Acute coronary no-flow phenomenon is a complication that occurs in some cases during heart surgery. Basically, the phenomenon occurs with a very low frequency. Acute Coronary No-Flow Phenomenon represents a condition associated with a serious threat to the life of the affected patient. Typically, Acute Coronary No-Flow Phenomenon is when blood stops flowing in one or more coronary vessels of the heart.
What is acute coronary no-flow phenomenon?
Acute coronary no-flow phenomenon is a complication that sometimes occurs during heart surgery. In principle, acute coronary no-flow phenomenon is an enormously rare complication that arises primarily during surgical interventions on the heart. In English, the condition is often referred to among medical professionals as ‘abrupt coronary no-flow’. The most commonly used abbreviation for the phenomenon is ACNF. Acute coronary no-flow phenomenon is characterized primarily by the stagnation of blood flow in the coronary vessels of the heart. The interrupted flow of blood is usually associated with a so-called transcoronary ablation of the hypertrophy of the septum. In any case, Acute Coronary No-Flow Phenomenon is an acute emergency that threatens the life of the individual and requires immediate intervention. Acute Coronary No-Flow Phenomenon is often triggered by spasms in the muscles of the blood vessels. An enormously high level of stress on the part of the patient in advance of cardiac surgery appears to increase the risk for Acute Coronary No-Flow Phenomenon.
Causes
Acute coronary no-flow phenomenon generally occurs in very few patients during cardiac surgery. In such cases, the phenomenon usually presents during the so-called transcoronary ablation of septal hypertrophy. This medical procedure is often referred to by the abbreviation TASH. However, the complication develops in less than one percent of surgeries. The specific causes for the development of acute coronary no-flow phenomenon have not been conclusively researched at this time. What is certain, however, is that a spasm forms in the area of the coronary arteries. Numerous observations of patients indicate that the Acute Coronary No-Flow Phenomenon is probably often related to an enormous psychological stress of the affected persons before the surgical intervention. In view of the high stress level prior to heart surgery, some physicians assume that the neurotransmitters norepinephrine and epinephrine released during the stress phase may be involved in the development of the Acute Coronary No-Flow Phenomenon. However, this suspicion has not currently been confirmed by relevant scientific studies.
Symptoms, complaints, and signs
Acute coronary no-flow phenomenon manifests itself in certain typical signs and symptoms in the affected patient. Usually, the complication occurs during surgical intervention in the area of the heart. However, the phenomenon occurs with a very low probability. The characteristic leading symptom of Acute Coronary No-Flow Phenomenon is usually a failure of blood flow in one or even several coronary vessels of the heart. In the worst case, the flow of blood is interrupted in all coronary vessels. In principle, the phenomenon represents a risky complication, so emergency medical intervention is necessary as soon as possible. After all, due to the condition of failure of blood flow, the life of the affected person is in acute danger.
Diagnosis and course
The diagnosis of acute coronary no-flow phenomenon is made with regard to the characteristic symptomatology of the life-threatening complication. Because the phenomenon occurs in the vast majority of cases during cardiac surgery, an immediate diagnosis is usually required. This is usually performed by the operating or attending physicians. The absence of blood flow in the coronary blood vessels of the heart usually indicates relatively clearly the presence of Acute Coronary No-Flow Phenomenon.It is the task of the operating physicians to differentiate the complication from an interruption of the blood flow at the ramus interventricularis anterior. This problem arises in some cases when alcohol has been injected incorrectly. In this case, blood flow is interrupted in isolation or moves toward a side branch.
Complications
No-flow phenomenon is itself a complication. In most cases, it is life-threatening and can lead to the death of the patient if left untreated. The phenomenon causes blood flow in the coronary vessels of the heart to stop completely. Only one vessel or several vessels may be affected. Treatment of the no-flow phenomenon is acute and usually performed during the surgical procedure. If the blood flow stops for a longer period of time, the patient usually dies. The phenomenon occurs mainly when the patient has been injected with alcohol incorrectly. The treatment of the no-flow phenomenon is usually done by injecting Urapidil. The drug is injected directly into the patient’s coronary arteries, and in most cases other drugs are also used. The blood pressure must also be adjusted. It is usually not possible to prevent the no-flow phenomenon or to detect it before the operation. Therefore, treatment is also necessary directly during the operation. If the phenomenon is treated directly and properly, no further complications or sequelae will occur for the patient and life expectancy will not be affected.
When should one go to the doctor?
Usually, acute coronary no-flow phenomenon occurs immediately after heart surgery. For this reason, treatment of this complaint is also usually immediate, so seeing a doctor is not necessary. If no immediate treatment of coronary no-flow phenomenon is performed, death of the affected person will occur. In this case, there is a failure of blood flow in the patient’s heart. If this blood flow is not restored promptly, death of the affected person usually occurs. The patient’s life is in danger due to the acute coronary no-flow phenomenon and for this reason must also be treated immediately. In most cases, the coronary no-flow phenomenon is directly noticeable by the lack of blood flow, so that the treating physicians can start treatment immediately. In this process, blood flow can be restarted with the help of medication so that the patient eventually survives. If the treatment is quick and successful, there will be no further particular symptoms due to the coronary no-flow phenomenon. Life expectancy is also not then reduced by this disease.
Treatment and therapy
In the presence of acute coronary no-flow phenomenon, it is urgent to initiate immediate emergency medical measures. Only in this way will the life of the ill patient possibly be saved. In the majority of cases, acute coronary no-flow phenomenon is treated by doctors injecting the affected patient with the active substance urapidil. The drug is usually used in high doses and is injected into the coronary vessels of the heart. In addition, the drug norepinephrine is injected into the patient’s veins. In this way, the acute drop in blood pressure is compensated for. Both measures are emergency medical methods that are only to be used in case of urgent need. Otherwise, they themselves endanger the patient’s life.
Outlook and prognosis
No-flow phenomenon represents a very dangerous condition for the patient’s health and must be treated in any case. Without treatment, death usually results from no-flow phenomenon. The complaint causes blood to stop flowing in the coronary vessels of the heart. As a result, the patient may suffer cardiac death if prompt treatment is not given. Since this is only a very rare phenomenon that occurs mainly after surgical procedures on the heart, the probability of the no-flow phenomenon is relatively low. The phenomenon is usually treated with the help of medication. In this case, a new surgical intervention is not necessary. The medications can relieve the discomfort and allow blood flow again. As a result, the patient’s situation stabilizes immediately and no further restrictions or discomfort occur.In most cases, the no-flow phenomenon occurs immediately after the operation, so that the treatment can also be performed directly afterwards. If the treatment is quick and successful, there will be no further complications.
Prevention
Acute coronary no-flow phenomenon cannot always be prevented. In principle, prevention has been difficult to date because the causes of the phenomenon are not fully understood. Current observations suggest that any stress to the patient before surgery should be avoided.
This is what you can do yourself
The options for self-help are very limited in acute coronary no-flow phenomenon. The affected individual is not normally in a sufficient position at this stage of life to make changes or optimizations to his or her medical condition. Moreover, recovery is not possible without extensive medical care. On the contrary, in the event of complications or inadequate medical care, there is a risk of premature demise of the affected person. In order to help oneself, the choice should, if possible, fall on a treating physician who enjoys the confidence of the affected person or his relatives. Close contact and exchange with the responsible physicians or nurses is necessary so that open questions can be clarified. A comprehensive explanation of the disease is important so that surprises or malpractice can be avoided. The doctor’s or nurse’s instructions and assistance should be followed so that no additional problems or further deterioration of health occur. It is helpful if relatives additionally inform themselves about the situation and exert a calming influence on the patient. Stress, conflicts, reproaches or self-inflicted actions should be refrained from if possible. The assistance offered by doctors or nurses should be accepted so that the life-threatening condition can be overcome as quickly as possible. Aggressive behavior or time delays are to be avoided, as rapid and best possible stabilization of health is needed.
