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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.