Our heart works 24 hours a day, pumping oxygen and nutrient-rich blood to the whole body. For normal functioning of the human heart, blood is continuously supplied to the heart muscle through small arteries on the surface of heart, called coronary arteries. Heart attack occurs as a result of clogging of one of these arteries by blood clot which most often develops over an underlying obstruction caused by fat deposits in the wall of these arteries.
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ately on suspicion, the following steps must be undertaken by the family members:
Call your family physician. It is advisable to keep the contact numbers of your local doctor and nearby hospital stored in your cell phone, so that he can be reached without loosing time.
Try to reach the nearest hospital without wasting any time so that fatal consequences of heart attack could be treated immediately.
Chew/swallow a tablet of aspirin (300/325mg) immediately. It helps to dissolve the clot and re- duces the probability of death by almost 20%.
Don’t try self medication with indigenous preparations such as Hazmola and Eno etc. These unnecessarily result in loss of precious time and increase the risk of serious conse- quences.
Transfer to Specialist Hospital: Since heart attack occurs as a result of blockage in one of the three coronary arteries, the primary goal at the specialized cardiac centre is to re- establish the blood flow by dissolving the clot and clearing the obstruction, at the earliest, preferably within the first one hour. This can
Blockage In Coronary Artery
Heart attack re- mains one of the lead- ing causes of death all Dr. DS Gambhir over the globe. The first hour after onset of heart attack is called the ‘Golden Hour’ because, firstly most deaths following an attack occur during this period, and secondly restoring blood supply in the clogged artery during the first hour, provides the maximum benefit in terms of saving the heart function. Three Impor- tant Steps Fol- lowing Heart At- tack: After a per- son is suspected of an attack, there are three impor-
tant steps to be taken by the family members | or friends: (1) Recognizing the symptoms of heart attack; (2) Contacting your family physi- cian for immediate help, and (3) Reaching the hospital which has advanced facilities and ex- pertise to treat heart attacks.
Recognizing the Heart Attack: An adult, particularly male, must be suspected of having a heart attack if he complaints of one or more of the following symptoms: (1) severe pain in the centre of chest which is often described as suffocating, compressing or extreme tightness, particularly occurring at rest and radiating to left arm, back, neck or upper belly; (ii) sudden breathlessness without pain, particularly in dia- betics; (iii) these complains are often associ- ated with perspiration and restlessness.
The Role of Family Members: Immedi-
Atheroslerosis with Blood Clot (Lengthwise View)
be achieved by clot-dissolving drug, called ‘clot buster’ or per- forming the angioplasty and fixing a stent at the site of block- with Blood Clot age. Although clot-buster is
Atherosclerosis
(Cross Section)
osis
Atheroscler- easily available (Lengthwise with most hospi- View) tals, the success rate of dissolving the clot is only 50-60%. The underlying obstruction due to fat deposits in the wall of culprit artery remains and may re- sult in repeat attack. In contrast, immediate angioplasty is successful in 95% of cases, but requires specialist centre with cardiac cath lab. facilities, expertise and a much higher cost. Overall, survival and preservation of heart func- tions are better with angioplasty compared to clot-dissolving medicines.
In the light of these facts, the family should take the following decisions in consultation with family doctor:
Immediately shift the patient to a special- ized cardiac centre.
Make a right choice of the specialist cardi- ologist and the hospital. The treating cardiolo- gist must have a large experience in perform-
ing angioplasties.
Transport the patient in a fully equipped cardiac ambulance.
During transfer, the patient should be ac- companied by a resident doctor who should
CHARACTER
Pressing, Squeezing Heaviness, Aching, Tightness
SITE RADIATION DURATION PRECIPITATION RELIEF
Central Left Chest )
1-3 Mins Upto 15 Mins Exertion, Emotional Stress Rest, Sorbitrate
be able to manage complications on way to the hospital.
The Significance of First One Hour: It has been shown that deaths from heart attack decreased from 10% to 1%, and damage to the heart muscle reduced significantly in those treated within the “golden first hour”. In ap- proximately 40% of patients there is no re- sidual damage to the heart. Since the long- term outcome after a heart attack depends upon the extent of damage, those who are treated within the first hour, have very little or no effort intolerance, and are capable to lead a normal or near normal life.
Remember, denial that you are having a heart attack, could be fatal. Therefore, do not waste time and seize the opportunity of getting treatment during the golden hour to derive the maximum benefit at a specialized cardiac centre.
For more details call: Prof. D.S. Gambhir MD, DM, FAMS, FCSI, FICC, FCAPSC, FSCAI, FACC(USA) Group Director, Cardiology Kailash Health Care Ltd. Director, Kailash Hospital & Heart Institute, Noida-201301 Mobile: 9810237841, 9811041277 dsgambhir@yahoo.co.in
Formerly
Prof. Cardiology G.B.Pant Hospital, ND Honorary Editor, Indian Heart Journal (Official Publication of CSI) Past President
Cardiological Society of India (CSI) Indian College of Cardiology