How to treat the most common heart attacks

Date:
August 29, 2020
Source:
European Society of Cardiology
Summary:
One in five patients die within a year after the most common type
of heart attack.



FULL STORY ==========================================================================
One in five patients die within a year after the most common type of
heart attack. European Society of Cardiology (ESC) treatment guidelines
for non-ST- segment elevation acute coronary syndrome are published
online today in European Heart Journal, and on the ESC website.


========================================================================== Chest pain is the most common symptom, along with pain radiating to one
or both arms, the neck, or jaw. Anyone experiencing these symptoms should
call an ambulance immediately. Complications include potentially deadly
heart rhythm disorders (arrhythmias), which are another reason to seek
urgent medical help.

Treatment is aimed at the underlying cause. The main reason is fatty
deposits (atherosclerosis) that become surrounded by a blood clot,
narrowing the arteries supplying blood to the heart. In these cases,
patients should receive blood thinners and stents to restore blood
flow. For the first time, the guidelines recommend imaging to identify
other causes such as a tear in a blood vessel leading to the heart.

Regarding diagnosis, there is no distinguishing change on the
electrocardiogram (ECG), which may be normal. The key step is measuring
a chemical in the blood called troponin. When blood flow to the heart is decreased or blocked, heart cells die, and troponin levels rise. If levels
are normal, the measurement should be repeated one hour later to rule out
the diagnosis. If elevated, hospital admission is recommended to further evaluate the severity of the disease and decide the treatment strategy.

Given that the main cause is related to atherosclerosis, there is a
high risk of recurrence, which can also be deadly. Patients should be prescribed blood thinners and lipid lowering therapies. "Equally important
is a healthy lifestyle including smoking cessation, exercise, and a diet emphasising vegetables, fruits and whole grains while limiting saturated
fat and alcohol," said Professor Jean-Philippe Collet, Chairperson of the guidelines Task Force and professor of cardiology, Sorbonne University,
Paris, France.

Behavioural change and adherence to medication are best achieved
when patients are supported by a multidisciplinary team including cardiologists, general practitioners, nurses, dietitians,
physiotherapists, psychologists, and pharmacists.

The likelihood of triggering another heart attack during sexual
activity is low for most patients, and regular exercise decreases this
risk. Healthcare providers should ask patients about sexual activity
and offer advice and counselling.

Annual influenza vaccination is recommended -- especially for patients
aged 65 and over -- to prevent further heart attacks and increase
longevity.

"Women should receive equal access to care, a prompt diagnosis, and
treatments at the same rate and intensity as men," said Professor Holger Thiele, Chairperson of the guidelines Task Force and medical director, Department of Internal Medicine/Cardiology, Heart Centre Leipzig, Germany.


========================================================================== Story Source: Materials provided by European_Society_of_Cardiology. Note: Content may be edited for style and length.


========================================================================== Journal Reference:
1. Jean-Philippe Collet, Holger Thiele, Emanuele Barbato, Olivier
Barthe'le'my, Johann Bauersachs, Deepak L Bhatt, Paul Dendale,
Maria Dorobantu, Thor Edvardsen, Thierry Folliguet, Chris P Gale,
Martine Gilard, Alexander Jobs, Peter Ju"ni, Ekaterini Lambrinou,
Basil S Lewis, Julinda Mehilli, Emanuele Meliga, Be'la Merkely,
Christian Mueller, Marco Roffi, Frans H Rutten, Dirk Sibbing, George
C M Siontis, ESC Scientific Document Group. 2020 ESC Guidelines for
the management of acute coronary syndromes in patients presenting
without persistent ST-segment elevation: The Task Force for the
management of acute coronary syndromes in patients presenting
without persistent ST-segment elevation. European Heart Journal,
2020 DOI: 10.1093/eurheartj/ehaa575 ==========================================================================

Link to news story: https://www.sciencedaily.com/releases/2020/08/200829092746.htm

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