I would like to know if a person is having a heart attack and waits for 3 hours to be treated, will there be any permanent, irriversable damage to the heart? Left anterior decending artery showed TIMI grad 1 flow past a severe narrowing in the uppper mid LAD. There, there is an eccentric 99% narrowing, with a filling defect consistant with the presence of possible thrombus.. Percutaneous coronary intervention on left anterior decending artery. Dr. finally decided to proceed with PCI. A 3.5 x 15mm Xience drug-eluting stent was placed successfully in that lesion.
Dr. says it is not possible to tell if the paitent still has viable muscle in the LAD territory beyond the lesion.
Any help and answers would be greatly appreciated. Thank you
I was in the same position years ago. I had had a silent heart attack and occluded coronary vessels. The heart was enlarged and the contractility of the heart's wall was impaired due to cell damage. As it turns out medication reduced the heart' size and contractility returned to normal. The damaged heart cell's were hibernating and within a few months with a stent to supply more blood to the cells. The cells were revitalized and least some heart cells were revitalized. I believe your doctor is saying there may have been some heart cell damage, but it may take some time to know if heart wall is severely impaired.
I know your feeling, but there is a possibility for the heart to return to adequate functionality. Hope this helps. Thanks for sharing and take care.
There is a nuclear viability scan. This is used to see if cells are absorbing the injected contrast, which obviously means they are taking substances from blood, meaning they are alive. It's quite a long scan but well worth it. As far as I am aware, this is the best way to detect any dead heart tissue. Stunned tissue, which has been partially damaged will still absorb the contrast because it will be making repairs as well as sustaining itself.
As with me, in few months your doctor will give you an echocardiogram. That test will use ultra sound to view your heart in real time. Any impairment of the wall movement (hypokinesis) will show or not. Also, the test will determine if your left ventricle is normal in size, if there is any valve damage (my mitral valve sustained damage from an enlarged left ventricle). Additionally, the echo will provide a reference by calculating the heart's contractility with estimate of the heart's ability to pump blood into circulation with each heartbeat (EF).
Stunned cells can be revitalized after a few days after oxygenated blood is restored. It is time sensitive probably within hours. Not appropriate, unless there is an acute MI.
I am referring to are hibernating myocardium cells. After a heart attack, some areas of heart muscle do not pump as they should. Some areas will have permanent damage. Other areas are able to return to their normal function if blood flow is returned to that area (by medications or a procedure). Hibernating myocardium is heart muscle that is "resting" and may possibly return to normal function. This is the condition I am
referring to and an echo in few months will or later disclose the condition.
I believe I tried to get that point across with a discussion of angina and its long term effects causing hypoxia or periods of less than normal oxygenated blood flow and the effect would be based on cell tolerance...some cells may damaged other cells not.
A viability scan is not appropriate. It is probably the last test given to determine the heart muscle damage prior to surgery.
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