United States Public Health Service - Healthy People Year 2000

Every 10 years the United States Public Health publishes the doctrine Healthy People and seeks to have strategies put together to reduce health problems in the United States. In 1990 the doctrine Healthy People-Year 2000 was put together and will be reported upon in early 1999. Already the process is in place to put together the goals for Healthy People -Year 2010. In the goals and objectives for Healthy People -Year 2000*, the concept of utilizing the community hospital to serve as a center for implementation of heart attack care was conceived.

This evolved around the community hospital setting up a Chest Pain Center within the emergency room to focus on the heart attack problem by providing focused care not only for acute cardiac emergencies (crashing events) but also to help evaluate patients with all types of chest discomfort in an effort to get at patients with acute coronary syndromes as well as patients with high risk for subsequent coronary artery disease.

This strategy has been highly successful as evidence by the exponential growth of chest pain centers throughout the United States. The strategy brings together in this effort emergency physicians and cardiologists as well as critical care nurses, nuclear cardiologists, laboratory physicians etc... and begins a learning curve of progress very similar to that which took place during the coronary care movement of the 1960's.

The strategy has been developed in response to the public health need to put into practice discoveries made in medical management and balloon angioplasty as a result of a better understanding of the pathophysiology of acute myocardial infarction.