Category Archives: Mortality Rates

What is a Silent Heart Attack?

A study of approximately 9,500 middle-age adults found that nearly half of the heart attacks that occurred during the study period were “silent”. TheDr Haghighat patients were not aware they had a heart attack and did not seek medical attention however, their electrocardiogram (ECG) screening during a regular follow-up appointment showed that a heart attack had occurred.

The study, Atherosclerosis Risk in Communities (ARIC), analyzed the causes and outcomes of atherosclerosis – hardening of the arteries. Over an average of nine years after the start of the study, 317 participants had silent heart attacks while 386 had heart attacks with clinical symptoms.

Amir Haghighat, M.D., interventional cardiologist at the Cardiovascular Institute in Panama City, clarifies that “Silent does not necessarily mean a total lack of symptoms. More likely, it’s that the symptoms were subtle or not recognized as a heart problem.”   Frequently, television and movies depict a heart attack as a dramatic event with crushing chest pain. “Chest pain is a common symptom, however everyone experiences heart symptoms differently.” says Dr. Haghighat. “For some, it may be shortness of breath, pain in their left arm, in their neck or jaw, or even in the shoulder blades, and it may not be as dramatic as you think.”

“The outcome of a silent heart attack is as bad as a heart attack that is recognized while it is happening,” said Elsayed Z. Soliman, M.D., MSc., M.S., study senior author and director of the epidemiological cardiology research center at Wake Forest Baptist Medical Center, Winston-Salem, North Carolina. “And because patients don’t know they have had a silent heart attack, they may not receive the treatment they need to prevent another one.”

Dr. Haghighat stresses that these study results are further proof that patients should see their primary care providers regularly and discuss any unusual symptoms they may be experiencing. “We all know when we’re feeling something different in our bodies and it’s important to discuss it with a healthcare provider,” says Dr. Haghighat. “Take note of when your symptoms occur, do they happen with exertion or at rest? Don’t ignore symptoms just because they come and go. Your primary doctor may be able to identify the issue with basic screenings and prescribe preventative measures. Or in the case of a “silent” heart attack, coordinate treatment with a cardiologist that can lower your risk of having additional heart attacks.”

After following participants in the ARIC study for 20 years, researchers found that having a silent heart attack increased the chances of dying from heart disease by three times. As a result, silent heart attacks should be treated just as aggressively, once discovered, as a heart attack with recognizable symptoms. “For both kinds of heart attacks,” says Dr. Haghighat, “the risk factors and the treatment are the same. Even though a patient may not have experienced a scary heart event in an ER, they still need to be proactive and make lifestyle changes to reduce their risk such as quitting smoking, losing excess weight, eating healthy and getting regular exercise.”

News on Local Hospital Quality & Pricing Data — Bay Medical Recognized for both Quality & Value

Patients today are fortunate to have an increasing amount of public data available to them about hospitals and healthcare providers in order to make the most informed decision on where and from whom to receive care.  In June 2015, several sources published data regarding outcomes and charges for hospital care.  Here at the Cardiovascular Institute, we see patients from all over Northwest Florida, so we reviewed the data currently posted for all Northwest Florida hospitals from Pensacola to Tallahassee, as well as the hospitals in Dothan, to see where area patients can go to receive the best quality and value care.

The data most accessible to the public comes from Medicare and is used by a variety of websites to report on mortality rates for the most common conditions and procedures.  The data we found for Coronary Interventions showed Bay Medical with an in-hospital mortality rate of 0.80% – the lowest in the region.   Most other area hospitals had rates in the 2 – 5% range.  Heart Failure is another commonly rated condition and several sites noted that Bay Medical’s in-hospital mortality rates were among the best in the nation.  We certainly found them to be the best in the region in our review of the available data, with a 1.6% mortality rate out of 1,315 cases.  Only one other hospital came close, West Florida , located in Pensacola, with a 1.71%.  All others were in the 2-7% range.

Coronary Bypass Surgery (CABG) is another procedure that is commonly rated in public data, however not all hospitals who offer Coronary Interventions provide this next level of service.  Having the back-up of cardiothoracic surgeons who can offer this procedure in the facility where you have a coronary intervention gives you added security and can be life-saving.  In this category, Bay Medical had a 0.0% in-hospital mortality rate.  Once again, this was the lowest rate in the region by far.  Gulf Coast Regional Medical Center and Sacred Heart on the Emerald Coast do not offer this procedure and were not rated. However, most other hospitals in the region had rates in the range of 2-6%.

Heart Attack is also rated.  Bay Medical Center was the second lowest in-hospital mortality in the region, behind West Florida Hospital in Pensacola, at 5.27%.  The other hospitals in our region had rates ranging from 6-11%.

As the only cardiology group practicing at Bay Medical Center, we were excited to see how favorably Bay Medical compared with others in the region as this reflects directly on the care that we provide.  At Bay Medical, we have the support of administration as they continually invest time and resources into a top of the line heart program and the clinical expertise of well-trained nursing staff caring for our patients.  Together, we make a great team and it shows in these publicly reported outcomes.

In addition to quality data, average charges are also available to the public if you know where to look.  In Florida, the easiest place to find this information is a state site called www.floridahealthfinder.gov.   A recent independent analysis of this charge information found Bay Medical Center to be among the Top 10 Best Values in Florida based on price and quality.  In a separate nationwide study recently reported in the Washington Post, three hospitals in our region were listed among the Top 50 for over-charging with an average charge that is 10 times what Medicare will cover.  One is here in Panama City.   For those who have Medicare, or in-network insurance plans, this practice of overcharging may not have a direct impact on what you pay, however, it does impact overall insurance rates .  As a tourist community, we have many out-of-state visitors who unfortunately find themselves in need of medical care out-of-network.  It is in cases such as these, where insurers and consumers are faced with this price gouging.   Insurers pass this cost along in the form of higher rates for everyone the following year.  In addition, with insurance policies having increasing deductible and out-of-pocket expenses, charges matter.

In the past, consumers did not have access to this information and frequently had no idea of the hospital’s reputation for caring for their condition or of what the charges might be until after they’ve received the care.  As a result, pricing and quality in healthcare have varied widely and often do not go hand-in-hand.

We encourage you to do your research and support institutions who are offering a quality service at a value price.  This is how we will make a difference in the American healthcare system.

For those who wish to research hospital quality in our area or look at how our local hospitals fare on other types of conditions, we recommend:

www.HealthGrades.com   –  This website uses star ratings, however we encourage you to look at the detail information provided to see actual mortality rates.  The stars are based on the actual versus a predicted rate.  Some hospitals have a much higher predicted rate and as a result may have a higher star rating than another hospital with a lower actual mortality rate.

www.medicare.gov/HospitalCompare   – This website only monitors mortality rates for several of the most common conditions. It includes other quality data and patient satisfaction data to help you get a broader picture of a hospital’s overall care.

www.floridahealthfinder.gov  – This website allows you to compare hospitals versus state averages to see a clear picture of price, length of stay for a certain conditions and roughly how many cases a hospital treats of that condition.  When a hospital treats far less of a certain condition than another, it’s possible they have less expertise in that area.

www.consumerreports.org (subscription required)

*The rates reported here were posted in June 2015.  These sites are updated and rates change as newer data becomes available.  Before making your healthcare decisions, please check for the most current quality data available.