Attack it within golden hour, says Dr R K Jaswal of Fortis Hospital Mohali

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Chandigarh, Nov 29, 2015 : The best treatment for heart attack is to attack it within the golden hour, before it damages the heart or kills the patient. These words of advice, coming from a doctor who has 10,000 angioplasties from the wrist under his belt, received rapt attention from an audience comprising scores of his post operated patients and opinion makers from across the tri-city at an awareness lecture held at Mountview Hotel here on Sunday.

Speaking on the topic ‘How can you get the best treatment if you, or your near ones, suffer a Heart Attack’, Dr. R.K. Jaswal, D.M. Cardiology, Director Cardiology, Fortis Hospital Mohali, informed the audience that till 1985 there was no treatment for heart attack available anywhere in the world. At that time nearly 50% of the patients suffering a heart attack used to die. Today, if you can get primary angioplasty done at earliest (within golden hour of onset of heart attack) there are 98% chances of surviving. For this you need a highly experienced operator in a big high volume centre and the angioplasty should be done through the wrist artery, rather than the conventional groin artery, he added.

Dr. R.K. Jaswal recalled that since they started doing primary angioplasty from the wrist artery at Fortis Hospital Mohali in 2002 as part of a team, he had performed nearly 10,000 such operations with excellent results. This is among the beat experiences in the world for treating heart attack, he said, adding that some of his challenging cases were presented at world congresses held at Shanghai and Beijing in China and San Francisco in USA.

He also provided tips to the audience to prevent heart attack. These included adopting a healthy lifestyle by eating low fat, low sugar diet, exercising regularly, keeping weight under check, cease smoking and early diagnosis and treatment of silent killers like diabetes mellitus, high blood pressure and raised cholesterol levels.

As per WHO estimates, 23.6 million people will lose their lives to cardiovascular disease by 2030. That most of these deaths are projected to occur in South East Asia is very worrisome, said Dr Jaswal, adding, “Low and middle income countries are disproportionately affected by the global cardiovascular disease epidemic, contributing 82% of these deaths.”

Talking about the Indian scenario, he said, “Ten per cent of adult population – which is nearly 6 crore – is affected by heart disease. It is said that 91 people per hour are dying because of cardiovascular diseases in our country, clearly making us one of the worst sufferers in this regard.”

Calling heart disease a ‘growing but preventable epidemic’, the noted cardiologist said, “Anyone can have a heart attack, and it’s often like a bolt out of the blue. An extreme preparedness on part of patient as well as his treating cardiologist is required at all times, backed by precise and latest knowledge of best treatment options. Studies show that only 16% of heart attack patients have symptoms of exertional angina prior to the attack.”

Therefore, for the remaining 84%, when heart attack strikes, there is often disbelief, denial and panic in the family. “Every 30 minute delay in help during the first 3 hours is associated with an 8% increase in relative mortality at 1 year,” Dr Jaswal warned, thus emphasizing on timely and expert help immediately.

“A heart attack literally means that the heart has been set on flame. There are two ways to extinguish the fire – fibrinolysis (breakdown of clots) and primary PCI. Studies have time and again proved that when performed rapidly after arrival at an experienced centre, primary angioplasty (PPCI) is superior to other remedial measures for heart attack,” he said.

Sharing the gist of a lecture Dr Jaswal had delivered at World Congress CIT in 2010 at Beijing, he said, “High volume centres have hospital protocols shortening the ‘Door to Cath Lab time’ and highly experienced doctors can quickly open the blocked artery by virtue of their sheer experience and perfection, especially when faced with technically challenging situations during Transradial P.P.C.I. (Angioplasty through the Wrist) and during technically challenging coronary lesions.”

Giving the take home message, the doctor said, “Heart Attack is like raging bull which will kill or seriously injure the victim. You need a saviour who has the will and skill to challenge and kill this raging bull quickly before it kills your patient.”