You’ve been out shoveling the driveway and start to feel sick: Chest discomfort, shortness of breath, cold sweat and nausea.

These are classic signs of heart attacks, which strike more than 1 million times a year across the country and contribute to about 445,000 deaths.

Heart patients in this region have an edge, with some of the latest science and expertise available in local hospitals.

“There is definitely some cutting-edge technology that we are implementing in Johnstown,” said Dr. Samir Hadeed, chief of cardiology at Memorial Medical Center.

Memorial’s open-heart surgery program is backed up by its state-of-the-art catheterization laboratory, where diagnostic imaging equipment supports minimally-invasive angioplasty procedures that open blocked coronary arteries.

Twenty-five miles south, Somerset Hospital’s cath lab was one of the state’s first hospitals approved to offer angioplasty without a cardiac surgery program.

“We are a rural area,” said Pam Geary, supervisor of interventional cardiology at Somerset. “When you have someone come in with an acute heart attack, time is muscle. This program really saves heart tissue.”

For American Heart Month in February, the local hospitals join the American Heart Association and Centers for Disease Control and Prevention to call attention to the nation’s leading cause of death.

During a heart attack, blood feeding the heart muscle is restricted because coronary arteries are blocked, usually from buildup of a fat-like substance called plaque. If the deposits tear or rupture, it can unleash blood clots which block the artery, causing a heart attack.

Early intervention is key, the National Heart Lung and Blood Institutes of the National Institutes of Health stresses. Quick response can allow doctors to use clot-busting drugs and other artery-opening treatments in cath labs that can stop a heart attack and limit muscle damage. Others may require heart bypass surgery in Memorial’s operating rooms.

To be most effective, treatment should begin within an hour.

The most common intervention is opening the artery with angioplasty, in which a cardiologist inserts a balloon-like device through an incision in the patient’s leg, Hadeed said. Often a wire mesh tube called a stent is put over a balloon catheter and placed in the area of blockage to keep the vessel open.

Somerset’s nonsurgical cath-eterization program was launched in 2002 as a pilot project to bring life-saving heart intervention to more rural areas. Memorial partnered with its competitor in 2006 for support when the state threatened to shut down the program unless it joined in a larger study, even though Somerset’s results compared favorably to most hospitals offering cardiac surgery.

“Our outcomes have been very good,” Geary said. “We have strict criteria as far as the lesions we can attack.”

For those in need of more than angioplasty, patients have the latest advances in heart surgery available at Memorial. A heart bypass is often the lifesaver. In a bypass, surgeons can take a vein segment from the patient’s leg and connect it to reroute blood around damaged coronary arteries to feed the heart muscle.

Additional technology is available to help prevent future heart problems. In addition to angioplasty and stents, Somerset has begun implanting pacemakers. The electronic device replaces the body’s natural electronic rhythm-producing group of cells called a sinus node. Once in the chest wall, the pacemaker monitors the heart, delivering electrical pulses when needed to make the heart beat in a normal rhythm.

Somerset’s newest offering is an implantable cardioverter defibrillator.

Resembling a pacemaker, the ICD also monitors heart rhythms, but delivers more powerful shocks if dangerous rhythms are detected.

“It’s like a shocking pacemaker,” Geary said. “The ICD prevents sudden cardiac arrest.”

Finally, Memorial’s program offers laser angioplasty and recently begun using the world’s smallest heart pump.

In laser angioplasty, a laser-tipped catheter is inserted into an obstructed artery.

“We tend to use a lot of advanced technology,” Hadeed said. “With the laser, we can mechanically shave off the plaque on the interior of the artery.”

The Abiomed Impella 2.5 heart pump can be temporarily implanted to help keep a weakened heart functioning while damage is repaired. Memorial first used the pump last fall.

Since then, there has been no call for its assistance.

“We just have done one, which is good because you only reserve it for those who are really really sick and don’t have any other options,” Hadeed said.

“You hope your patients are not that sick.”