) is available 24 hours a day, seven days a week.

9. Inpatient Mortality
The mortality rate (measured as a percentage) provides general information about the quality of care delivery, and can be an important quality indicator. However, some hospitals care for patients with a greater severity of illness and therefore may have a higher mortality rate.

According to the most recent national data from the Healthcare Cost and Utilization Project (HCUP) Nationwide Inpatient Sample from the Agency for Healthcare Research and Quality (AHRQ), inpatient mortality rate for heart attack in the US for all reporting hospitals was 7.5 percent.

Akron General Medical Center's inpatient mortality rate for heart attack was 2.5% in 2006, which is better than the national mortality rate in HCUP's sample.

10. Average Length of Stay for Myocardial Infarction
The average length of stay (measured in days) provides general information about the efficiency of care delivery, and is therefore an important quality indicator. However, patients with a greater severity of illness may have a longer average length of stay.

According to the most recent national data from the Healthcare Cost and Utilization Project (HCUP) Nationwide Inpatient Sample from the Agency for Healthcare Research and Quality (AHRQ), average length of stay for heart attack in the US was 5.4 days.

In 2006, the average length of stay (ALOS) for heart attack patients at Akron General Medical Center was 4.97 days, which is better than the national ALOS for heart attack in HCUP's nationwide sample.

11. Physician Board Certification
A board-certified physician has completed an approved educational training program and an evaluation process including an examination designed to assess the knowledge, skills, and experience necessary to provide quality patient care in that specialty. A specialty certificate is issued by a medical specialty certifying board, which is valid, nationwide. Although certification is not required for an individual physician to practice medicine, most hospitals and managed care organizations require that at least a certain percentage of their staff be "board certified." Today approximately 89 percent of licensed physicians are certified by one or more ABMS Member Boards (American Board of Medical Specialties).

There are many specialists included in the care of heart attack survivors, including those in: emergency medicine, thoracic surgery and internal medicine. Internal medicine includes sub-specialties of cardiology (both general and interventional) and electrophysiology. Each of these may be certified by a member board in their specialty.

Many people who have a heart attack are initially treated by a physician specializing in emergency medicine, then by a general cardiologist. An interventional cardiologist (physician specializing in non-surgical procedures such as the balloon procedure/PTCA) is consulted if appropriate, as is a heart surgeon. If there are heart rhythm disturbances, then an electrophysiologist (cardiologist who specializes in the treatment of electrical conduction problems within the heart) may also be consulted. Critical care medicine physicians may be responsible for coordinating care in the intensive or coronary care unit setting if this level of care is needed. Other specialists may consult for heart attack survivors who have additional medical conditions or situations requiring specialized knowledge and skill.

At Akron General Medical Center the percent of physicians who treat heart attack patients are board certified as follows: