GOOD TIME FOR A HEART ATTACK
There has never been a better time to have a heart attack. These days, if you get to a decent hospital within the first 2 hours of feeling the pain, your chances of walking away without damage are very high – providing you tell medical staff if you have taken Viagra in the past 24 hours.
Standard treatment cannot be followed if you’ve taken Viagra.
On arrival in the hospital emergency unit, heart-attack patients are routinely given nitrates to open their vessels and increase the amount of blood getting to their heart. Even if they have taken nitrate tablets (anginine) at home before coming in, they are given an intravenous dose in hospital.
But nitrates can kill patients who have taken Viagra. Viagra dilates blood vessels too, and the combined effect of Viagra and nitrates opens the vessels so much that blood pressure drops dramatically. This sends the patient into a state of profound hypotension. With little pressure in the vessels, even less blood gets to the distressed heart. This effect may be so intense that it cannot initially be reversed.
The complications associated with Viagra aside, cardiac care these days is excellent. Apart from advances in technology, changes in attitude have improved everyone’s chances of survival.
Thirty years ago, a definite but subtle form of ageism existed. If demand for space in a coronary-care ward of a hospital was too high, young people would get priority. There was a perception that people older than 65 had already had a good innings and could wait.
That attitude is now dead. Today, regardless of age, everyone gets the best available treatment and benefits from the latest advances.
Ten years ago, when a man arrived at hospital with a heart attack, he would be given aspirin, oxygen and nitrates. Then he would be sent off to a coronary-care ward where he would wait to see if complications developed. That was the convention: as problems arose, they were treated.
Now doctors are far more interventionist in treatment and in prevention of heart-muscle damage. Aggressive public-health campaigns pump out the message that time is critical.
If the chest pain persists for 15 to 20 minutes, an ambulance should be called. Prompt treatment can save muscle: if administered within 2 hours, it can prevent damage. If treatment is delayed until between 2 and 4 hours after the onset of pain, some damage may occur. If delayed until more than 4 hours have elapsed, there will usually be some damage.
When a man having a heart attack arrives at hospital these days, a treatment decision is made soon after the nitrates, aspirin and oxygen have been administered. At this point, the patient will probably be given an expensive squirt of thrombolysis to dissolve his clot or be sent to the cardiac catheter laboratory.
If he is sent to the catheter laboratory, dye will be injected into his coronary arteries to locate the blockage. Once the blockage is found, it will be cleared away. Debris that has accumulated on the inside walls of the artery, thereby narrowing it, may also be cleaned away.
If necessary, the artery may be reinforced with a small device called a stent. This whole process can cost several thousand dollars. While these measures may appear costly, they are economical in the long term because they help prevent disability and erase the need for life-long medication.
Men who have chest pain and fail to disclose that they have taken Viagra may also fail to benefit from these latest advances.
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