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Lorenzo

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Heart Attack: The Treatment
« on: June 11, 2010, 09:08:03 PM »
Treatment Procedures:





Linkback: https://tubagbohol.mikeligalig.com/index.php?topic=29304.0

lionshearth

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Re: Heart Attack: The Treatment
« Reply #1 on: June 12, 2010, 04:10:20 PM »
Kumusta sa tanan dire sa TB?Sir Lorenz, bahin ining heart attack,unsa may mga maayong paagi ini nga maka survive kita?sa panahon nga moataki kini nga sakit unya wala kitay maka pangayu-an ug tabang unsay angay natong buhaton?
"love one another" love another one

Lorenzo

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Re: Heart Attack: The Treatment
« Reply #2 on: June 13, 2010, 07:03:38 AM »
Hello Lionhearth,

Thank you for your question. In case of heart attack (Myocardial Infarction), it is best that one takes immediate coronary medication. Your doctor will probably prescribe you what is called Heparin , this is used for immediate / acute conditions after heart attack. Afterwards, you will be weened off heparin for warfarin (which is used for longterm treatment) After you suffer a heart attack, you will be placed under aspirin regimen for chronicity (long term) treatment as well as blood thinners, and platelet blockers.

Some medication that i would ask your doctor to prescribe you if you are already a patient with CVD (cardiovascular disease) :

1. Asprin
2. Heparin (to be taken if woman is pregnant)
3. Warfarin (not to be taken if woman is pregnant)--this is for chronic treatment.


In the event that a person is having a Myocardial Infarction, the patient will know that they have it by the following symptoms:
1. Retrosternal chest pain
2. Pain that radiates to back, left arm, and jaw of face
3. Pain does not go away and subsists for 2+ hour duration

If the pain does not go away after taking nitroglycerin, nitroprusside or any other venodilators (taken for angina), then this is a case of myocardial infarction.

__


When you know that you are having a heart attack, you will want to call for 911 or immediately have yourself taken to the hospital. The physicians there will give you O2 therapy, at the same time they will give you an IV dose of thrombus-busters. They will give you Streptokinas, Urokinase or Altepase, which will literally break down the thrombin formation that is causing the atherosclerotic plaque forming in the arterial system, thus causing the infarction of the myocardium (heart apparatus).

It is important that the patient who is suffering the syptoms of infarction (cerebrovascular= stroke) or (myocardial = heart) be given these drugs in order to restore proper function of the heart and the brain. If the heart is deprived of proper blood , nercrosis will set in and the heart tissue will be replaced with fibrosis and thus lead to a decreased functioning of the heart. This will eventually cause Cardiomyopathy or cardiohypertrophy; this is the enlarged growth of the heart in order to compensate for the dead tissue in the surrounding heart apparatus. If this is uncorrected, will eventually lead to CHF (Congestive heart failure; chronic heart failure).

To answer your question; you might want to have with you asirin ; and carry it with you on daily basis so as to maintain your blood levels and prevent further accumulation of atherosclerotic plaque from forming into a total plug, which if it does, will cause a occlusion of the main arteries to the heart (coronary artery, right descending, interventricular, posterior coronary etc).

And remember to ask your doctor about heparin, warfarin, leuvovorin, streptokinase, urokinase, altepase, and asprin.

~~

For patients with heart problems or history of heart problems: remember this motto:

AN ASPIRIN A DAY KEEPS THE HEART ATTACK/ STROKE AWAY.




Yours,
Lorenzo



Lorenzo

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Re: Heart Attack: The Treatment
« Reply #3 on: June 13, 2010, 07:11:54 AM »


In case that a patient does not have aspirin or any medication whatsoever , It is important that the patient asks to be taken to the hospital IMMEDIATELY. A heart attack is not something that we can just wait to go away; a heart attack is indicative of some kind of occlusion in the arteries, and can signify some kind of thrombus formation or microthrombi. It important to treat the underlying condition of the heart attack; which in thise case is probably a damaged endothelial lining in the artery.

When the artery's endothelial lining is damaged, it attracts the platelets and then aggregation to form a clot. If the clot is uncontrolled, it can form an atheroscerlotic clot. And if this clot is uncontrolled, small parts will break off and form microthrombi in other parts of the artery and arterial system.

This can lead to D. I. C (disseminated intravascular coagulation), which if not treated can cause and lead to perfuse bleeding, thrombocytopenia and cardiomyopathy.

It is therefore very important to go to the hospital if you or any one is experiencing a heart attack.

If untreated or ignored, can be fatal.


lionshearth

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Re: Heart Attack: The Treatment
« Reply #4 on: June 13, 2010, 11:22:33 AM »
Salamat kaayo sa mga importanting informasyon, kay sa panahon karon nga ningtaas na ang temperatura,dili nato mahibalu-an ang dagan sa panahon basin sa dalan samtang nag lakaw kalit lang moataki kining tridor nga sakit. Kay sa mga remote area nga walay regular check up sa blood pressure kasagaran mahitabo kining mga biktims ini, unya dala sa kakulangan sa kaalam ug informasyon, or sa kalisod sa kinabuhi hinungdan sa pagkamatay, wala rabay gipili nga edad ini sa pagkakaron daghan na ang biktimang mga batan-on pa dilikado wala pa rabay liwat...hehehe
salamat kaayo Bro.Enzo...

Lorenzo

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Re: Heart Attack: The Treatment
« Reply #5 on: June 13, 2010, 01:18:20 PM »

Don't thank me, my friend, but thank the LORD THY GOD who works in all of us.

Remember that everything is by HIS GRACE. The LORD saideth to us, ask and you shall receive, knock and the door shall be opened unto you, seek, and you shall find.

So always ask. It is never wrong to ask.




Yours in Christ,
Lorenzo

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Re: Heart Attack: The Treatment
« Reply #6 on: June 13, 2010, 01:22:45 PM »

Mao jud, my friend, and well said. You really drive it to the core with your message. Thank  You!

Mulligan

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Re: Heart Attack: The Treatment
« Reply #7 on: June 14, 2010, 09:53:18 PM »

Halo Doc Bran,

Can I take aspirin daily even if I'm not suffering or experiencing signs of heart problems?  Are there any side effects?

Thanks,

Bedo

On vacation mode =:p

Lorenzo

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Re: Heart Attack: The Treatment
« Reply #8 on: June 14, 2010, 10:20:54 PM »

Hey bai Bedo,
If you do not have signs or experiencing heart problems or no history of heart problems (this also includes hematological conditions--blood clotting), and if you are not suffering from any form of arthritis or headaches , then there is no need to take aspirin per chronic treatment. The only reason for this is that aspirin should be taken only for its indicative uses (pain reliever, fever reducer, blood thinner) because long-term aspirin intake (especially in high doses) can cause gastric bleeding. So for patients with ulcers and a history of bleeding, this would be contraindicated.

What I would recommend you do so that you can take the right strategic initiative in dealing with heart/cardiovascular health is:

1. Check your BP level (if it is over 130/80-90) then you are in stages of early hypertension; if >140/110 then this is Hypertension and medication should be asked: ask your GP for ace inhibitors (captopril, lisinopril) or if you are refractive to ace inhibitors (in case you have allergic rxn , such as coughing, then we suggest you ask for ARBs (angiotension receptor blockers= losartan). Ask your GP also for CCBs (calcium channel blockers) and KCBs (potassium channel blockers).


2. Check your Lipid levels: Check your LDL levels (low density lipoprotein) , your HDL levels (high density lipoproteins), and your Triglyceride Levels.
--If you do have high LDL, low HDL and high TGL, then your physician will treat you. Ask for the following: Niacin, Fenofibrates/gemzofibril etc.
Normally, you would want to lower your LDL , raise your HDL, and lower your TGL levels. :)


3. Check your sugar levels, glucose levels and your insulin levels. Diabetes is usually an undetected disease that associates with CVD problems. So check it.

4. Check your cholesterol level. Make sure this is in the right level.

5. Check your heart performance; ask your GP or cardiologist to perform this

6. Place yourself on a regular exercise regimen. This is important.

7. A high fiber diet is excellent. Remember that high fiber lowers TGL levels, which is indicated for cardiovascular health.



~~

All the best, bai Bedo!! :)


-Bran

Lorenzo

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Re: Heart Attack: The Treatment
« Reply #9 on: June 15, 2010, 01:47:13 PM »
Bai Bedo,

I will recommend one thing that is healthy:

Take omega 3& 6 fish oil, have a fiber-rich diet, and exercise regularly. These are good supplements. The omega 3&6 effectively reduces your ldl and raises your hdl, while the fiber diet reduces triglyceride levels.

This combo can effectively strengthen cardiovascular health.


Scarb

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Re: Heart Attack: The Treatment
« Reply #10 on: October 15, 2010, 04:33:53 AM »
informative..!  8)
“Logical consequences are the scarecrows of fools and the beacons of wise men.”~Thomas Henry Huxley~

Lorenzo

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Re: Heart Attack: The Treatment
« Reply #11 on: October 20, 2010, 01:00:45 PM »
you're welcome!  :)

Lorenzo

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Re: Heart Attack: The Treatment
« Reply #12 on: January 10, 2011, 02:06:45 AM »
Arterial Supply of the Heart. Any occlusion of this can result in hypoxic injury to the pericardium.

Presented by: A. Lorenzo Lucino, Medical Intern


Lorenzo

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Re: Heart Attack: The Treatment
« Reply #13 on: January 10, 2011, 02:17:11 AM »

Bedo, aspirin is also known as a COX inhibitor. It effectively prevents platelets from aggregating further, thereby preventing further thrombosis / thrombocclusive diseases to manifest.

In acute cases, it would be necessary to take heparin / warfarin (if one is taking heparin, one should monitor one's PTT levels and if one is taking warfarin one should monitor the PT levels).

Your local cardiologist should be able to prescribe you these if necessary.

Good luck!

Lorenzo

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Re: Heart Attack: The Treatment
« Reply #14 on: January 10, 2011, 02:24:48 AM »
On that note:

If i were the acting internal medicine doctor, and if i had a patient with thrombotic diseases, the plan of action would be to:

1. identify the platelet aggregation pathology
2. treat the cause


---

in treating the cause we identify that platelet aggregation occurs because of the following:

a. vWF (von willibrand factor)
b. ADP (adenosine di phosphate)
c. COX
d. thrombotic growth


I will treat this by attacking the said factors/ inhibit it.

A. prescribe vWF inhibitors
B. prescrib ADP blockers : Ticlopidine and Clopidogrel
C. prescribe COX inhibitors: Aspirin
D. prescribe direct thrombus blockers: Hirudin / hirudin derivatives
E. block glycoprotein factor IIa/IIIb by: Abciximab



Then, monitor levels.
Ask patient to return in a month.
Perform a cbc later that month; check rbc and wbc.
~~~



Lorenzo

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Re: Heart Attack: The Treatment
« Reply #15 on: January 10, 2011, 02:30:23 AM »
When a patient immediately suffers a heart attack (Myocardial Infarct), the standard medical cocktail given (to prevent post-mi arrthymic induced death) are the following:


1. Morphine
2. Lidocaine
3. Oxygen
4. Nitroglycerin
5. Aspirin




I had a patient who suffered an MI on the bed, and after stabilizing, he was placed in the said pills. Because of the Lidocaine, we prevented post-MI arrthymia (which is the #1 cause of death for post-MI patients).

Thus, saving his life 2 times.

For those who have a family history of Heart Attack, check your levels. You might be at risk. Don't be afraid to consult your cardiologist.

And remember. Health IS Wealth.




Best,
Lorenzo Lucino, Medical Intern







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