Those first six hours are crucial

The first six hours after a heart attack being a crucial period for
patients, cardiologists suggest thrombolytic treatment for those
suffering heart attacks inareas 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 angioplastycosts 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
internalbleeding, 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 only1.2 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 conductedby 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 toplay a bigger role in
educating people about the risk factors."

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