Therapy
The prognosis of a heart attack is mainly dependent on the first minutes to hours after the onset of the attack. Since somatic cells can only survive without oxygen for a certain period of time, immediate and adequate treatment is crucial for the future condition of the heart. If the vascular occlusion is removed within the first hour, it is not at all unlikely that the heart muscle will recover without permanent damage.
The best measure that can therefore be taken by a medical layperson is therefore to immediately alert the emergency services via the number 112 if a heart attack is suspected. However, driving to the clinic by car is strongly discouraged, as a collapse may occur while driving. If a cardiac arrest occurs as a result of the infarction, immediate cardiopulmonary resuscitation in the form of cardiac pressure massage and mouth-to-mouth resuscitation is necessary.Meanwhile, external defibrillators are also available in many shopping malls and other public places.
Their use is very simple even for laymen and is often more effective than simple cardiac massage. Once the rescue service has arrived, they first carry out a speedy clinical examination including blood pressure measurement and listening to the heart with a stethoscope. Thanks to a quickly performed ECG, it is often possible to detect the so-called ST-elevation, which is typical for heart attacks.
On the basis of this, the urgency of the infarction can be assessed. An indwelling venous catheter can now be used to start a drug therapy. In addition to the administration of painkillers and anticoagulant drugs, the main focus is on securing the oxygen supply to the patient, which is achieved as required by administering oxygen through an oxygen mask.
In addition, drugs can be administered to treat nausea and to calm the patient. Once the patient has arrived at the hospital, the primary goal is to open the occluded or at least severely constricted coronary vessel as quickly as possible. This can be achieved by various methods.
In primary percutaneous coronary intervention, often colloquially referred to simply as a cardiac catheter, a very thin cardiac catheter is advanced through a vein in the thigh up to the occluded blood vessel, which then causes a mechanical reopening of the coronary vessel. In this case a stent is inserted. The second possibility is the so-called lysis therapy, in which a blood clot-dissolving agent is administered via a venous access.
Depending on the equipment of the rescue service, this can also be done in the ambulance. Depending on necessity and availability, both methods are also used in combination. The treatment of heart attack patients is usually carried out in the intensive care unit, as this provides better monitoring of the patient.
Discharge home is often possible after only 5 to 8 days. However, after a suffered infarction, in most cases a lifelong intake of medication is necessary in order to avoid renewed infarctions. For this purpose, various medications such as blood pressure and blood fat reducers, as well as anticoagulants are prescribed. It may also be necessary to insert an implantable defibrillator to protect against sudden cardiac arrest or to insert a bypass to ensure the blood supply to the heart.
