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heart block and Angioplasty

    HEART BLOCK AND ANGIOPLASTY

heart block and  Angioplasty


If there are blockages in the heart blood vessels

Don't ignore chest pains that occur when your work  and get better at rest. Seek immediate treatment

Coronary arteries are blood vessels that supply blood to the muscles of the heart. A heart attack occurs when any of these become blocked and blood flow to the heart muscle stops. Fat deposits and blood clots can cause blockages.

Pain only during exertion

Coronary heart diseases present in many ways. Some people may not experience any particular symptoms when they have a block. Others may experience symptoms only during labor. Chest pain or shortness of breath may occur. However, it does not feel difficult when not working. This is because, even if there is a block, the blood flow to the heart muscle may not be completely blocked. The blood that passes through that block when it is not working is enough for the heart to function. That is why there are no symptoms. However, when more blood flow is needed, the blood passing through the block becomes insufficient for the heart to function and symptoms appear.

Acute coronary syndrome

Some people experience chest pain (angina) even with mild exertion. Often this is a precursor to a heart attack. There are now blood tests to see if this can lead to a heart attack. It is evaluated by measuring the presence of troponin in the blood. High blood levels of cardiac troponin-T and troponin-I, chemicals released from damaged heart muscle, should be taken seriously. About 10 percent of such people are at risk of heart attack. Troponin-negative people have a less than 1 percent chance of having a heart attack in the next month.

Heart attack

A heart attack occurs when a blood vessel that carries blood to the heart is blocked and blood flow to the heart muscle suddenly stops. Some people experience it as chest pain. However, other times the symptoms may not be noticeable. ST segment elevation myocardial infarction (STEM) is a complete stoppage of blood flow to the heart muscle. ECG It is decided by assessment. In such a situation, damage to the heart muscle occurs quickly. However, the condition in which the blood flow does not stop completely and the function of the heart is interrupted is called NSTEMI (Non ST segment Elevation Myocardial Infarction). It should be understood that this is a precursor of a heart attack and should be treated immediately. N-semi can cause permanent muscle damage.

A silent heart attack

A silent heart attack is when a heart attack occurs without chest pain or other symptoms. However, early signs of a heart attack can be seen on an ECG or echocardiogram. Often these heart attacks are not completely silent. The patient may not recognize the symptoms. But it is important to understand that some people may not have any symptoms at all. In people with uncontrolled diabetes, the pain following a heart attack may not be recognized if the nerve damage occurs.

Indications for coronary heart disease

Pain or heaviness in the middle of the chest. Common symptoms include a sore throat, discomfort in the lower jaw, chest pain and pain spreading to the left arm. In a few, the pain spreads to the right arm. Symptoms like these are likely to be coronary heart disease. In particular, do not ignore pain that comes on with physical activity and improves with rest. Although heartburn is not a symptom of coronary heart disease, few people have symptoms that feel like heartburn. However, sudden stabbing pains and pain only when breathing are not symptoms of coronary heart disease.

possibilities

People who are prone to coronary heart disease should understand this and take necessary precautions. Elderly people, people with uncontrolled diabetes, smokers, people with hereditary risk of heart disease and especially those with close relatives with heart disease should take necessary precautions. Elevated cholesterol levels also increase the risk. In particular, the bad cholesterol, LDL. HDL is the good cholesterol. Being too low also increases the risk.

Men under the age of 55 and women under the age of 65 have a hereditary risk of heart disease. People with one or more risk factors should take precautions.

To detect cardiovascular diseases

 If you have chest pain or other suspicious symptoms, seek medical attention immediately. By understanding the pattern of chest pain and when it occurs, it is possible to arrive at a preliminary conclusion. ECG is important in heart attack tests. ECG changes in cardiac activity. It can be understood by analyzing the report. However, in all patients, ECG changes may not be evident. However, ECG abnormalities are evident in patients with complete cardiac arrest. Moreover, ECG changes are also seen in people who have had a previous heart attack. Sometimes, the ECG is repeated more than once. It is also necessary to take.

Now, ECG can be done with smart devices. Systems are being developed to pick it up and send it to the hospital. By this, arrangements can be made before the patient reaches the hospital. ECG It can be helpful for initial assessment even if the device is not technically proficient.

Echo cardiogram

An echo cardiogram helps to understand how the heart's pumping action is and whether any part of it is dysfunctional. Those who have had a previous heart attack may not have proper contractions in some parts of the heart wall. All this will be clear in this test.

Angiogram to look for blockages

If coronary heart disease is diagnosed, an angiogram test is often ordered. An angiogram test can accurately diagnose blockages in blood vessels to the heart. An angiogram is used to determine whether a blockage in a heart blood vessel can be treated with medication, an angioplasty, or bypass surgery. Angioplasty is decided based on the symptoms, the severity of the blockage, whether the blockage is in a major blood vessel, and whether the blockage is present in the vessel, and whether the blood supply from that vessel has already been completely destroyed. If the blood vessel is completely occluded and the part that needs to be pumped through has been completely destroyed, then there is not much benefit in pumping more blood to that part. Even removing such blocks may not be beneficial.

In some people, when blood vessels become blocked and the heart pumps less, the heart may experience irregular heartbeats. Arrhythmias such as dangerous atrial fibrillation and ventricular tachycardia can also occur in people with poor pumping of the heart. In such case it will also provide curative treatment.

Do not delay treatment

 In the event of a heart attack, the most important thing is to get the right treatment right away. If you have any kind of symptoms, you should go to the hospital immediately. Don't delay treatment thinking that the chest pain will go away. The first hour is the most dangerous. That is why it is said that treatment should be given as soon as possible. The first hour after a heart attack is called the golden hour. If the occluded vessel can be unblocked and blood flow restored at this stage, damage to the heart muscle can be minimized. Over time, damage to the heart muscle increases. By the time twelve hours have passed, it is more likely that the heart muscle will have been completely destroyed.

If a heart attack is confirmed, there are three types of treatment. Perform angioplasty without delay and primary angioplasty to remove the obstruction. Thrombocytic therapy, which dissolves the blood clot, is given where this is not available. Next is pharmaco-invasive therapy. That is, give thrombolytic therapy if angioplasty is delayed and angioplasty if ineffective.

Don't waste time to give first aid to those with heart attack symptoms. Moreover, it is not possible to confirm whether this symptom is the same as a heart attack. All this can be ensured only by reaching the hospital. Sit until there is chest pain or shortness of breath. Then, if there is darkness in the eyes and blurred vision, it should be laid down and immediately transferred to the hospital.

A heart attack can be followed by cardiac arrest or cardiac arrest. There is a difference between a heart attack and a heart attack. CPR for those who have collapsed and have no pulse. May have to pay. However, none of this should be the reason for delaying hospitalization.

On arrival at the hospital

Patients with suspected or confirmed cardiac arrest are transferred to the intensive care unit. Health status should be closely monitored and major physical examinations should be performed. Blood pressure increases or decreases, chest swelling will be checked. Medicines to help reduce platelet activity may also be needed. It helps prevent new blood clots from forming.

Thrombolytic therapy

Thrombolytic therapy is a treatment that dissolves blood clots that cause blockages in blood vessels with drugs. Among thrombolytic drugs, Tissue Plasminogen Activator drugs are more preferred. This is because they are known as clot-specific drugs. Thrombolytic therapy is given first if the initial visit is to a hospital that is not equipped to perform primary angioplasty, or if it takes time to get to such a hospital. Those who fail thrombolytic therapy should proceed to angioplasty as soon as possible.

The drugs used in thrombolytic therapy are only powerful enough to dissolve blood clots. Therefore, some people are more prone to bleeding. People who have had a recent stroke or who have undergone surgery are more likely to develop this condition. If so, you should tell your doctor before starting thrombolytic therapy.

Angioplasty to remove the blockage

Coronary angioplasty is a treatment method in which fatty deposits and other obstructions in the heart arteries are removed and blood vessels are expanded to facilitate blood flow. 

Blood vessels leading to the heart can sometimes become blocked due to obesity or other causes. If there are such blockages, the heart will not get enough blood and the function of the heart will be in crisis. Angioplasty is a treatment for removing blockages in blood vessels. Angio means blood vessels and plasty means repair. Therefore, the treatment of repairing blood vessels is called angioplasty. Fresh blood reaches the heart through the coronary arteries. Coronary angioplasty is an angioplasty performed to remove a blockage in these arteries. Angioplasty is performed not only to unblock blood vessels in the heart, but also to unblock blood vessels in other parts of the body. It is called peripheral angioplasty, and if it is done in a blood vessel leading to the brain, it is called carotid angioplasty.

When the blood vessels are blocked

Blockage in blood vessels is caused by a condition called atherosclerosis. Fat gain is not the only reason for this. Certain types of fat can build up in the blood vessels as well as various types of cells. All these together (plaque block). Such changes in the blood vessels start at a young age, but they are recognized only after a long time.

Another reason is lifestyle diseases. Diabetes, high BP, cholesterol abnormalities etc can lead to blockage. Lack of exercise, emotional stress, smoking, and genetic factors are also risk factors for a block. However, those who do not have these do not get this disease.

When angioplasty

Angioplasty may be necessary in either case. Angioplasty is performed to remove blockages found in blood vessels during physical examination. Angioplasty is needed when drug treatment for the block does not work, or when the block is so severe that medication is unlikely to change. Blocks that completely block the blood supply are generally removed by angioplasty. Not all blocks need to be changed. Remove blockages that affect heart function. This will help prevent the risk of heart attack due to complete blockage of the blood vessel. Primary angioplasty is done to remove a blood clot immediately after a heart attack. Generally, people think that bypass angioplasty is only necessary if there is one or two blocks and if there is more block, it is necessary. But the severity of the block, not the number, is the criterion for angioplasty. Bypass surgery is only considered if the major artery is in the bifurcation or if there is a long-term Tia block. Even in an older patient with more than one block, bypass carries more risk. Some patients may have reduced heart pumping and may have kidney problems. Patients who have had a stroke or are at risk of having a stroke at the time of surgery. All of them can undergo angioplasty.

Angiogram for examination

If symptoms do not improve despite medication and lifestyle changes, the patient should have an angiogram. This way we can know how much and where the blockage is in the blood vessel. Angioplasty is decided based on the information obtained from this.

Arteries to all parts of the body come from the aorta. Therefore, the radial artery of the wrist, the ulnar artery and the femoral artery of the thigh are chosen for angiogram. A catheter (hollow tube) can be passed through either of these to access the coronary artery and the left ventricle of the heart. Once the catheter is inserted into the artery, a dye is injected into the coronary artery. This helps to detect blockages and other problems in the blood vessels. This is the angiogram test. After analyzing this, the location for angioplasty will be determined.

Angioplasty is performed

Angioplasty is performed under local anesthesia. How long the angioplasty takes depends on the severity of the block. Typically, angioplasty takes 30-45 minutes. Even though the hurdles are higher, it takes more time. Angioplasty has a success rate of 95-98 percent. In an angioplasty, another catheter is passed through the same artery and a thin balloon is inflated to reach the block in the blood vessel, as was done in the angiogram. Then the blood vessel will expand. Then St. is put there. With this, the blood flow through it becomes smooth.

A medicated (medicated) stent made of metal is used to widen the blood vessel. In the past, unmedicated scents were used. But there is a downside to this. A few days after they are placed in the blood vessel, these centile cells and the endothelium, which is the wall of the blood vessel, accumulate and become blocked again. But drug-eluting stents are less likely to have this problem. Within a few weeks after a medicated stent is placed, the drug begins to leach out of the polymer in the stent. This will prevent the excessive growth of its cells. This helps keep the cells from dividing and hitting the stent. People with diabetes, kidney disease, narrow blood vessel diameter, and long-term block can still get a block even after having a stent. A medicated stent is used to reduce these conditions. Earlier only stainless steel was used. Then came cobalt and chromium alloys. In this way, the thickness of the cent was reduced. Later, biodegradable polymers were developed that dissolve after a few days. After that, the type of scent that completely dissolves within a few days arrived. It is called bioabsorbable vascular scaffold (BVS) because it is not made of metal. A new type of this is now in use.

After angioplasty

You will have to stay in the hospital for two or three days. How much can be strained is calculated according to the pumping capacity of the heart. So after normalization patients can do everything as before. Those who don't will return to normal within weeks. Those who have been treated for a heart attack will need to exercise and diet accordingly. This is because the heart muscle is slightly damaged during an attack. It takes time to get right. It takes about 3-4 weeks depending on the severity of the problem.

exercise

Follow a healthy lifestyle. Avoid smoking (a little bit doesn't matter). Exercise for at least half an hour five days a week. Do not do high intensity exercises. Jogging and walking are enough to condition the body. Those who work sitting should get up and walk.

 Food

Foods high in starch should be reduced. Eat enough protein. Obese people should lose weight. Use of salt should be reduced. Consuming too much salt can lead to water retention in people with poor heart pumping. Use oil sparingly. Fish and poultry can be eaten in moderation. Eat fruits. People with diabetes should follow their prescribed diet.

Do I still need medication after angioplasty?

Medicines should be taken even after angioplasty. Even after the block is replaced, there is a chance of recurrence. Medicines have to be taken for life to avoid this. This can prevent the rapid development of atherosclerosis, the condition that causes the block. Treatment options, including angioplasty to reverse the block, should be seen as a continuation of drug therapy. Angioplasty is not a substitute for drug treatment. Blockages can occur in arteries in other parts of the body, just like in the coronary arteries. That is why the medicine is continued even after angioplasty.

Anti-platelet agents (drugs to prevent blood clots - aspirin, etc.) and cholesterol-lowering drugs are needed for life. It is not possible to avoid drugs assuming that cholesterol is normal. Because how much cholesterol should be lowered depends on the patient's risk. A diabetic patient presenting with a coronary artery block may have cholesterol levels much lower than those of a normal healthy person. Normal cholesterol levels in these patients can be very different from normal healthy individuals.

Statins are the best cholesterol-lowering drugs. They don't just lower cholesterol. These drugs can also help reduce the risk of heart attacks due to blockages in blood vessels. High-dose cholesterol-lowering agents (high-dose cholesterol-lowering agents) are recommended for high-risk patients who have had a previous heart attack, who have had more than one block, and who have blocks in a certain location.



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All the information mentioned here is compiled from the knowledge of scholars, doctors, etc."



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