Heart Attack Treatment.
The Primary objective in the treatment of Heart attack or treatment of myocardial infarctionis to restore blood supply to that part of the heart, which has been affected by the blocked coronary artery. This has to be done on a war footing as more heart muscle may get involved and the damage may become permanent, if blood supply is not restored quickly.
The efficacy of the treatment of heart attack is most, when it is started within an hour of the onset of heart attack symptoms. This also ensures less incidence of heart attack complications, some of which can be lethal.
Treatment of Heart Attack|Management of Heart Attack.
The treatment of heart attack can be categorized into two parts:
A) General treatment of heart attack.
B) Specific treatment of heart attack.
A) General treatment of heart attack:
- Patient has to be admitted to the ICCU ward of the hospital, and connected to the ECG monitoring machine. This ensures continuous monitoring of the heart.
- Oxygen is administered to the patient, so that the blood stays rich in oxygen content. This ensures adequate oxygen supply to the body tissues, thereby reducing the demand of the body for blood supply to the heart. In short, the work load on the heart is reduced.
- Nitroglycerine is administered, to increase the blood supply to the heart, as it acts as a vasodilator. (dilates the blood vessels)
- I.V. fluids are started to infuse the patient and keep the intravenous route open for administering I.V. drugs urgently.
- Aspirin is given because of its anti clotting properties.
- Chest pain is treated with pain relievers such as morphine or pethidine.
All the above steps are carried out within minutes of admission with more than one paramedic attending on the patient.
B) Specific Treatment for Heart Attack.
Here, we explain the treatment that is carried out to restore blood supply, which has been disturbed by the blood clot in the coronary artery. This treatment is carried out by Medicines for Heart Attack and, if required by Surgical intervention.
Medicines for heart attack.
- Thrombolytic agents, also called clot busters, are to be administered within an hour of an attack for maximum efficacy. They help by dissolving the clot in the coronary artery and restore blood supply. They are, however contraindicated in patients having history of internal bleeding, brain tumour, peptic ulcer, recent history of some major surgery and in pregnant ladies.
- Beta blockers such as Atenolol and propanolol, work by reducing the load on the heart by lowering the blood pressure, reducing the chest pain and preventing arrhythmias, which are the major complications of a heart attack, responsible for death of the patient.
- Ace inhibitors such as ramipril, and load on the heart. reduce blood pressure.
- Cholesterol reducing agents when the cholesterol blood level is high and the block has been due to plaque in the artery.
Surgery for Heart Attack.
- Angioplasty is a procedure, in which a catheter is inserted through the femoral vein and guided under visual monitoring into the heart and to the site of coronary artery blockage. This catheter has an attachment at the distal end where by a balloon is inflated and the plaque is flattened against the artery wall. The artery lumen is opened and blood flow is restored. With the help of the catheter, a stent may be placed at the site of blockage to keep the artery open.
Angioplasty is performed after an angiography has confirmed the clot and its location.
Images below of an angioplasty:
- Coronary Bypass surgery is a surgery where the site of blockage is bypassed . Required lengths of a vein or artery are removed from elsewhere in the body and anastomosed in such a fashion so that, a bypass is created around the blocked part of the artery to allow the blood flow to resume to the affected part. Shown below in image.
Picture showing how bypass surgery is done.
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