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The sooner the obstruction in the blood vessel can be removed, the better are the chances of saving the heart muscle, says Dr. Harsh Wardhan, Chief of cardiology at the Primus Hospital, in an interview with Dr. HK Chopra.“The treatment of STEMI is always first priority. The ancillary issues like accelerated hypertension can be treated simultaneously.” “Dealing with hypertension is not a big deal because many drugs used to lower BP are also helpful with STEMI, like beta blockers, intravenous ACE inhibitors and the nitrogen dip.”“Nevertheless, caution must be exercised while giving thrombolytic treatment because chances of intracranial hemorrhage are high in STEMI patients with high BP,” Dr. Wardhan warns. While it is necessary to control BP, Dr. Harsh also warns us that it shouldn’t be brought down drastically because BP is bound to fall once the blocked artery is opened. “The trick is to gradually bring down the BP while simultaneously trying to open the blocked artery.”As a cautionary step, the blood pressure is continuously monitored throughout the procedure. Controlling sympathetic overactivity, which is the prime reason for high BP, would also be helpful, adds Dr. Wardhan.
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