Heart Attack - Medical Malpractice LawyersLEGAL HELPLINE: ☎ 855 804 7125
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Heart Attack - Overview
Heart attacks and related conditions are the number one killer of patients in the US and Canada each year with more than a million Americans deaths per year. It is also known as a myocardial infarction or an acute MI and results in permanent, irreversible damage to the heart muscle because of blockage of the coronary arteries. The coronary arteries are the arteries that provide oxygen and blood to the heart muscle. When they become blocked with cholesterol plaques, they are at higher risk of thrombus or blood clots and tissue death. The heart muscle does not often have duplication of arteries to the same heart area so that blockage means heart death. The amount of heart muscle damage depends on where the thrombus occurs and how many arteries are affected.
The coronary arteries collect fat, cholesterol, triglycerides and calcium, which leads to a hard plaque blocking the artery in a concentric way. When they become severely narrowed, the clots are more likely to occur, especially if the plaque ruptures and triggers platelet aggregation. The circulation is cut off by the blockage and heart muscle begins to die. You can also have relatively normal coronary arteries but have coronary spasm that effectively blocks off the circulation to the heart muscle.
Heart attack symptoms are variable depending on the person. Diabetics may have few or no heart attack symptoms. Usual symptoms include pressure in the chest that radiates to the back, jaw or neck, the feeling that someone is sitting on your chest, pain that feels like indigestion or heartburn, nausea, vomiting, sweating or dizziness. Anxiety and weakness can be symptoms some people experience. If the symptoms last longer than a half hour, you need to seek medical attention. If you have nitro-glycerine tablets and if three tablets do not take care of the pain, call 911.
If you are prompt about getting medical attention, you have the chance of having an angioplasty with stent placement. This can save heart muscle. You can also have clot buster medication that will also open up the vessel and can save heart damage to the muscle. You need to be treated within one to two hours for best treatment of heart attack.
Doctors can do many different tests to see whether or not there is a heart attack going on. The first test you want to have done is an ECG or EKG. This is an electrocardiogram that looks at damage or stress on the heart's electrical activity. You can repeat the ECG to look for progression of the heart attack. The other good test is a blood CPK and CPK-MB band test. CPK-MB is released when the heart muscle is damaged and can be checked serially to check for ongoing heart damage. It isn't something that shows up right away, however, so you need to use the ECG to best take care of the heart attack before the CPK-MB shows up as too high. The LDH level also defines heart damage and is done in a serial fashion. A heart catheterization can be done soon after symptoms and signs occur that also serve the dual purpose of opening up the arteries via angioplasty.
Doctors are prompt in treating heart attacks. Aspirin is given at the scene or in the ambulance. TPA or other clot busters can be given as soon as the diagnosis of heart attack is made. Clot busters are followed by giving Coumadin in order to keep the blood thin until the heart attack heals. Later, aspirin or Plavix, an antiplatelet drug is used to prevent further thromboses in the coronary arteries.
The cardiac catheterization laboratory is an important place when it comes to a heart attack It can assess how much damage is being done and can crack open areas of plaque. Thrombi can be removed and other areas of the heart at risk can be treated at the same time. In some cases, it can indicate that an emergency bypass surgery is necessary. All blockages of the heart can be treated using a heart bypass surgery.
Further heart attacks can be prevented by taking cholesterol-lowering medication, lowering the blood pressure and preventing clot formation with anti-platelet medications. Sometimes anti-arrhythmic medication is used to prevent common arrhythmias that can occur after a person has a heart attack.
Cardiovascular Disease Overview
Cardiovascular disease is the same as heart and blood vessel disease. It includes those diseases caused by atherosclerosis which is a buildup of plaque within the walls of the arteries. As the arteries narrow, the heart can get less and less oxygen and blood clots can form in the narrowed arteries so the heart gets no oxygen in certain areas and it causes a heart attack. A stroke happens in basically the same way.
A heart attack happens when the blood flow to a part of the heart is blocked by a narrowed artery and a blood clot forms. There is absolutely no blood flow to a part of the heart and that part dies unless a doctor provides the patient with immediate clot busting drugs so that the clot can be dissolved. With proper treatment, most people survive their heart attack and have normal lives after that. There needs to be lifestyle changes and new medications to make the right changes to avoid a second heart attack.
An ischemic stroke happens when atherosclerosis blocks an artery and a blood clot further blocks the artery causing a lack of circulation to part of the brain. The brain can tolerate only a few hours without circulation so that the clot busting drugs must be given within 4 hours of the onset of the stroke. A hemorrhagic stroke is less likely but it results from bleeding in the brain. It is usually controlled by uncontrolled hypertension.
Some effects of stroke are permanent if the blood lacks in oxygen for too long. Brain cells are never replaced once they die. Injured cells, however, are able to repair themselves. The repair occurs slowly over time, improving bodily function. Strength and sensation may improve and speech can improve over the long run. This happens through careful and thorough rehabilitation.
Other manifestations of cardiovascular disease include heart failure, which means a weak heart that isn’t pumping fully. The body’s oxygen need isn’t getting met properly and fluid backs up behind the heart. Heart failure usually happens as a result of a previous heart attack or from things like high blood pressure or valvular disease.
Arrhythmias are another manifestation of coronary artery disease. This is an abnormal rhythm of the heart. The heart can go too fast, too slow or have an irregular rhythm. It’s called bradycardia when the heart is going to slow. It is called tachycardia when the heart is going too fast, greater than 100 beats per minute. If a heart has an arrhythmia, it can cause a lowered cardiac output so the heart can’t pump enough blood to meet the needs of the body.
A heart valve problem happens when a valve is stiff and doesn’t open enough to let blood flow through it or when a valve is floppy and allows too much blood to flow backwards when it should be going forwards. This is usually treated medically until it gets dangerous and then surgery is used to repair the valve. If the valve is not properly managed and repaired, it means that the patient may go into acute or chronic heart failure and the patient may die.
The proper treatment for cardiovascular disease is essential for maintaining a healthy life. For example, a heart valve problem is treated with medications and heart valve surgery. Arrhythmias are treated with medications and sometimes with ablation therapy to destroy the areas of the heart that are causing the arrhythmia to occur. Some patients undergo cardiac defibrillation while others require a pacemaker. A heart attack is treated with clot busting medications in the beginning along with a coronary angioplasty or coronary artery bypass graft. Other medications are used after a heart attack, depending on the situation. A stroke is treated with clot busters within 3 hours of onset as well as with a carotid endarterectomy.
The GP should be familiar with diagnostic tests to diagnose cardiovascular disease. These include carotid ultrasounds, coronary ultrasounds, stress tests with or without medication to artificially increase the heart rate. These are tests the GP should do on a regular basis to patients who might be at risk for coronary artery disease. If these tests aren’t done, the person isn’t caught early enough in the disease to make a big difference in the patient’s eventual outcome.
Medical Malpractice Lawyers
The medical profession which includes doctors, nurses and hospital technicians usually provides a caring service with a high standard of excellence however there are occasions when things do go wrong. Our litigation service is completely free and our Canadian lawyers will deal with your cardiovascular disease case using a contingency fee arrangement which means that if you don’t succeed in receiving a financial settlement then your lawyer medical malpractice lawyer won't get paid.LEGAL HELPLINE: ☎ 855 804 7125
The author of the substantive medical writing on this website is Dr. Christine Traxler MD whose biography can be read here