A matter of life and death
If it turns out that the patient is having a heart attack, medical management starts straight away.
If it is a severe heart attack, what doctors refer to as STEMI (ST segment elevation myocardial infarction), the patient will immediately be sent to the catheterisation lab for an angioplasty, a procedure where the blocked artery is opened with a balloon-like device.
“An angioplasty is the most preferred treatment in such an emergency. In STEMI cases, time is critical from when the patient comes into the ER to the lifesaving procedure. Ideally, the door-to-balloon time should be no more than 90 minutes.
“Of course, not all patients who come in will need this procedure. Some just require medication, which can be administered through the bloodstream,” he continues.
There is a wide range of heartrelated issues that an ER will see in a given week. For example, out of 10 cases Dr Asad sees in the ER on a given day, on average seven of them will be heart-related.
It is important for people to know where they can go during a heart emergency, says Dr Asad.
During a cardiac medical emergency, the person must go to the right hospital that is equipped with the right facilities and services so that vital time is not lost. HERE are some common heart-related emergencies that an ER physician will deal with:
Unstable angina – a condition where there is not enough blood flow or oxygen to the heart. Patients experience chest pains of increasing intensity and duration, but often when an ECG or blood test is administered, results are normal. This means a heart attack may occur at any time and the patient should go for an angiogram within the next 24 hours.
Arrhythmia – this is basically where the heart pumps at an irregular rhythm or there is ventricular fibrillation (where the cardiac muscles of the ventricles contract in an uncoordinated manner). Blood that should be sent out of the heart becomes compromised.
Acute pulmonary oedema – this happens when the heart is not strong enough to send out all the blood that the lungs send to it and there is a backflow of blood into the lungs, causing the lungs to flood. The patient will start feeling breathless, and eventually experience a cardiac arrest. The doctor will intubate the patient to improve oxygen flow and administer medication to draw the liquid out of the lungs.