When Joyce Moss recently arrived at Loyola University Hospital with a life-threatening heart attack, it took just 42 minutes to perform an emergency balloon angioplasty.

The procedure opened up an artery that was 100 percent blocked. "There was no damage to the heart because of how quick they were," said Moss, 56, of Berwyn. "I feel good."

Once a heart attack is confirmed, it takes less than five minutes to prep the patient. The interventional cardiologist then threads a catheter (thin tube) from an artery in the groin to the heart. The cardiologist inflates a balloon at the tip of the catheter to open the artery. In many cases, the cardiologist places a stent (wire mesh tube) to keep the artery open.

The doctor must be fast and accurate. "You become very focused," said interventional cardiologist Dr. Bruce Lewis. "It's like shooting a three-pointer with two seconds to go, except that you can't afford to miss." Lewis is a professor in the division of cardiology at Stritch.

Experience helps improve outcomes. Interventional cardiologists on the HARRT team each perform approximately 300 angioplasties per year. "We have seen just about every permutation," Lewis said.

A task force of the American College of Cardiology and American Heart Association recommends that a patient undergoing a heart attack receive a balloon angioplasty as soon as possible or at least within 90 minutes of arriving at the hospital- known as the door-to-balloon time. Speed "is of central importance because the benefits of therapy diminish rapidly with delays in treatment," the task force said in a recent statement published in the heart association journal Circulation.

During a heart attack, a blockage in an artery stops blood flow. Heart muscle begins to die due to lack of blood and oxygen. An emergency angioplasty can reopen a blocked artery and restore blood flow. The procedure does the most good if done within one hour of the patient's arrival, known as the Golden Hour. After three hours, there may not be enough benefits to justify the risks of the procedure.

"Time is heart muscle," said Dr. David Wilber, director of Loyola's Cardiovascular Institute. "The sooner we can open the artery, the better."

A balloon angioplasty is the most effective way to reopen an artery, according to a review of 23 studies published in the British medical journal Lancet. In the studies, heart attack patients were randomly assigned to receive a balloon angioplasty or an intravenous clot-busting drug such as streptokinase. Among patients receiving clot-busting drugs, 14 percent died or suffered a stroke or subsequent heart attack, compared with only 8 percent in the angioplasty group.