The first six hours after a heart attack being a crucial period for patients, cardiologists suggest thrombolytic treatment for those suffering heart attacks in areas that are poorly connected.

Thrombolytic treatment is basically an injection that bursts or dissolves the clot that clogs or obstructs the blood flow to a portion of the heart. Saturday being observed as the World Heart Day, city cardiologists explained to The Hindu both the advantages and disadvantages of providing thrombolytic treatment to the needy patients.

An ideal solution

Thrombolytic treatment could be an ideal solution as there may be a delay in bringing patients to the hospital. It can be provided even by a general physician within six hours of the attack and can help save lives, especially in places that lack cardiac care facilities, says C.N. Manjunath, director, Jayadeva Institute of Cardiovascular Sciences and Research.

Medical treatment needs to be streamlined to avoid delay in bringing the patient to the hospital. “If a patient does not get treatment for every 30 minutes after the attack, the risk of death increases by 7 per cent,” he adds.

Explaining the thrombolytic treatment, V.S. Prakash, head of the Department of Cardiology at M.S. Ramaiah Hospital, says people seek this treatment as it is less expensive compared to angioplasty. “While thrombolytic treatment can cost anywhere between Rs. 10,000 and Rs. 40,000, an angioplasty costs close to Rs. 1 lakh.”

However, Dr. Prakash cautioned that patients need to understand that the treatment does not end at thrombolytic treatment. “After this treatment, they need to consult a cardiologist who will suggest the future course of treatment.”

Though cardiologists say that the goal of the treatment after the attack should aim at reducing the death rate, and survival with good heart function, J. Kannan, cardiologist at Narayana Hrudalaya, pointed that the thrombolytic treatment might be useful to 60 per cent of the patients. Side effect of this treatment could sometimes cause internal bleeding, he cautioned.

“After the attack, the heart muscle starts dying as the blood supply is stopped. So there is a need to restore blood flow as quickly as possible,” he suggested.

Prevention

With the incidence of cardiovascular diseases increasing every year, cardiologists say the best way is prevention. Annually, close to 2.5 million deaths in India are attributed to myocardial infarction (commonly known as heart attack).

“In 1990, there were only 1.2 million deaths because of this. But the incidence is increasing rapidly and the only way to deal with it is by working out preventive strategies,” Dr. Prakash added.

A recent study conducted by the Jayadeva institute on 1,042 heart patients identified diabetes, hypertension, cholesterol, obesity and smoking to be the risk factors for heart attack. “As much as 25 per cent of the heart attack patients are below 40 and the incidence is increasing in the younger age groups,” Dr. Manjunath pointed out, and added that the family physician needs to play a bigger role in educating people about the risk factors.”

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