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A recent study reported that using recommended medical treatment guidelines
for heart attack patients resulted in an almost 50% reduction in the rate
of death or heart failure. Additionally the likelihood of experiencing a
second heart attack within the next 6 months was far less likely.
New treatment guidelines are designed to rapidly diagnose an acute heart attack in the Emergency Room.
The patient is immediately treated with aspirin to thin the blood and a Beta-blocker to
improve cardiac efficiency. The patient is then moved to the cardiac catheterization lab where the
blocked artery is opened with a balloon and a stent is deployed. Under certain circumstances
however, a better option for the patient may be the administration of "clot busting" drugs to
open the blocked artery chemically.
Once the artery is opened the patient begins to take
medicines long term to keep the artery and stent open (Plavix and aspirin), to help the
artery wall to relax and dilate (ACE inhibitors) and to prevent the accumulation of fatty
plaques in the vessel by lowering cholesterol (statins).
The combination of rapid opening of the blocked artery and subsequent medicines to
keep the artery open and prevent recurrent blockage leads to a major reduction in the amount
of damage to the heart. If less heart muscle dies with a heart attack then the likelihood of
heart failure is reduced.
Additionally, if the artery can be kept open the likelihood of a second
heart attack is diminished. These results are encouraging but could be even better if people
became aware of the typical signs and symptoms of a heart attack and seek earlier medical attention.
Signs and symptoms of a heart attack:
- Chest pain
- Shortness of breath
- Sweating
- Nausea and vomiting
summarized by Michael J. Harkins, M.D., F.A.C.C.
Source: "Decline in Rates of Death and Heart Failure in Acute Coronary Syndromes, 1999-2006,"
Fox et al.,
JAMA May 2, 2007; 297: 1892-1900.
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