The treatment of myocardial infarction
The treatment of myocardial infarction can be divided into immediate or urgent and secondary prevention
Immediate treatment involves restoring blood flow to the heart as soon as possible (TIME IS MYOCARDIUM) as well as measures for protecting the heart and relieving symptoms.
Immediate restoration of flow is the cornerstone of treatment. The gold standard method is primary angioplasty (balloon). This assumes that there are procedures in place for accurate and early diagnosis and transfer to a special lab where a coronary angiogram is performed by highly trained staff in an effort to find the occluded artery and open it with a balloon. A metallic stent can then be implanted to keep the artery open. If the hospital does not have the necessary procedures in place for primary angioplasty, fibrinolytic therapy can be give. This is an intravenous form of medication which breaks up the clot causing the problem. Cardiac catheterisation can be performed at later stage.
Along with restoration of flow, the patient receives medication for symptom relief, prevention of extension of the arterial obstruction and protection of the myocardium from the damage caused by the infarction.
The patient is admitted to a coronary care unit under close supervision and their stay lasts from 3 to 7 days if there are no complications.
Treatment does not of course finish with the re-opening of the vessel. Coronary artery disease is a diffuse problem in all the arteries and repairing one point with a balloon is not enough. Long term administration of medication, medical supervision and preventive investigations like blood and exercise tests are required.
The most important element that a patient can add to their health is changing their lifestyle. Stopping smoking, weight loss, healthy diet, exercise, controlling blood pressure, cholesterol and glucose are all considered very important and patients and their families should adopt a new, healthy lifestyle
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