| Greater public
awareness about heart attacks and changes in lifestyle have contributed to a
dramatic reduction in the incidence of heart attacks during the last four
decades. Improved anticoagulant drugs such as hirudin and hirulog, are being
tested and may complement current therapies. The role of the "super aspirins"
(Reopro and Integrilin) is currently being investigated as well. More effective
versions of TPA are being developed. Increasingly, paramedics can do ECGs in the
field, diagnose a heart attack, and take patients directly to hospitals that
have the ability to do PTCA and stenting. This can save time and reduce damage
to the heart. Recent data has shown that lowering blood LDL levels even further
than previously suggested may further decrease the risk of heart attacks.
Research also has shown that inflammation may play a role in the development of
atherosclerosis, and this is an active area of current investigation. There also
is early evidence that with genetic engineering it may be possible to develop a
drug that can be administered to clear plaques from arteries (a "scavenger
molecule").
Heart Attack At
A Glance
* A heart
attack results when a blood clot completely obstructs a coronary artery
supplying blood to the heart muscle and heart muscle dies.
* The blood
clot that causes the heart attack usually forms at the site of rupture of an
atherosclerotic, cholesterol plaque on the inner wall of a coronary
artery.
* The most
common symptom of heart attack is chest pain.
* The most
common complications of a heart attack are heart failure, and ventricular
fibrillation.
* The risk
factors for atherosclerosis and heart attack include elevated cholesterol
levels, increased blood pressure, tobacco use, diabetes, male gender and a
family history of heart attacks at an early age.
* Heart
attacks are diagnosed with electrocardiograms and measurement of cardiac enzymes
in blood
* Early
reopening of blocked coronary arteries reduces the amount of damage to the heart
and improves the prognosis for a heart attack.
* Medical
treatment for heart attacks may include anti-platelet, anti-coagulant, and clot
dissolving drugs as well as angiotensin converting enzyme (ACE) inhibitors, beta
blockers and oxygen.
*
Interventional treatment for heart attacks may include coronary angiography with
percutaneous transluminal coronary angioplasty (PTCA), coronary artery stents,
and coronary artery bypass grafting (CABG).
* Patients
suffering a heart attack are hospitalized for several days to detect heart
rhythm disturbances, shortness of breath, and chest pain.
* Further
heart attacks can be prevented by aspirin, beta blockers, ACE inhibitors,
discontinuing smoking, weight reduction, exercise, good control of blood
pressure and diabetes, following a low cholesterol and low saturated fat diet
that is high in omega-3-fatty acids, taking multivitamins with an increased
amount of folic acid, decreasing LDL cholesterol, and increasing HDL
cholesterol
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