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Author Topic: Waiting for three hours for treatment during a heart attack  (Read 1992 times)
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njsjcf Topic starter
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« on: May 22, 2010, 09:05:15 pm »

A patient knows he's having a heart attack, but he is made to wait for three hours before being seen by medical professionals, while it is obvious to the patient that he is having a heart attack, by the symptoms we are all taught to look for.  When finally seen by an ER Doctor, it is determined that the condition is severe enough to have the patient air-lifted to the nearest cardiac unit and administers a clot buster medication prior to helicopter transport.  Ultimately it is determined that the patient's left anterior descending artery was occluded, and was in fact still 99% occluded when a stent was ultimately placed under angiography.
Both the angiography and echocardiography show an aneruism at the distal, anterior apex.  The echo shows that the akinetic segments are not thin, auggesting a recent myocardial infarction. Please explain your thoughts regarding this situation in as much detail as possible.  Was the patient handled correctly?  If not, what should have been done differently? Could the aneurism have been caused or worsened by the three hour delay in rendering medical treatment?What harm may have been done by the way the patient was handled?  This has nothing to do with the hospital care!!!  Please answer!  Thank you!
« Last Edit: June 02, 2010, 10:38:27 pm by njsjcf » Logged
drbalo
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« Reply #1 on: May 22, 2010, 09:25:26 pm »

well, we cant put the blame just like that. We have to understand the situation in the hospital. Is the hospital very busy? Was there any other more urgent cases that the ER doctor had to attend to?

Was the patient given aspirin or sublingual nitrate? The diagnosis of acute myocardial infarction does not need echo or angiogram. A positive history, ECG changes and/or positive cardiac enzymes will do. If the diagnosis is clear why is the patient not given thrombolytic therapy?

Can you answer my questions first?
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njsjcf Topic starter
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« Reply #2 on: May 22, 2010, 10:51:39 pm »

yes, I can answer your question first:  He is a 43 year old in a prison environment!  He believes he is having a heart attack and requests to go to medical ASAP but is told he can't be seen until (count has cleared).  He reports having strange tingling sensations across his chest, feeling similar to indesgestion, a heavy tightness in his chest and numbness in the back of both arms.  He had just finished running 5 mmiles, 45 min. earlier. After waiting an hour and 20 min.  he is permitted to "walk alone" to the medical wing.  When he arrived there, he was told they are busy and he must wait another 20 min. After 20 min. a nurse takes him in to exam room and does an EKG.  Several min. later, he is seen by a P.A. who determines that he was probably in the midst of an acute M.I.  It then takes another hour before the dsecision is made to transport him to the nearest hospital.  There, the ER doctor determines that his condition is severe enough to have the patient air-lifted to the nearest cardiac unit and administeres TNK, prior to helicopter transport. Time frame, aprox. 3 hrs. at this point!
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kenazari
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« Reply #3 on: September 24, 2010, 11:41:20 pm »

The first 3 to 6 hours after the onset of a heart attack is absolutely critical. First, most  arrhythmias seen with  heart attacks occur during the first hours. If these arrhythmias occur while the victim is under medical care, can almost always be stopped in time to avoid catastrophe.Further if the artery can be opened in the early hours after the accident occurs, most of the heart muscle dies can be saved, more permanent heart damage can be avoided and the patient risk of death or permanent disability can be reduced greatly. But if treatment is delayed more than six hours, the amount of heart muscle that can still be saved significantly reduced.
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naturalimmunity
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« Reply #4 on: February 28, 2011, 09:45:59 pm »

It is very disgusting of the medical staff
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