Heart Attack (cont.)
What is new in heart attack?
Greater public awareness about heart attacks and changes in lifestyle have
contributed to a dramatic reduction in the incidence of heart attacks during the
last four decades. Improved anticoagulant drugs such as hirudin and hirulog, are
being tested and may complement current therapies. The role of the "super
aspirins" [abciximab (Reopro) and
eptifibatide (Integrilin)] is currently being investigated as well.
More effective versions of TPA are being developed. Increasingly, paramedics can
do ECGs in the field, diagnose a heart attack, and take patients directly to
hospitals that have the ability to do PTCA and stenting. This can save time and
reduce damage to the heart. At present, the accepted best treatment for a heart
attack is identification promptly of the diagnosis, and transport to a hospital
that can perform prompt catheterization and PTCA or stenting within the first 90
minutes of the cardiac event.
Recent data has shown that lowering blood LDL levels
even further than previously suggested may further decrease the risk of heart
attacks.
Research also has shown that inflammation may play a role in the
development of atherosclerosis, and this is an active area of current
investigation. There also is early evidence that with genetic engineering it may
be possible to develop a drug that can be administered to clear plaques from
arteries (a "scavenger molecule").
Heart Attack At A Glance
- A heart attack results when a blood clot completely
obstructs a coronary artery supplying blood to the heart muscle and heart
muscle dies.
- The blood clot that causes the heart attack usually
forms at the site of rupture of an atherosclerotic, cholesterol plaque on the
inner wall of a coronary artery.
- The most common symptom of heart attack is chest
pain.
- The most common complications of a heart attack are
heart failure, and ventricular fibrillation.
- The risk factors for atherosclerosis and heart attack
include elevated cholesterol levels, increased blood pressure, tobacco use,
diabetes, male gender and a family history of heart attacks at an early
age.
- Heart attacks are diagnosed with electrocardiograms
and measurement of cardiac enzymes in blood
- Early reopening of blocked coronary arteries reduces
the amount of damage to the heart and improves the prognosis for a heart
attack.
- Medical treatment for heart attacks may include
anti-platelet, anti-coagulant, and clot dissolving drugs as well as
angiotensin converting enzyme (ACE) inhibitors, beta blockers and oxygen.
- Interventional treatment for heart attacks may include
coronary angiography with percutaneous transluminal coronary angioplasty
(PTCA), coronary artery stents, and coronary artery bypass grafting (CABG).
- Patients suffering a heart attack are hospitalized for
several days to detect heart rhythm disturbances, shortness of breath, and
chest pain.
- Further heart attacks can be prevented by aspirin, beta blockers, ACE
inhibitors, discontinuing smoking, weight reduction, exercise, good control of
blood pressure and diabetes, following a low cholesterol and low saturated fat
diet that is high in omega-3-fatty acids, taking multivitamins with an increased
amount of folic acid, decreasing LDL cholesterol, and increasing HDL
cholesterol.
Click here to read the Heart
Attack Treatment article.
Last Editorial Review: 6/26/2008
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