Know your life-saving heart treatment options

No doubt, being faced with a heart attack or stroke is devastating. It can be comforting to know your medical options.

• If you reach the hospital quickly, doctors may try to open up your coronary arteries mechanically. This is known as percutaneous intervention (PCI) or angioplasty, and is the preferred option if time permits.
• A thin tube with a balloon at the tip is threaded up from your groin or wrist and into your coronary artery.
• A small amount of dye is injected so that the site of the blockage can be seen using an X-ray video (a test called a coronary angiogram) and the balloon is inflated to widen the artery.
• The tube is then withdrawn, although a small metal coil known as a stent is usually left in place in the artery to keep it open and prevent further blockages.
• Some stents release drugs to help keep the artery clear.

• Angioplasty is successful in opening up about 90 per cent of clogged arteries.
• It rapidly relieves pain and can reduce damage to the heart muscle.
• This is not a suitable procedure for some conditions.
• If your main coronary artery is blocked, or if you have multiple blockages or a complicating condition like diabetes, doctors may perform an immediate coronary artery bypass graft (CABG) instead.

• A CABG entails open-heart surgery, a major procedure.
• A healthy blood vessel taken from elsewhere in the body is linked to the two ends of your coronary artery on either side of a blockage to provide an alternative passage for blood to flow to your heart muscle.
• Often, two or three coronary arteries are bypassed during the same operation.

• Doctors may also give you thrombolytic drugs like streptokinase or reteplase to dissolve the clot blocking the coronary artery and restore blood flow to the heart.
• Thrombolytic drugs work by attacking fibrin, the substance in your blood that keeps a clot together.
• The drugs are most effective within the first three to four hours following the onset of symptoms.
• However, they will give satisfactory results up to six hours after and still have some benefit up to 12 hours after symptoms have first appeared.

• Thrombolytic or clot-busting drugs have revolutionized the treatment of heart attacks.
• These drugs are effective in opening up the coronary arteries in about half of all patients, reducing damage and improving the chances of long-term survival.
• In some areas, ambulance paramedics responding to suspected heart-attack calls now carry thrombolytic drugs with them, so that they can be administered straight away (after an ECG test has been carried out, to confirm the heart attack).
• When the patient arrives in the hospital, doctors will monitor his or her condition carefully, since clot-busting drugs can promote bleeding.

• In North America, telemedicine is helping doctors who serve remote arctic communities, as well as those in innumerable other situations where a doctor can't quickly reach a patient.
• Where the technology exists, a doctor is able to log on to his laptop at home, linking up to a camera at the hospital.
• It lets him ir her examine an emergency patient remotely, while a highly trained nurse acts as his eyes and ears.
• The doctor can focus on particular parts of the patient's body — even the pupils in the patient's eyes, for example.
• He can also talk and listen to his or her patients.