Time is a critical element when dealing with matters of the heart: Health expert
Heart disease is the leading cause of death for both men and women. There are plenty of steps you can take to both prevent and manage coronary artery disease. The largest contributors to heart disease are not eating right and being sedentary.
When we eat a lot of foods high in unhealthy fats, such as red meat and processed foods, and don’t exercise, the arteries that feed the heart blood and oxygen become lined with plaque. When plaque builds up, it causes a condition called atherosclerosis, and blood has trouble flowing through the arteries.
This decreases the amount of oxygenated blood to your heart. Plaque is made up of cholesterol, cells and other materials and it’s dangerous because it causes narrowing of arteries and can even rupture them. A rupture can be fatal because the soft inside of the plaque is released, causing a clot that can block blood flow.
Partial blockage can cause angina, which is pain or pressure in the chest, back or shoulders. Complete blockage causes a heart attack.
If a patient has significant plaque build-up 70 per cent of an artery is blocked — it is recommended to open the artery by stent, an minimally invasive procedure to place a tube (stent) in the artery to open it up and let the blood flow more freely. In severe cases, a bypass surgery is performed, which diverts blood around a section of a blocked artery.
People who have suffered heart attacks should be offered immediate treatment to restore blood flow under the new guidelines which emphasise that time is of the essence. The most important reason we give patients a stent is to unblock an artery.
Nearly 1/3 of potentially salvageable heart muscle is lost within one hour of the coronary artery being blocked and half is lost within three hours. The more heart muscle that is lost, the poorer the outcome for the patient. Therefore, restoring blood flow to the heart as quickly as possible is the most important priority that means “time is muscle”. The quicker a person can get help, the more of the heart muscle can be saved.
The guidelines recommended that coronary angioplasty, and stenting (collectively known as primary percutaneous coronary intervention (PPCI) is the best way quickly to unblock a coronary artery and restore adequate blood flow following a heart attack or myocardial infarction.
PPCI treats people with severe heart attacks, where a cardiac artery is completely blocked. The aim is to get the victim’s artery reopened within 90 minutes after seeking medical help. The patient is rushed to the cardiac unit (cath lab) where a catheter is inserted into their right wrist. Through this, a tiny wire is navigated by the interventional cardiologist to the blocked heart artery.
By quickly locating and treating the site of the blockage, emergency angioplasty reduces the damage to heart muscle and helps the heart function better in the future.
Timing is critical and reducing the time between patients’ arrival for emergency angioplasty procedure, can have dramatic effects on patient outcomes. Many studies show that patients who transferred to PPCI centre that is equipped by cath-lab have better outcome including lower mortality and prolong the survival with less recurrent heart attack after PCI.
Also destination protocol for emergency medical system that bypass the non-PPCI capable hospitals and shorten the system delays to angioplasty have been improved outcome in patients.