Around one-third of the heart attack patients do not undergo medication or open blocked arteries within the prescribed 12-hour span after a heart attack. Every year, around one million people have a heart attack, and half of them die within an hour of the start of the signs or before reaching the hospital.
As long as the individual is stable, angioplasty to unclog an artery involved in a heart attack is not appropriate if performed more than 24 hours after the incident. One should not undergo an angioplasty if the patient seeks treatment for symptoms that turn out to be a day-old heart attack and the heart is stable at the time. Medical care should be equally successful, although presenting a lower risk of complications. The risk of experiencing heart failure over the next three years increases by 4% for every hour spent between the onset of symptoms and angioplasty.
With the aid of X-ray scans, doctors will insert a long, thin tube called a catheter into an artery in the groyne or wrist and thread it to the affected artery. Then a small amount of dye is inserted through the catheter to the artery, which makes the blockages or narrowing visible in the images. After this, doctors insert a catheter with a balloon on the tip through the first catheter and guided it to the heart. Doctors inflate the balloon when the catheter enters the blocked or narrowed region of the artery in the heart, which reopens the artery and increases blood flow. In the end, the balloon is deflated and removed from the body.
Moreover, angioplasty is combined with the placement of a tiny wire mesh tube known as a stent. This stent aids in holding the artery open, lessening its chance of narrowing again.
Angioplasty can be chosen for the patient if:
- Medication and lifestyle changes couldn’t help in bettering the condition of the patient.
- A worsening chest pain.
- A heart attack.
In most cases, an angioplasty takes about 30 minutes to two hours, although it can take longer in some cases. The patient will be given a local anaesthetic to numb the region in the groyne or wrist where a catheter (a fine, flexible, hollow tube) will be passed through an artery at the start of the operation.
It saves lives, reduces heart muscle damage, and relieves chest pain. If the patient has persistent angina, angioplasty is a good option. It might not prevent the patient from having another heart attack, but it will help the patient manage their symptoms and live a regular, healthy life.
Angioplasty is a less invasive technique for treating artery blockages than bypass surgery, but it also has some complications:
- Re-narrowing of the artery: There is a small risk of re-narrowing the treated artery when angioplasty is combined with drug-eluting stent placement. Bare-metal stents are rarely used, but these stents decrease the risk of re-narrowing of the artery by about 10% to 20%.
- Blood clots: Blood clots can be developed within stents even after the procedure. These clots can become a reason for a heart attack and can close the artery.
- Bleeding: The patient can experience bleeding from the leg or arm where the catheter was inserted. This might result in a bruise, but if severe bleeding occurs, then the patient must visit the doctors.
Other rare risks:
- Heart attack- It is quite rare to have a heart attack during the procedure.
- Coronary Artery Damage- The coronary artery might be torn or ruptured during the procedure, and these complications may call for emergency bypass surgery.
- Kidney Issues- The contrast dye used in the angioplasty and stent placement can cause kidney damage, especially in people who already have kidney issues.
- Abnormal Heartbeat- The heart might beat too quickly or too slowly during the procedure.
- Stroke- If plaques break loose when the catheter is being threaded via the aorta, it might cause a stroke during angioplasty. Blood clots can also be formed in catheters and travel to the brain if they break loose.
Once the patient enters a hospital, it’s up to the professionals to avoid delay in the treatment, but the attendants with the patient are responsible for preventing the first holdup.
In acute myocardial infarction, hospital delay in achieving reperfusion with coronary angioplasty, as well as a delay with thrombolytic treatment, raises mortality. Angioplasty should be performed without delay in hospitals. The most severe issues are a scarcity of professional organisations that provide PPCI services 24 hours a day, seven days a week, and a delay in invasive care due to lengthy transportation. The impact of delayed reperfusion treatment on clinical results in STEMI and long-term mortality, as well as logistical issues with cardiac care delivery, have been extensively addressed. Furthermore, controlling the risk factors, such as high cholesterol and high blood pressure, can prevent a heart attack in the first place.