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                                                                'RESET    THE   HEART'

                      SO AS TO REVIVE SEVERE MYOCARDIAL

                          INFARCTION AND HEART FAILURE

 

        The most common and most dangerous heart diseases are severe acute myocardial infarction and heart failure.

 

SEVERE ACUTE MYOCARDIAL INFARCTION :-

        According to KILLIP classification, the severity of acute myocardial infarction is graded as :

                                                              Characteristics                                           Mortality

                    Grade 1                  no pulmonary rale and no S3 heart sound                        6%

                    Grade 2                  pulmonary rale present in <1/2 lung field                        17%

                    Grade 3                  pulmonary rale present in >1/2 lung field,

                                                   pulmonary edema,S3 heart sound present                       38%

                    Grade 4                  cardiogenic shock                                                            81%

 

Case 1:

        68 years old male, with no past history of systemic diseases, was brought to the Emergency Room

because of sudden onset of severe chest pain, cold sweating and then conscious loss.  His blood pressure

was 88/57 mmHg and in cardiogenic shock.  Chest X-ray showed cardiomegaly and pulmonary edema.  

Electrocardiogram showed large area myocardial infarction.  Cardiac echo showed large area of myocardial

infarction with heart failure (ejection fraction, or the heart contractility, was 33%).  According to KILLIP

classification, this is grade 4 severe acute myocardial infarction, with mortality 81%.  He was treated

immediately with the (traditional) therapy of thrombolytic agent plus my therapy to "reset the heart

(conditions)".  The cardiac enzymes (which elevate if there is cardiac muscle damage) CK and CKMB

levels were 10032 and 473 units/l after 6 hrs, 8844 and 426 units/l after 12 hours and 5478 and 174

 units/l after 18 hours, respectively.  After one week, patient had no more chest discomfort and discharged well.

 

SEVERE HEART FAILURE :-

        According to New York Heart Association Classification, the severity of heart failure is graded as :

                                                    Characteristics                                       Mortality

                 Grade 1            no chest discomfort or dyspnea with  

                                         ordinary daily activity                                    

                 Grade 2            presence of chest discomfort or dyspnea

                                         with ordinary daily activity                                       34%

                 Grade 3            presence of chest discomfort or dyspnea

                                         with less than ordinary daily activity                         34%

                 Grade 4            presence of chest discomfort or dyspnea

                                         even at rest                                                                 82%

 

Case 2:-

        63 years old male, with past history of coronary artery disease, was brought to the Emergency

Room because of chest tightness, dyspnea and near syncope.  Even though he received mechanical

ventilation and (traditional) inotropic agents, he was still semi-comatose and in shock (blood pressure

72/55mmHg, blood oxygen saturation 75%).  His extremities were cyanotic.  Chest X-ray showed

huge cardiomegaly and severe pulmonary edema.  Cardiac echo showed very severe heart failure with

ejection fractin only 10-15%.  According to New York Heart Association Classification, this is

grade 4 severe heart failure, with mortality 82%.  He was treated continuously with the inotropic agents

plus my therapy to "reset the heart (conditons)".  After one week, he was transferred to ordinary ward

and discharged after another four days.  Two months later, his ejection fraction became 25% (at OPD

follow up).

 

        The signs and symptoms of acute myocardial infarction include:  chest tightness or pain or discomfort

(commonly with radiation to left shoulder or arm, neck, jaw), dyspnea, dizziness, palpitation, nausea,

vomiting, cold sweating, weakness, diaphoresis etc.  The signs and symptoms of heart failure include:

dyspnea, exertional dyspnea, decreased daily activity,dyspnea when lying flat, general weakness, edema,

abdominal distention, palpitation, dizziness etc.  Therefore, whenever the above signs and symptoms

occur, particulary acute onset, persistent or progressive, one should consult the Emergency Room

immediately.