Saving Lives: Time is Muscle

If you look at your fist, that's the size of your heart. And if you're a car, you are looking at your machine. How you function depends on how good your machine is.

Of all the body muscles, only the heart depends on oxygen to survive. For it to function properly, there must be a good flow of blood from the coronary arteries to the muscles. Any obstruction, partially or complete, results to having a heart attack. Any heart muscle, deprived of an oxygen, results to a chest pain. And a heart attack can be mild or severe, depending on how much muscle death occurred.

What happens during a heart attack?

The coronary arteries bring oxygenated blood to the heart muscles, and when these arteries, either one or two, or can be three, are blocked partially or completely, these muscles without their nutrients will literally die as the cardiac muscles are very dependent to oxygen. A patient with ongoing heart attack will need immediate treatment as this is an emergency in the sense that an irritated heart can produce abnormal rhythms that can be deadly. Aside from serious consequences that can occur simultaneously.

Another important reason is the TIME IS MUSCLE concept.

The receiving muscles, without its' oxygen will die. Prolong occlusion will result in wider area of affected muscle death that can affect the loss of its' pumping function. This then affects the heart' contractility that can just be ACUTE or long-term, depending on the heart's recovery. More often, with no immediate management, muscle death occurs which can be debilitating. 

Experience wise, a lot of patients brought to our Heart Attack Centre that were delayed mostly suffered serious complications, including death. Although a classical chest pain is the most common sign, symptoms of pain or numbness in the jaw, neck, shoulders radiating to the arm have also been reported. Most patients have also described the pain as heaviness, as if somebody is sitting on their chests. Indigestion pain have also been reported.

One consideration is that, not all heart attacks have chest pain. What's more scary is that, these patients just collapsed without warning or have reported other physical symptoms like nausea & vomiting, dizziness or very diaphoretic, BUT WITH NO CHEST PAIN.

Immediate Angioplasty

Only Heart Attack Centres have this facility all over UK, so patients diagnosed with a heart attack, either from the Emergency Departments or by the responding ambulance, patients MUST  be brought to the nearest facility immediately. The government have this initiative of having the door to needle time to be one hour. From the moment the ambulance arrived in the hospital to the time that the blockage was removed, facilities need to adhere to this, otherwise it will get fined.

Literature says that in each heartbeat, the Left Ventricle (LV) pumped 70mls of blood, about 280 Liters per hour. A moderate to severe LV dysfunction can give limitations to certain activities. As the cardiac  muscles can't pumped as much, less contractility limits the pumped blood throughout the body, most specifically to major organs, like the heart and the brain. Activities with heart failure depends on how much muscle death have occurred, leading to long-term debilitations. Symptoms can be shortness of breath (SOB) on a minimal exertion to a few yards or further.

Immediate treatment

Since not all heart attack patients experience the classical symptom of having chest pain, minimal symptoms don't always prompt a patient to go to the hospital or call an ambulance. More often than not, there is a delay in it's recognition, hence it's management.

A delay can be deadly. If not, it is debilitating. A heart attack of more than 12 hours can affect so much muscle that the LV becomes impaired. Although Angioplasty can open those blocked arteries, the dead muscles will not recover. In acute phase, (less than 12 hours) the chance of recovery is higher.

Compared this to patients that have had immediate access to treatment, debilitating effects are avoided. If this is the case, one's lifestyle will just need minimal changes. Just adherence to cardiac medications that prevents another heart attack in the future.

Remember, time is muscle.

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