What is a Heart Attack?
A heart attack is a serious condition with potentially fatal consequences. It is a situation where there is a lack of blood supply to the heart muscle due to a block in the blood vessel supplying the heart muscle.
Why this important to treat?
A heart attack is the number one killer disease in the world. Sadly India will become the âHeart attack capitalâ of the world in addition to the dubious distinction of âDiabetes Capitalâ of the world. The heart is a pump and supplies blood (food and oxygen) to all the body parts to function properly. Once there is no blood supply, there is damage to the heart muscle which is usually permanent. Therefore the treatment goal is to act before there is much heart muscle damage by opening the blocked blood vessel to re-establish the blood flow.
How soon should treatment be given?
As mentioned, before the goal is to prevent any heart muscle damage which can be permanent. According to evidence from multiple clinical trials, the best time frame is before 60-90 minutes. This gives the patient the best chance to have a successful outcome. The process of opening the blocked artery and inserting a stent is called Angioplasty. The procedure performed in this situation is called Primary Angioplasty (the medical term being Primary Percutaneous Coronary Intervention). In addition to the procedure, medications play an important role in managing these patients. The chances of complications from heart attack including the risk of dying significantly increases with time.
Is this treatment available widely?
Yes, this treatment is widely available throughout the country, particularly in all major cardiac centers. It is not yet available in the smaller districts and villages, unfortunately. It is performed by the Interventional Cardiologist who specializes in the treatment of this condition. Both the Government of India and the Karnataka State Governments have made provisions for free treatment not only in Government hospitals but also in Private (Corporate) hospitals for Below Poverty Level (BPL) patients.
What is the first step any concerned patient should do?
Once the patient has any of the concerned symptoms (chest pain, discomfort, chest uneasiness, left shoulder/arm pain and or breathlessness), he/she should consult the nearest available doctor. If there is a suspicion of a heart attack, the patient should come to the nearest cardiac center for further diagnosis and treatment. The time delay should be as minimal as possible.
Is there an alternative to Primary angioplasty?
For those who are not able to afford this treatment or are too far away from a cardiac centre that can provide for this treatment, there is an alternative called âThrombolysisâ (clot-busting injection treatment). Although this is less superior compared to Primary angioplasty, this can be a lifesaver in many situations. Most patients still need angioplasty afterwards.
Dr. Praveen P Sadarmin | Consultant â Cardiology â Adult | St. Marthaâs Heart Centre, Sampangi Rama Nagar, Bangalore