An estimated 785,000 Americans will suffer their first heart attack in 2010, predicts the American Heart Association. Timeliness of treatment and the extent of damage caused by the heart attack determine whether a non-surgical or surgical heart repair is necessary. Research on new treatment methods is ongoing and aimed at providing better long-term prognosis by preventing the development of heart failure.
Heart Attack Overview
A heart attack occurs when blood vessels supplying oxygen-rich blood to the heart muscle become partially or wholly blocked by plaque and blood clots. In the absence of oxygen, tissue begins to die and the heart muscle is unable to pump normally. The electrical conduction system of the heart can also be affected causing erratic heartbeats. The severity of a heart attack is determined by how many blood vessels are affected and the extent to which blood flow has been limited or completely interrupted. Damage caused by heart attacks can lead to heart failure.
Non-Surgical Treatment
Opening blocked blood vessels and reducing stress on the heart are the main goals of heart attack treatments. This can be accomplished non-surgically through the use of various medications. Medications commonly prescribed to increase blood flow allow blood vessels to relax and dilate, and dissolve the clots associated with blockages. Additionally, drugs can be used to slow the heart rate and reduce the force of contraction to decrease the stress placed on the heart. Correcting complications within the electrical system of the heart to keep it beating in rhythm is the responsibility of antiarrhythmic medications. Medications can be used as a stand-alone treatment, or in conjunction with surgical treatments depending on the severity of the heart attack.
Surgical Treatments
When medications are unable to remove the blockage, surgical treatment options become necessary. Coronary angioplasty involves inserting a catheter into a partially blocked artery and inflating a balloon to push the plaque against the walls of the vessels to allow more blood to flow through. A piece of wire-mesh tubing, called a stent, holds the plaque in place. Cardiologist Andrew Michaels reports in a 2002 article appearing in "Circulation" that balloon angioplasty is not an option for complete arterial blockages, or for individuals whose arteries are too small for the angioplasty procedure. In this case, coronary artery bypass grafting is used to restore blood flow to the heart. This procedure involves detouring blood flow around the blockage by attaching a new vessel above and below the blockage, thus bypassing the blockage.
Timeliness of Treatment
The benefit of restoring blood flow to the heart is based on the timeliness of treatment. Clot busting medications and coronary angioplasty are most effective when completed within the first 90 minutes of a heart attack. When angioplasty treatment is delayed beyond 90 minutes, the rate of death within 30 days and at one year post-heart attack increases significantly, according to research in the "Journal of the American Medical Association." This highlights the urgency of recognizing the signs of a heart attack and receiving prompt treatment.
Advancing Medicine
An average heart attack causes the death of approximately one billion heart muscle cells. This cell death causes structural and functional disruptions in the heart leading to heart failure. The use of stem cells injected into the heart muscle to stimulate repair and prevent permanent structural damage is a treatment method currently being investigated. In the prominent scientific journal "Nature," Dr. Vincent Segers states that stem cell therapy is capable of reversing the damage a heart attack causes. His research indicates this treatment option has the potential to significantly decrease the number of patients with heart failure caused by heart attacks.
References
- "Circulation"; Heart Disease and Stroke Statistics 2010 Update; Donald Lloyd-Jones, M.D.; 2010
- "Circulation"; Angioplasty Versus Bypass Surgery for Coronary Artery Disease; Andrew D Michaels, M.D.; 2002
- "Journal of the American Medical Association"; Association Between Timeliness of Reperfusion Therapy and Clinical Outcomes in ST-Elevation Myocardial Infarction; Laurie Lambert, Ph.D.; 2010
- "Nature"; Stem-Cell Therapy for Cardiac Disease; Vincent F.M. Segers; 2008
