A revolution took place in the treatment of heart attack after the year 1999-2000. The limitations of fibrinolytic medicines used for dissolving the blood clot were very well understood. It was confirmed that if a patient reaches the hospital after 3 to 6 hours of heart attack, there is very little chance of success with these medicines. Many victims of heart attack reach the hospital in a very serious condition with much lowered blood pressure, severe shortness of breath or very poor efficiency of heart. Fibrinolytic medicines do not work during these complications and there is very little time available to save a patient’s life. In such cases a method of treatment is needed which can open the block of the heart attack related artery quickly and consistently, and which has no serious side effects. Primary angioplasty is one such revolutionary invention.
The patient was taken to the cardiac catheterization laboratory during heart attack only. Angiography is done in emergency and the artery with 95 to 100 % blockage, which is the cause of heart attack, is opened immediately with a balloon.If need be, the catheter to suck blood clots and anticoagulant injections are also used. In the initial years there were some doubts about the usefulness of placing a stent during primary angioplasty, but through many studies it is now well proved that placing a stent and that also a drug eluting one, gives very good short-term and long-term results.
Teamwork of an experienced interventional cardiologist and well equipped hospital is a must for primary angioplasty. If best efforts are made, the artery can be opened in more than 95% of cases and chances of the patient surviving and getting rapid recovery are increased. It has now been proved that primary angioplasty is a highly superior treatment as compared to fibrinolytic. It preserves the efficiency of the patient’s heart, reduces chance of heart rhythm disturbances, reduces the possibility of heart attack complications and increases the possibility of saving a patient’s life. Hence, if this treatment is available in the hospital and if the patient is prepared to bear its expenses, primary angioplasty is the most desired treatment.