Primary angioplasty for heart attack

A heart attack (myocardial infarction) occurs when a coronary artery suddenly becomes blocked, most often by a clot forming on an atherosclerotic plaque. The heart muscle deprived of blood starts to suffer within minutes: every minute counts. Primary angioplasty means performing an emergency coronary angiogram and immediately reopening the culprit artery with a balloon and a stent. The procedure is carried out under local anaesthesia, most often through the wrist artery. The cardiologist locates the blocked artery, crosses the clot with a very fine guidewire, dilates the artery and places a drug-eluting stent. Powerful anticoagulant and antiplatelet medicines are given at the same time to prevent the clot from re-forming. Other narrowed arteries, if any, are treated at the same time or later, depending on the situation. Guidelines make primary angioplasty the reference treatment for ST-elevation myocardial infarction when it can be performed quickly, ideally within the first 12 hours after the onset of pain. Severe, crushing chest pain lasting more than a few minutes, sometimes spreading to the arm, jaw or back, should prompt an immediate call to the emergency services (SAMU 190 in Tunisia), and you should never drive yourself. At Clinique Pasteur Tunis, the emergency department, the catheterisation laboratory and the cardiac intensive care unit work together to treat heart attacks as quickly as possible.