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Coronary Angioplasty ballooning your heart to heatlh
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The road to recovery following a heart attack is usually about eight to twelve weeks long. This includes a gradual return to normal activity, changes in diet and 1iving, a graded exercise programme, medication, and perhaps, surgery, and in time, return to work. The success rests upon the treating cardiologist, a compliant patient, and a caring family.
After a heart attack, how long does the patient need to stay in the hospital?
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Why is the patient made to avoid all physical activity and advised complete bed rest in the immediate post-infarction period?
By when is the minimal physical activity resumed like walking to the bathroom?
By the time the patient is fit to be discharged from the hospital, how much can he do?
By when is climbing of stairs allowed?
Is it safe to take short walks outdoors?
What are the restrictions on diet?
Is alcohol allowed?
What about smoking?
Can a patient drive?
Is the patient allowed to fly?
What medications are commonly required after return from the hospital?
Is it natural for the patient to feel weak, depressed, anxious and irritable during the first few weeks at home?
How soon can the patient return to work?
Are any other precautions helpful?
Would bypass surgery come in useful at this stage?
After a heart attack, how long does the patient need to stay in the hospital? Top
The total duration of hospitalization in uncomplicated cases of myocardial infarction is usually ten to fourteen days, but many physicians prefer to keep their patients for three weeks, while others reduce the period to as short as one week when the opportunities for home convalescence are ideal.
Patients with complications obviously need to stay longer. In them, the decision is more individualized, depending upon the rapidity with which the complications are resolved and the home situation to which the patient is returning.
Why is the patient made to avoid all physical activity and advised complete bed rest in the immediate post-infarction period? Top
It has been irrefutably demonstrated that any factor which increases the load on the heart at such a time is likely to increase the size of the infarct, and the extent of damage. It is to prevent this that absolute bed rest is advised for the first 48 hours. Six to eight weeks must elapse before the healing of the dead heart muscle is complete and the weak dead tissue is replaced by strong scar tissue.
It is to provide the most favourable possible circumstances for healing that physical activity is curtailed in the latter
period.
By when is the minimal physical activity resumed like walking to the bathroom? Top
Hall is well, the patient is usually allowed to sit just 48 hours after the attack, for short periods of 15 to 30 minutes. He may use a bedside commode and eat unassisted. For bathing, however, he needs to be helped. He may be given passive exercises, especially of the leg muscles, to prevent stasis of blood in leg veins which can be potentially dangerous. By about the fourth day, he is allowed to sit for 30 to 60 minutes in a bedside chair twice a day.
Standing and gradual ambulation begins between the fourth and seventh days, postinfarction. If no complications occur, the patient may walk to a nearby bathroom.
By the time the patient is fit to be discharged from the hospital, how much can he do? Top
Usually, by this time, he can take short, level walks. Many hospitals conduct a limited exercise tolerance test just prior to discharging their patients. This helps identify the high-risk patients and aids in formulating physical activity prescription for each patient.
By when is climbing of stairs allowed? Top
Usually by the end of five weeks one floor may be climbed. Other physicians however advocate that it can be done as early as the third week.
Is it safe to take short walks outdoors? Top
Yes, from the fifth week onwards short outdoor walks
are permissible. The distance should be increased gradually.
At about eight weeks a submaximal exercise test is conducted and further advice given.
Some patients may occasionally still have problems with postural hypotension. On standing up from a bed or a chair, they may feel dizzy. If this happens, the doctor should be
consulted.
What are the restrictions on diet? Top
During the first five days, a low-calorie, easily digestible diet eaten in small amounts, at shorter intervals, is preferred. This helps keep the load on the heart in check. If heart failure is present, salt intake has to be restricted. As constipation is common during convalescence, increased roughage in the diet would be helpful.
During the second week, increasing amounts of food may be introduced in the diet. The total calories and saturated fats,
however, need to be restricted.
Is alcohol allowed? Top
It is better to quit-altogether. But if one must-only an occasional peg or two is permitted.
What about smoking? Top
No. Cigarette, bidi, cigar or pipe-all are taboo.
Can a patient drive? Top
It is not safe to do so until after the first three months. Later, it may be all right.
Is the patient allowed to fly? Top
On this, international airlines rules vary. Most would permit at four to six weeks, provided the doctor certifies fitness to travel.
It would be better to avoid air travel for the first three months. As a general rule, any patient who is not short of breath at rest is fit to fly.
Some international airlines make special arrangements for the transport of patient and luggage at the airport if advance notice is given.
What medications are commonly required after return from the hospital? Top
This differs with each case. Some require antiarrhythmic drugs for curtailing waywardness of the heart; others need beta blockers, long-acting nitrates and calcium blockers, if there is coronary insufficiency.
Patients in heart failure need diuretics and digitalis. Some physicians prescribe anti-platelet aggregator drugs such as aspirin, persantin or sulphinpyrazone on a long-term basis to (possibly) reduce the risk of another attack.
Is it natural for the patient to feel weak, depressed, anxious and irritable during the first few weeks at home? Top
Yes. Both physical and psychologial factors are responsible for it. A healthy, .positive attitude of the patient, an understanding, loving spouse, and a caring family can, however, easily change things for the better.
How soon can the patient return to work? Top
The timing of return to work depends on many factors, particularly the type of employment a person has.
Those with sedentary occupations can often return to work at eight to ten weeks. In the beginning, they may take things easy, like staying at work part-time for a few weeks, travelling out of the rush hour, and not entering into any kind of arguments. When a person is self-employed, he may even begin earlier, in a small way at home or be taken to the office for a few hours.
Persons employed in heavier manual occupations need to take at least a 12-week lay-off from work. Some may even need a change to a lighter job.
Are any other precautions helpful? Top
Avoidance of all risk factors (see Chapter 2) is recommended. Further, an outlook of optimism, positive thinking, and relaxed living may be extremely beneficial. Meditation and Yoga can help too.
Would bypass surgery come in useful at this stage? TopPerhaps, if anginal symptoms occur, or changes of ischaemia of the heart are found during an exercise tolerance test.

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