heart attack
 


Heart Attack


Almost all heart attacks occur when a blood clot suddenly and completely blocks a coronary artery.

This condition is called a coronary thrombosis, or simply a coronary. The part of the heart muscle nourished by the blocked artery becomes damaged by lack of oxygen.

Unless blood flow returns within minutes, muscle damage increases. Heart cells begin to die after four to six hours without blood. The damage can affect the heart's ability to pump and may cause the patient's death. If the clot can be dissolved within four to six hours, damage to the heart can be reduced. Symptoms. Some people have no warning signs at the beginning of a heart attack. But many people experience angina, dizziness, indigestion, or other symptoms. Most heart attacks cause severe pain. Patients describe the pain as a dull, crushing ache in the chest, but discomfort may extend into the neck, jaw, arms, or back.

The pain may last from a few minutes to several hours. Anyone with chest pain who suspects the pain may be due to a heart attack should seek medical help immediately.

Some patients may stop breathing, and their hearts may stop beating. A first-aid technique called cardiopulmonary resuscitation (CPR) can maintain breathing and circulation until a patient can be taken to a hospital. But CPR should be performed only by someone trained in the technique.

Diagnosis and treatment.

Injured heart muscle causes abnormal ECG waves. Soon after a patient reaches the hospital, doctors administer an ECG to determine that symptoms result from a heart attack and not some other disorder. Doctors also use certain blood tests to detect a heart attack. But these tests are not useful until a few hours after an attack. Doctors may administer a strong painkilling drug, such as morphine, to relieve the pain of a heart attack. They also use drugs to dissolve clots in the blocked artery or may perform emergency angioplasty or bypass surgery.

After doctors stabilize the condition of a heart attack patient, they admit the person to the hospital and monitor him or her for complications in the intensive care unit. Some hospitals have a specialized intensive care unit called a coronary care unit for heart patients. Two major complications are heart failure and arrhythmia. Heart failure occurs if the heart cannot pump enough blood because of extensive damage to the heart muscle. In most cases, heart failure can be successfully treated. In arrhythmia, the heart's electrical system produces an abnormal pattern of beats. Most arrhythmias can be readily treated, but a type called ventricular fibrillation can cause sudden death. Ventricular fibrillation occurs when electrical signals in the ventricles fire randomly.

More than 20 percent of heart attack patients who do not get medical care die. Some people die before they can reach a doctor, but other patients ignore their symptoms and delay treatment. The death rate among hospitalized patients ranges from 5 to 10 percent. Heart attack patients with ongoing chest pain, arrhythmias, or heart failure have a greater risk of another attack than do patients without these problems.

Source : World Book 2005


 




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Researchers at the U.S. Department of Energy’s Argonne National Laboratory and the University of Chicago have developed a promising new approach to saving stroke and cardiac arrest victims by using a specially engineered ice slurry to cool organs.

The technology is also being investigated as a way to improve laparoscopic surgery. The idea is to rapidly cool the blood of targeted organs with a highly fluid mixture of small, smooth ice particles suspended in saline solution.

Quickly lowering organ temperature by 4 to 10 degrees Celsius below the normal 37C introduces cell protective hypothermia, which greatly reduces cell death. For sudden stroke or heart attack, rapid blood cooling could delay the death of heart and brain cells, giving doctors and paramedics more time to revive victims.

In the United States alone, sudden cardiac arrest strikes about 1,000 people a day. For people who suffer cardiac arrest outside the hospital, the survival rate is only 2 to 4 percent. Ten to 12 minutes after an arrest, brain cells start dying rapidly because of lack of blood flow to the brain.

In the procedure, slurry would be delivered through small tubes into the lungs or other organs, such as the stomach, which are used as in-body heat exchangers to cool the surrounding blood. For cardiac arrest, medics would perform chest compressions to circulate the cooled blood, allowing it to reach the brain and preserve brain cells.

The biologically compatible ice slurry melts in the body, releasing its cooling to the body internally and becoming a single-phase liquid like hospital medical drip-bag saline solution.


Data show that ice slurry cools the brain by 2 to 5 degrees Celsius in a few minutes — faster than any other method currently available. For example, external cooling by chilling blankets can take 3 to 5 hours.

The ice slurry appears to keep the brain cool for an hour. Ice slurry technology could also give surgeons more time to perform minimally invasive laparoscopic surgery, which frequently requires temporarily stopping blood flow to organs, such as kidneys or the liver. Cooling these organs before stopping their blood supply would give surgeons more time to operate before organ cells began to die from lack of oxygen.

Research related to laparoscopic kidney surgery has shown that the ice slurry can be readily delivered by a small tube through existing laparoscopic surgery penetration ports using endoscope viewing to guide coating the external surface of an organ, cooling it 15 degrees C or more in 10 minutes.

Development of this technology is funded by the National Institutes of Health. A new company, Cold Core Therapeutics, Inc., has been started to commercialize the technology. The company has received stage A venture capital funding.


Source :
Argonne National Laboratory is a U.S. Department of Energy laboratory managed by U Chicago Argonne, LLC

 

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