Goa has been identified as the leading state in India for providing rapid treatment for patients experiencing severe heart attacks, particularly those with blocked coronary arteries. Recent findings presented at the National Cardiovascular Summit, held by the Goa government in partnership with health-tech company Tricog, indicated that patients can now receive stabilising treatment within 19 minutes of arrival at any public healthcare facility in the state.

The advanced technology used in Goa enables the detection of serious heart attacks in mere minutes, even at primary health centres. Following the initial treatment of thrombolysis, where medications dissolve harmful blood clots, patients are subsequently referred to higher medical centres for further care.

In 2019, Goa became the first Indian state to adopt the hub-and-spoke model specifically for ST-elevation myocardial infarction (STEMI), a critical form of heart attack characterised by a complete blockage of a coronary artery. This initiative came eight years after national guidelines were issued by the Union health ministry to enhance emergency cardiac care across India.

Significance of the Hub-and-Spoke Model

Developed by STEMI India and endorsed by the Indian Council of Medical Research (ICMR) in 2011, the STEMI model aims to mitigate the high mortality rates associated with major heart attacks nationwide. It establishes a decentralised system consisting of a digital hub-and-spoke network that provides timely, critical care irrespective of geographical location.

When a patient presents symptoms such as chest pain or breathlessness at a primary healthcare facility, an AI-powered ECG is conducted. Specialists at Tricog analyse the ECG in real-time, offering results to on-duty doctors within minutes. Dr Charit Bhograj, a cardiologist and CEO of Tricog, noted that the detection time for heart attacks has been reduced to under eight minutes since the model’s implementation.

This rapid response is essential, as delays can significantly impact patient survival rates. Lower-tier medical facilities, often staffed by MBBS doctors instead of cardiologists, have been trained to provide thrombolysis—a crucial intervention that occurs prior to more invasive procedures like percutaneous coronary intervention (PCI). This training helps ensure that patients receive timely care before they are transferred to higher-level hospitals.

The Impact of Goa’s Health Initiatives

Health Minister Vishwajit Rane highlighted the state’s commitment to equitable healthcare access in Goa. He recounted his father’s past heart attack experience, affirming that the initiative’s objective is to deliver high-quality care to all residents, not just those with specific advantages. Initially launching with Goa Medical College and Hospital as the hub, the project has expanded its reach to 20 primary health centres by 2021.

To date, over 461,000 cases have been evaluated, with more than 11,600 identified as life-threatening. Comparatively, a patient in Goa typically reaches a hospital in just over two hours, whereas the national average can stretch from 4.5 to 13 hours. ECG confirmations usually occur within 12 minutes, followed by thrombolysis within 19 minutes when necessary, before patients are transported for PCI.

The summit’s data indicated that in-hospital mortality rates for acute heart attacks have dramatically decreased, from 7.2 per cent in 2019 to just 1 per cent currently. This model is also being adopted by several other states, yielding promising results in saving lives, with the hope of widespread implementation across India in the near future.

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