Waiting to get treatment during a heart attack

[njsjcf]

I would like to know if a person who is having a heart attack waits for 3 hours for help will have permanent irreversible damage to the heart?  patient had severe 99% mid LAD lesion, with TIMI grade 1 flow in the upper left anterior decending artery.  Report says it is not possible to tell if patient still has viable muscle in the LAD territory beyond the lesion. Is there permanent, irreversible damage?

[kenkeith]

For your convenience I have pasted the information from your other post.
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. .

[kenkeith]

I answered your other post in detail and you may want to refer to that post.  It is better if you keep your information confined to one post.  If you have any followup questions, feel free to ask.

[ed34]

Just to add. My cardiologist told me there is roughly 30-40 minutes available before tissue death is imminent. The less time involved though the better, so if Nitrates are issued in the first half an hour, nearly always all the tissue recovers.

[ed34]

This is not an easy question to answer and depends on a few factors.
a) was this patient in hospital for 3 hours after a heart attack
b) was this patient at home or away from medical facilities for those 3 hours

If (a) then it is likely a good proportion will be reversible. This is because a hospital will stabilise the situation by administering Nitrates to open blood vessels and give Aspirin to prevent clotting. If pain free from these interventions, then the heart will not be suffering any further damage.
If (b) and pain was felt through most of those three hours, then it is likely there will be some permanent damage.