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Coronary Heart
Disease - Appropriate Time For Intervention
In the setting of a heart attack, the first
6 hours from onset of the blockage is a crucial time
period. During these "golden" hours we try to open up the
coronary artery so that the muscle tissue beyond can be saved. This
is done with medicines to dissolve the blood clot. If this is not
successful one may try for emergency revascularisation with invasive
modalities like surgery or angioplasty provided the blood flow could
be established within first 6 hours. In most of the cases this is
not possible. And even if it is possible, it carries a lot of risk.
That is in this period, any invasive procedure means, maximum
benefit with maximum risk.
After first 6 hours and before 6 weeks
there is maximum risk with
no benefit and therefore one should not go for any
invasive treatment at this stage.
After 6 weeks the benefit is moderate
and risk is moderate.
But the ideal thing to do is after these 6 weeks to prepare patient
fully for another 6 weeks and to do a planned surgery after a total
of 3 months from the heart attack to minimize the risk and maximize
the benefits.
The patients who are diagnosed of having this disease but without
heart attack, also should undergo appropriate preparation before they
undergo any invasive procedure so that they have maximum benefit with
minimum risk.
Back to Coronary
Heart Disease
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