The Heart & Vascular Center at Brigham and Women’s Hospital (BWH) has developed multispecialty teams for rapid assessment, triage, and management of patients with acute cardiac conditions.
Acute Aortic Rapid Response
Our team provides 24-hour emergency-level response and customized therapies to all patients suffering from aneurysms, dissections, and traumatic disruptions. Specialists in cardiac surgery, vascular and endovascular surgery, cardiology, vascular medicine, cardiovascular imaging, and cardiac and vascular anesthesia collaborate to provide expert evaluation for all acute aortic emergencies combined with multiple approaches to treatment, including endovascular techniques, minimally-invasive cardiac procedures, and open procedures, for patients with complex aortic disease.
A multidisciplinary team of specialists in vascular medicine, vascular surgery, pulmonary medicine, emergency medicine, critical care, cardiothoracic surgery, interventional cardiology, and thoracic imaging are quickly assembled for patients potentially suffering from a pulmonary embolism. Rapid assessment by the team and state-of-the-art imaging are employed to choose the most appropriate therapy for each patient. Treatment approaches include intensive anticoagulation, including the non-vitamin-K oral anticoagulants if appropriate, and systemic thrombolytic therapies to catheter-based low-dose thrombolytic therapy and surgical embolectomy. In patients found to have chronic thromboembolic pulmonary hypertension (CTEPH), pulmonary thromboendarterectomy or balloon pulmonary artery angioplasty are performed in appropriate places.
Patients with cardiogenic shock receive immediate triage and intervention with the development of the Shock Team protocols, which stipulate that all patients with cardiogenic shock be brought to the Cardiac Intensive Care Unit where a cardiac intensivist rapidly evaluates a patient prior to activating a paging system calling into action a critical care cardiologist, an advanced heart disease specialist, a cardiac surgeon with expertise in extra-corporeal life support (ECLS) and ventricular assist device (VAD) implantation, and an interventional cardiologist who can provide short-term catheter-based interventions and mechanical circulatory support.