Guide to Heart Disease

Q. Are there any clot dissolving agents now available which can effectively remove the blocking of the clot in the heart artery ?
A. Yes. These are known as “Thrombolytic agents” and sold under the name of urokinase, T-pa, Streptokinase etc. These powerful agents unfortunately can work only if given within the first 4 hours of acute thrombosis. They are very expensive and are supposed to work more in Anterior infarction. Their use in Inferior infarction is controversial. These strong drugs can be given only in a hospital where good facilities are available. The big question in our country is that how many patients can reach such a well equipped unit in first 4 hours of the attack symptoms ? (Not from the time of diagnosis but from the time of major or severe symptoms.) In western countries, the service of a helicopter is therefore introduced.
These drugs are not effective in severe angina or unstable angina because the mechanism here is not thrombus clot blockade but the aggregation of platelets in the main. But the side effects of these drugs can be heavy and serious. They are — reperfusion arrhythmias, bleeding in the brain or any other body organs and reocclusion which can occur in about 40% of patients.

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