5 top treatments used in Heart Attack
- Aspirin treatment
- The control of cardiac pain
- Analgesics, such as Morphine
- Nitrates, nitroglycerin
- Oxygen and oxytherapy
Aspirin in Heart Attack treatment, doses
This agent is effective across the entire spectrum of acute coronary syndromes and now forms part of the initial management strategy of patients with suspected Heart Attack.The goal of aspirin treatment is to quickly block formation of thromboxane in platelets by cyclooxygenase inhibition. Because low doses (40 to 80 mg) take several days to achieve full antiplatelet effect, at least 160 to 325 mg should be administered acutely into emergency department.
To achieve therapeutic blood levels rapidly, the patient should chew the tables, thus promoting bucal absorption rather than absorption through the gastric mucosa.
More about the Aspirin in Heart Attack Treatment:
Aspirin 81mg dose in Heart Attack
Aspirin prevents clots and thrombus appearance
Myocardial Infarction Treatment
Control of cardiac pain
Analgesia is an important element of management of Heart Attack patients in the emergency department. The pain must be avoided anyways, even sometimes at the emergency units, some clinicians fear about the some obscuring responses due to antiischemic or reperfusion therapy.The pain in Myocardial Infarction contributes to the heightened sympathetic activity that is particularly prominent during the early phases of Heart Attack.
In patients with angina (chest pain) the pain control is performed with some tests to nitrates, analgesics (morphine), oxygen, and beta-adrenoceptor blockers. The pain associated to Myocardial Infarction is due to the ischemic processes taking place in the heart muscle.
This is why, many interventions which are directed to remove the ischemic process, usually relieves the pain or completely decreases it.
Analgesics in pain relief
Although a wide variety of analgesics agents has been used to treat or relief the pain associated to Heart Attacks, including Mepiridine, Pentazocine, and Morphine, the last one remains the drug of choice, except in patients with Morphine sensibility.The reduction of anxiety resulting from the patient's restlessness and the activity of the autonomic nervous system, with a consequent reduction of the heart's metabolic demands. The beneficial effect of morphine in patients with pulmonary edema is, also, unequivocal.
Morphine diminishes the blood pressure, and as a result of hypotension, the patient must be ready for some exercises like rising the legs up in horizontal position, for to increase the blood flow to the upper body, if the blood pressure declines below 100 mm/Hg.
Sometimes as a side effect of Morphine, may appear nausea and vomiting. These are treated with Phenothiazine.
Nitrates in Myocardial Infarction
By virtue of their capacity to enhance coronary blood flow by coronary vasodilatation (enlarging the blood vessels) and to decrease the ventricular preload by increasing the venous capacitance, sublingual nitrates are indicated for most patients with an acute coronary syndrome.At present, the only groups of patients with Heart Attack in whom sublingual nitroglycerin should not be given are those with inferior MI and suspected right ventricular infarction.
Once it is ascertained that hypotension is not present, a sublingual nitroglycerin tablet should be administered and the patient observed carefully for improvement in symptoms or change in hemodyncs, if an iHeart Attacknitial dose is will tolerated and appears to be of benefit, further nitrates should be administered, with careful monitoring of the vital signs.
Even small doses may produce sudden hypotension and bradycardia, a reaction that can be life threatening but which can be easily reversed with atropine if quickly recognized.
More on nitroglycerine:
Nitroglycerine in Coronary Heart Disease
Oxygen and Oxytherapy
Hypoxemia may occur in patients with Heart Attack, and is usually secondary to the disturbances of ventilation of the lungs and the perfusion deficiency at the same level.Also, pneumonia and other pulmonary diseases are additional causes of hypoxemia. It is common practice to all patients hospitalized with Heart Attack wit oxygen for at least 24 to 48 hours.
It was deducted experimentally that the oxygen has a protective function against the ischemic processes in infracted myocardium.
The estimation of the blood saturation with oxygen is made through oximetry, an increasingly available technology, and this way it is determined whether or not, the oxygen helps in Heart Attack, as sometimes it may increase the blood vessels resistance and lower cardiac output.
References:
Heart Disease, Volume 2, Eugene Braunwald, Douglas P Zipes, Peter Libby
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