Dr. Kulick received his undergraduate and medical degrees from the University of Southern California, School of Medicine. He performed his residency in internal medicine at the Harbor-University of California Los Angeles Medical Center and a fellowship in the section of cardiology at the Los Angeles County-University of Southern California Medical Center. He is board certified in Internal Medicine and Cardiology.
Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.
What Are Some of the Treatment Options and Guidelines?
Early treatment can prevent or limit damage to the heart muscle. Acting fast,
at the first symptoms of heart attack, can save your life. Medical personnel can
begin diagnosis and treatment even before you get to the hospital.
Certain treatments are usually started right away if a heart attack is
suspected, even before the diagnosis is confirmed. These include:
Oxygen
Aspirin to prevent further blood clotting
Nitroglycerin, to reduce the workload on the heart and improve blood flow
through the coronary arteries
Treatment for chest pain
Once the diagnosis of heart attack is confirmed or strongly suspected,
treatments to try to restore blood flow to the heart are started as soon as
possible. Treatments include drugs such as beta blockers, ACE inhibitors,
and anticoagulants, antiplatelet (aspirin and clopidogrel) and medical
procedures such as angioplasty, coronary artery bypass grafting.
SOURCE: National Heart Lung and Blood Institute.com. How Is a Heart Attack Treated?
What is a heart attack?
A heart attack (also known as a myocardial infarction) is the death of heart
muscle from the sudden blockage of a coronary artery by a blood clot. Coronary
arteries are blood vessels that supply the heart muscle with blood and oxygen.
Blockage of a coronary artery deprives the heart muscle of blood and oxygen,
causing injury to the heart muscle. Injury to the heart muscle causes chest pain
and pressure. If blood flow is not restored within 20 to 40 minutes,
irreversible death of the heart muscle will begin to occur. Muscle continues to
die for six to eight hours at which time the heart attack usually is "complete." The
dead heart muscle is replaced by scar tissue.
Approximately one million Americans suffer a heart attack each year. Four
hundred thousand of them die as a result of their heart attack.
Click here
to view interactive photos of hearts that have suffered a heart attack.
How is a heart attack treated?
Treatment of heart attacks include:
Anti-platelet medications to prevent formation of
blood clots in the arteries
Anti-coagulant medications to prevent growth of
blood clots in the arteries
Coronary angiography with either percutaneous transluminal coronary
angioplasty (PTCA)
with or without stenting to open blocked coronary arteries
Clot-dissolving medications to open blocked arteries
Supplemental oxygen to increase the supply of oxygen
to the heart's muscle
Medications to decrease the need for oxygen by the
heart's muscle
Medications to prevent abnormal heart rhythms
The primary goal of treatment is to quickly open the blocked artery and
restore blood flow to the heart muscle, a process called reperfusion. Once the
artery is open, damage to heart muscle ceases, and the patient becomes pain
free. By minimizing the extent of heart muscle damage, early reperfusion
preserves the pumping function of the heart. Optimal benefit is obtained if
reperfusion can be established within the first four to six hours of a heart attack. Delay
in establishing reperfusion can result in more widespread damage to heart muscle
and a greater reduction in the ability of the heart to pump blood. Patients with
hearts that are unable to pump sufficient blood develop heart failure, decreased
ability to exercise, and abnormal heart rhythms. Thus, the amount of healthy
heart muscle remaining after a heart attack is the most important determinant of
the future quality of life and longevity.
Congestive heart failure (CHF) is a condition in which the heart's function as a pump is inadequate to meet the body's needs. A poor blood supply resulting from congestive heart failure may cause the body's organ systems to fail, leading to a weakened heart muscle and fluid accumulation in the lungs and body tissue. There are many diseases that can impair pumping efficiency and symptoms of congestive heart failure including fatigue, diminished exercise capacity, shortness of breath, and swelling. Treatments include lifestyle modifications, medications, heart transplant, and therapy.
Blood clots can occur in the venous and arterial vascular system. Blood clots can form in the heart, legs, arteries, veins, bladder, urinary tract and uterus. Risk factors for blood clots include high blood pressure and cholesterol, diabetes, smoking, and family history. Symptoms of a blood clot depend on the location of the clot. Some blood clots are a medical emergency. Blood clots are treated depending upon the cause of the clot. Blood clots can be prevented by lowering the risk factors for developing blood clots.
Cholesterol is naturally produced by the body, and is a building block for cell membranes and hormones. Low-density lipoprotein (LDL) cholesterol is the "bad" cholesterol, conversely, high-density lipoprotein (HDL) cholesterol is the "good" cholesterol. High cholesterol treatment includes lifestyle changes (diet and exercise), and medications such as statins, bile acid resins, and fibric acid derivatives.
Heart attack happens when a blood clot completely obstructs a coronary
artery supplying blood to the heart muscle. A heart attack can cause chest pain, heart failure, and electrical
instability of the heart.
Heart failure is caused by many conditions including coronary artery disease, heart attack, cardiomyopathy, and conditions that overwork the heart. Symptoms of heart failure include congested lungs, fluid and water retention, dizziness, fatigue and weakness, and rapid or irregular heartbeats.
Heart disease, particularly coronary artery disease is the leading cause of heart attacks. Women are more likely to die from a heart attack than men. High cholesterol, high blood pressure, obesity, and high triglycerides are contributors to heart disease. Some of the common symptoms of a heart attack in women include chest pain, shortness of breath, nausea, feeling faint or woozy, and more. Heart disease can be prevented by lifestyle changes and controlling high blood pressure, cholesterol, weight, and diseases such as diabetes.
Heart attacks are the major causes of unexpected, sudden death among men and women. A heart attack is also a significant cause of heart failure. Learn the risk factors for heart attack such as high blood pressure, diabetes, and other heart conditions. Lowering your risk factor, lifestyle changes, and in some cases medication are the most effective way of preventing a heart attack.
Fabry disease (Fabry's disease, alpha-galactosidase-A) is a genetic disorder with symptoms such as burning sensations in the hands, small-raised reddish-purplish blemishes on the skin, fever, decreases sweating, and GI difficulties. Fabry disease patients are at increased risk of heart attack, heart disease, kidney failure, and stroke. Symptoms of Fabry disease can be treated with medication.
A heart attack is a layperson's term for a sudden blockage of a coronary artery. This photo essay inlcudes graphics, pictures, and illustrations of diseased heart tissue and the mechanisms that lead to coronary artery disease, and possible heart attack.
Biologic rhythms, or biorhythms, are how our bodies respond to the regular phases of the sun, moon, and seasons. A medical chronobiologist studies how the "body clock" or biorhythms affect diseases and how the body clock responds to treatment of diseases and conditions at different times of the day.
Cholesterol occurs naturally in the body. High blood cholesterol levels increase a person's risk of developing heart disease, heart attacks, strokes, TIAs, and more. In addition to medication (fibrates, statins, bile acid sequestrants, and niacin), lifestyle changes can be made to lower blood cholesterol levels
Vitamins and exercise can lower your risk for heart attack and heart disease. Folic acid, vitamins, and homocysteine levels are interconnected and affect your risk for heart disease or heart attack. Antioxidants and exercise also play a key role in heart attack and heart disease prevention. Lower your risk factors for heart disease and heart attack by lowering cholesterol, lowering blood pressure, diabetes prevention, and smoking cesssation.
Smoking increases the risk of heart disease in women and men. Nicotine in cigarettes decrease oxygen to the heart, increases blood pressure, blood clots, and damages coronary arteries. Learn how to quit smoking today, to prolong your life.
Most people associate cigarette smoking with breathing problems and
lung cancer. But did you know that smoking is also a major cause of
heart disease for
men and women?
About 20% of all deaths from heart disease in the U.S. are directly related
to cigarette smoking. That's because smoking is a major cause of coronary artery
disease.
A person's risk of heart disease and heart attack greatly increases with the
number of cigarettes he or she smokes. Smokers continue to increase their risk
of heart attack the longer they smoke. People who smoke a pack of cigarettes a
day have more than twice the risk of heart attack than nonsmokers. Women who
smoke and also take birth control pills increase several times their risk of
heart attack, stroke, and peripheral vascular disease.
Cigarette smoke not only affects smokers. When you smoke, the people around
you are also at risk for developing health prob...
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