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HEART ATTACK: PART FOUR

© Kathleen Newton

When a person who is exhibiting symptoms of a heart attack arrives at the Emergency Room, the emergency staff moves quickly to definitively diagnose Acute Myocardial Infarction (heart attack in progress). Early intervention is crucial, as the benefits are greatest if treatment is begun as soon as possible after the onset of symptoms.

Acute Myocardial Infarction is diagnosed by examining three primary factors:

*Signs and symptoms: does the patient have chest pain and other symptoms consistent with heart attack?

*Electrocardiogram: a patient experiencing a heart attack will have changes in heart rhythm, which is detected and recorded on paper. The ER physician then interprets the EKG.

*Cardiac enzymes: During an Acute Myocardial Infarction, changes occur in heart-specific enzymes that are present in the blood. A blood sample is taken and tested for these enzymes. The ER physician takes into consideration the levels of these enzymes when determining if a heart attack is occurring.

When a person is admitted to the ER with a suspected Myocardial Infarction:

*Supplemental oxygen is given to the patient to provide the ailing heart with much-needed oxygen.

*Nitroglycerin is given sublingually (under the tongue) for chest pain.

*Additional pain relief, such as Morphine or Demerol, is given if needed.

*Up to four aspirin are given. WHY ASPIRIN?? Aspirin thins the blood, making blood flow easier through partially blocked arteries.

TREATMENT FOR AN ACUTE MYOCARDIAL INFARCTION

Thrombolytic Therapy: Certain powerful drugs can be given to break up a clot that is blocking an artery. These "clot busters", such as Tissue Plasminogen Activator (TPA) and Streptokinase, are most effective when given within six hours of the onset of heart attack symptoms.

Coronary Artery Bypass Graft: During bypass surgery, a length of blood vessel is removed from the leg of the patient. The removed vessel is attached to the affected area of the coronary artery, bypassing the occlusion. More than one blocked area can be bypassed during the surgery. For example, in a triple bypass, three sections of blood vessel are removed from the leg, and are used to bypass three different areas of blocked artery.

Angioplasty: During angioplasty surgery, a catheter is inserted into the blocked coronary artery. The balloon-like tip of the tiny catheter is placed within the blocked area, and is gently inflated. This inflation causes the area of blocked vessel to stretch, resulting in a wider opening through which blood can more easily flow.

With the advances in technology seen in the last ten years, treatment for Acute Myocardial Infarction today is more effective than ever before. However, it's important to remember that the treatments explained above are NOT cures for heart disease. No matter what treatment is used for heart attack, lifestyle changes MUST be made in order to avoid subsequent heart attacks. Remember, you are at greater risk for a heart attack if you have had one in the past.

The copyright of the article HEART ATTACK: PART FOUR in First Aid is owned by Kathleen Newton. Permission to republish HEART ATTACK: PART FOUR in print or online must be granted by the author in writing.