COIMBATORE: A workshop on “Management of ST Elevation Myocardial Infarction”, to be held here on March 27 and 28, will set the tone for evolving a national programme on managing heart attack.

Kovai Medical Center and Hospital (KMCH) and Lumen (an annual workshop at Miami in the U.S. on this subject) have teamed up to conduct the workshop in Coimbatore.

With best practices from various nations being showcased, the workshop will also focus on training an entire heart attack management team consisting of cardiologists, nurses, catheterisation laboratory technicians and emergency room physicians.

ST elevation myocardial infarction (STEMI) is a form of heart attack. An estimated four million people suffer heart attacks every year in India. While there are Government-supported programmes in other parts of the world such as the U.S. and Europe, there is no such impetus in India, says course director of the workshop and cardiologist at KMCH Thomas Alexander.

“A lot of talking is done on this public health issue that has been ignored for many years. But, we need the logistics to save patients,” Dr. Alexander says. The logistics ranges from the immediate availability of doctors and other facilities to stabilise the patient, emergency transport and a complete cardiac care team at the hospital.

The American College of Cardiology' guideline is a time gap of only 90 minutes between an attack and angioplasty. Even in the U.S., only less than 50 per cent of the cases are able to meet this time stipulation.

A study of cases in India reveals it takes 360 minutes of median time for a patient to reach the cathlab since the onset of chest pain. To take only 90 minutes, there must be enough distribution of cathlabs, says Dr. Alexander. Poland, Czechoslovakia (now Czech Republic and Slovakia) and Denmark have done the rescue act well within the time limit because of government support. The quick response models from these countries will be presented at the workshop.

Government of India estimates say myocardial infarction will affect 64 million people in the country by 2015. Of these, 20 million will be under the age of 40. This calls for a national level intervention, Dr. Alexander says. Cardiovascular diseases kill more people than communicable diseases do. Therefore, it cannot be ignored as just a lifestyle disease,” he cautions.

The workshop will look at the role of the media in disseminating information and sensitisation.

There will be focus on emergency transport.

“Emergency Management and Research Institute ambulatory service's major focus is on trauma and pregnancy cases. We want it to focus on heart attacks too,” the cardiologist says.

The possibility of transmitting electro-cardiogram results through 3G facility can be explored.

The staff in the EMRI ambulance can be trained to do this. The same can be done by a primary health centre to the cardiologist at the hospital where the patient is being taken to.

India can look at the pharmaco-invasive option. A drug can be administered to the patient at the initial point of intervention, which is the primary health centre.

The patient can then be transported to the cathlab for the angioplasty. This model can be followed in countries like India where distance and the lack of quick transport combine to make a debilitating factor.

“With all these points that will be touched upon at the conference, we will kick-start the campaign for a national programme,” says Dr. Alexander.

Courtesy - Hindu