The heart is a muscular pump and its function is to pump blood to all parts of the body including the vital

organs like brain, kidney etc. Heart attack or acute myocardial infarction occurs when a blood clot blocks

one of the blood vessels of the heart, which supply blood to the heart muscle. This results in sudden

cessation of blood supply to a particular part of the heart muscle and this part of the muscle begins to die.

Heart attack is a life threatening condition. Prompt and appropriate treatment can save lives and prevent

permanent damage to the heart muscle. Time is of the essence as highlighted by the oldadage ’ Time is

muscle’ and this can be extrapolated to ’Time is Life’.

Primary angioplasty is an emergency key hole surgery done to unblock the blood vessel at the time of a heart

attack. Firstly, a coronary angiogram is performed either via the wrist or the groin. A catheter is passed via a

guide wire and threaded through into the blocked artery. The x-ray dye is injected via the catheter and x-ray

images taken at the same time to visualise the coronary arteries. The blocked artery is identified and is

opened with the help of an angioplasty wire, balloon and thrombosuction catheter. Following this a stent (a

metal coil with drug coating) is placed in the coronary artery to prevent re-blockage of the blood vessel.

What is Primary Angioplasty?

Common symptoms are sudden onset of severe central chest pain which can

radiate to the arms, back or jaw, difficulty in breathing, sweating, nausea, vomiting,

giddiness and extreme fatigue.

Heart attack is usually diagnosed with the help of ECG. In some instances echocardiography (ultrasound

scan of the heart) and troponin levels (blood test) aid in the diagnosis.

Who gets a heart attack?

Heart attack can affect anyone. But it is common in middle-aged males with history of smoking, family

history or presence of other risk factors like diabetes, hypercholesterolemia and hypertension

What is heart attack?

How is heart attack diagnosed?

Sparsh Super Specialty Hospitals, Bangalore

MBBS, MRCP, PhD (Cardiology), CCT (Cardiology, UK)

Dr. Ganesh Nallur Shivu

Consultant Interventional Cardiologist

Heart Failure Specialist

What is the best treatment for heart attack?

The main aim of treatment for heart attack involves opening the blocked blood vessel. This can be done by

either thrombolysis (intravenous medication commonly called as clot buster) or primary angioplasty.

Primary angioplasty when available offers the best chance of opening the artery and survival benefit which

is superior to thrombolysis.

What are the problems patients face to get the timely and best treatment?

As soon as the heart attack commences, the is chaemic heart muscle starts to die. It is therefore very

important to unblock the artery and terminate the heart attack at the earliest to salvage as much of the muscle

as possible. The other major risk of a heart attack is that the is chaemic muscle is very irritable and is prone

to develop life threatening arrhythmias (irregular heart beat). This accounts for a majority of the deaths that

occur prior to patient getting to the hospital. These life threatening arrhythmias are effectively treated by

providing a shock to the patient with a defibrillator and hence highlights the need for the patient to get to the

hospital at the earliest. The maximum benefit is offered when the definitive treatment (Primary angioplasty

or Thrombolysis) is given within 6 hours. After 6 hours the benefits of opening the artery starts to decline

steadily. It is therefore very important for any individual to identify the closest cardiac centre and get to that

centre as soon as possible so that definitive treatment can be instituted in a timely fashion.

What should an individual do if he develops symptoms suggestive of heart attack?

The first and foremost thing to do would be stop any activity and rest (either by sitting or lying down). Then

call for help and assistance of people close by. If available, take 300mg of aspirin and sublingual nitrate.

Seek urgent medical help and get to the closest hospital/clinic so that clinical examination by a doctor and an

ECG can be taken. If an heart attack is confirmed, the individual must get to the nearest cardiac centre on a

priority basis. Sometimes the doctor may have to do further tests to either confirm or refute the diagnosis of

the heart attack before definitive treatment commences.

How soon should the heart attack be treated? What is the golden hour concept??

A well co ordinated ‘heart attack treatment system’ is the need of the hour. Absence of awareness regarding the

signs and symptoms of a heart attack is the main hurdle that patients face in receiving timely and the best

treatment. Even today cardiologists see a number of patients who have had a heart attack, but have remained

at home thinking that the symptoms were of gastritis. It is sometimes difficult even for the healthcare

professionals to differentiate between symptoms of heart attack and gastritis without performing other tests

like ECG. It is therefore very important that patients don't self diagnose gastritis and seek medical help so that

appropriate investigations can be done to make accurate diagnosis. The other major hurdle, especially

for patients in India is the absence of well co ordinated emergency ambulance system and patients often do

not get to the cardiac centre in time. Because of these time delays, whatever treatment they receive in the

hospital does not give the desired results in spite of spending lots of money.

What are the common symptoms of heart attack?

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Advanced Services offered by Sparsh Cardiology Department

• Peripheral Aneurysm Surgery

• Peripheral Bypass Surgeries

• Carotid body Tumour Excision

• Carotid Endarterectomy

• Varicose Vein Surgery

• Arrhythmia surgery - Maze procedure

• Co-arctation of Aorta Surgery

• Hybrid Heart Procedure

Combined Stenting and MICS

Coronary Artery bypass surgery

• Hypertrophic Obstructive Cardiomyopathy - HOCM

• Pulmonary Endarterectomy

Thoracic Operations

• Lobectomy and Pneumonectomy

Vascular Operations

• General Cardiology Clinic

• preventive Cardiology

• Interventional Cardiology

• Electrophysiology

• Heart Failure managment

• Coronary Artery Bypass Grafting ( CABG)

• Heart Valve repair and Replacement

• Surgery of the Aorta

• Minimally Invasive Cardiac Surgery ( MICS )

• Surgery for Congenital Heart Disease

Cardiology Other Cardiac Operation

• VATS: Diagnostic and Therapeutic

• Mediastinal Tumour Excision

• Sympathectomy

• Surgery for Thoracic Outlet Syndrome

Cardiac Surgeries