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Heart Attack

Golden First Hour
Management of Heart Attack
Every organ in human body needs blood supply for its proper functioning. Heart is the central organ for supply of blood to all other parts of body viz. brain/kidneys etc. Heart itself derives blood from three arteries which are known as coronary arteries.
Occlusion by a blood clot in the blood flow of these coronary arteries leads to decreased blood supply to the muscle of the heart, which manifests itself as heart attack.

When to suspect a heart attack:
If a person complains of following symptoms:
  • Chest pain / constriction usually central in character spreading to arms especially left arm, jaws, neck or back.
  • Associated with sweating.
  • Restlessness.
  • Palpitation.
  • Sudden onset of shortness of breath.
  • Sudden onset acidity, gas, in stomach /vomiting.
  • In diabetic patients usually symptoms of Chest pain /constriction are not there.

What causes heart attack:
Heart attack occurs when there is 100% reduction of blood supply to the muscle. Usually there is gradual building of plaque (dirty material) in the lumen of arteries supplying heart over a certain time period and when a clot / thrombus sits over a plaque, it leads to sudden cut off, of supply to the muscle, that results in what we call heart attack.

Initiation of Treatment:
As early as possible
Earliest the blood supply is restored, better the chance of muscle survival. It is seen that 50% of deaths associated with heart attack occur within one hour of onset of symptoms. In view of large number of deaths occurring in such short time of symptoms underscores the importance of instituting treatment at the earliest possible.

Apart from mortality, there is considerable amount of decrease in morbidity associated with early treatment. If the muscle damage increases beyond a certain point, patient may land up in cardiogenic shock in acute phase or end up with chronic heart failure in times to come.

Some dreaded complications can also be avoided, like heart attack causing rupture of muscle or leakage of valves.

What to do at home in case of chest pain ?
  • Make the person as relaxed as possible Relaxed posture/clothes.
  • If he is not short of breath, make him lie down.
  • Give him chewable tablet of aspirin immediately.
  • Rush to a nearest medical care, preferably a heart institute.
  • Patient should never drive to the hospital. Instead, patient should be driven to the hospital.
Treatment in hospital Non cardiac set up:
In a hospital, initially the diagnosis is confirmed by doing an electrocardiogram( EGG) and if facility is available than echocardiography.

On the basis of clinical presentation and EGG findings, more than 90% cases of heart attack are diagnosed and immediate treatment is started which includes following:
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