Patients with signs of a heart attack must rush to an appropriate health facility as soon as possible, cardiologists and interventional cardiologists from across the world have stressed.
Speaking at the 6th Advanced Cardiovascular Therapeutics 2011 symposium organised jointly by Madras Medical Mission and Cleveland Clinic, US, here on Friday, Ajit Mullasari, Director, Cardiology, MMM, said the focus was on management of acute myocardial infarction, a debilitating and devastating problem. The mean age of occurrence is 54 years in India, almost a decade ahead of when it occurs in the West.
A Lancet study indicated that in India, in case of a heart attack, only 10 per cent used ambulance facilities. The rest used public or private transportation. “The problem with this is that it is only in a well-equipped ambulance that you can get support even while on the way to hospital, including defibrillation,” Dr. Mullasari said.
The message to patients is, “When you have chest pain, you need to be in a cardiac care centre.” The ideal standard of door-to-balloon time (for an angioplasty) is about 90 minutes, he said.
While debates rage about the advantages of using a radial procedure (through the arm) as against a femoral procedure (through the groin) for angioplasty, it is essential to remember that a high quality procedure, best suited to the patient, must be done, Stephen Ellis from the Cleveland Clinic said.
The warning sign is not just chest pain, added Mathew Samuel Kalarickal, course director, ACT 2011. Patients would also have to be on the watch for any abnormal pain or discomfort, in the left and right arms, abdomen, jaw and back. “Especially if you fall in a risk group, do not ignore these signs. Most people dismiss these signs as gastric problems. It may not even be a heart attack, but if it is, missing the symptoms will be fatal.”
Marc Silvestri, Service Cardio-vasculaire Polyclinique Parc Rambot, France, re-emphasised, “Go early. The patients always think it is something else, and will wait. That is not advisable.”
Ravi Nair, cardiologist, Cleveland Clinic, explained that many people succumbed to heart attack; about 40 per cent never reached the hospital. It is absolutely essential to educate people about the need to reach hospital at the earliest.
Over the last few years, cardiovascular disease had reached epidemic proportions in the country, owing to a surge in other conditions such as diabetes, hypertension, dislipidemia (high cholesterol), a sedentary lifestyle, and smoking. In addition, pollution is also a risk that affects the arteries, not only of the heart, but also other organs and limbs. This is called peripheral arterial disease, explained Mehdi Shishebor, interventional cardiologist, Cleveland Clinic. It also has a significantly high mortality.
