Chances of having a repeat attack are only 5% in five years
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Supported by an Unrestricted Educational Grant from
Dr. S Ramakrishnan
Additional Professor, Department of Cardiology
“Once the looming dangers of a heart attack subside and the patient becomes stable, the most important thing is to give reassurance to the patient, discuss dietary precautions, and begin pharmacotherapy,” Dr. Ramakrishnan tells Dr. Manish Verma in an interview.
“Statins, dual antiplatelet agents like clopidogrel, prasugrel and ticagrelor along with aspirin, beta-blockers and ACE inhibitors must be initiated.”
“Post-procedure period is also a critical phase, where lot of things can go wrong even if the patient is reperfused. So, the patient should be under ICU care until a few days.”
“Unforeseen complications like an arrhythmic event or a mechanical complication like mitral regurgitation or a ventricular septal rupture can lead to a sudden collapse of the patient even after thrombolysis. Events of reinfarction and recurrent ischemia are also likely.”
On the bright side, “your chance of having an attack is only 5% in five years. But your chance of not having an attack is 95%,” is what Dr. Ramakrishnan tells his STEMI patients to reassure them and help them get back to a routine worry-free life.
Appointing a dietician or paramedic for oneself is recommended to initiate lifestyle modification and prevent a repeat event.
“Even though adhering to multiple pills and therapies in routine life is difficult for a patient, drugs are prescribed individually in the beginning to achieve essential dosage. Once the doctor understands the tolerance level of the patient, usually a period of three months, combination drugs can be prescribed to reduce the pill burden.”
“These therapies usually run life-long to keep the risk factors like blood pressure in check. But after roughly one year, good combination drugs can be used to bring down pills to just two in a day.”