doctor. Klaus Renkop shares acute heart muscle injury: Part 4

Dr. Klaus Rentrop It describes how three scientific errors have hidden life -saving treatments for heart attacks from patients for 30 years.

In 1880, Dr. Karl Wittrt, a German pathology specialist, described the cause of heart attacks: blood clot (thrombosis) in one of the arteries of the heart in a spot that is already narrowed by atherosclerosis. The fully obstruction of the bowl suddenly stops blood flow to a portion of the heart muscle, which then dies. Dr. James Herik got acquainted with American doctors with this insight after 30 years. More research revealed that the formation of a thrombosis is caused by the narrowing of the arteries of the arteries, called “plaque rupture”.

Doctors hoped that the damaged heart muscle would heal during a period of lengthy bed for up to six weeks, which is the cornerstone of the treatment for half a century. However, about 30 % of patients died in the hospital due to the fatal violations of the heartbeat or the vast heart muscle loss.

Streptococcus, bacteria, stir blood clots in a process called the decomposition of thrombosis. This discovery by Dr. William Telite in 1933 led to the development of “Streptokinase”, the first thrombosis drug. Dr. Saul Sherry Group believed that steripokinaz could save the lives of infarction patients through “rapid melting of coronary clotting”. Blood flow will be restored to the heart and reduce muscle death, assume.

Their small experimental trial, published in 1958, was promising. Blood flow was re -established as some chemicals indicated in the blood. The hospital’s deaths were 15 % among patients who were treated within 14 hours of symptoms, compared to 30 % among those who later treated. However, Sherry, a blood specialist, could not evaluate the dissolution of the thrombosis in a larger experience because, he said, “Heart specialists no longer intertwine as a cause of severe decisiveness.”

In the late fifties of the last century, pathologists reported that blood clots were rare among the victims of heart attacks and suggested that these clots had evolved after an infarction. However, they always found wide -ranging coronary atherosclerosis. They suggest that blood flow without a complete blockage can cause infarction. In this view, clots developed only when a large infarction of the circulation is put blood circulation, making blood flow in the slow narrow law.

Some pathologists did not agree with this opinion, but cardiac specialists adopted it during the 1960s. They considered the solution of blood clots, which did not cause a heart attack, is useless. This first mistake came out of the course of the development of coagulation therapy to save life.

Important progress in treating heart attacks occurred, however, in 1962 with the introduction of coronary care units. Immediate recognition of the deadly violations of the heartbeat by trained individuals and treatment with a defibrium or heart attack devices has reduced the severity of the severity of infarction by half. The high deaths in the hospital of 15 % resulted from the function of the incomplete pump of hearts that were severely damaged.

Animal studies published by Dr. Eugene Braonwald in 1969 indicated that the extent of heart muscle death can be limited pharmacists, without restoring blood flow. This was the second mistake. It took control of research throughout the seventies. Nearly 50 “anti -reservation drugs” was reported to reduce the volume of experimental animals, either by reducing the demand for oxygen in the heart, preventing the accumulation of harmful substances, or saving energy independent of oxygen supply. Clinical experimental studies were promising. However, in the mid -eighties of the last century, the experiences designed better refuted the initial positive results.

Dr. Shaber has proven that even when reducing metabolism, the cells in the infarction area will inevitably increase energy and death unless blood flow is restored. No customer has ever fulfilled as an anti -ending drug.

Dr. Francis Francis Everhart was a young man, one of the few heart disease specialists who question the opinion that clots are not the cause of heart attacks. He became aware of the discussions between pathologists during a year’s fellowship in Saint -Paul, Minnesota, in 1967/68, after the completion of the heart disease fellowship. He continued to participate in the autopsy when surgery was a group of doctors. Berg and Kendall in Spokan, Washington appointed him in August 1968, and when he opened his own practice in March 1969. In the end, he concluded that clots caused heart attacks, and that only early blood flow could limit the size of the infarction. The successful Berg operations in the pre -interface patients convinced him that surgical awareness could achieve this goal.

However, coronary vessels would be needed before circumventing surgery. Filming of acute coronary vessels will also reveal the spread of overall coronary blockage at the beginning of heart attacks, as it settled on the issue of disagreement among pathologists. Everhart concept was radical at a time when rest in bed was still the cornerstone of treatment, and acute gaseous measures were considered harmful and anti -drug drugs.

Everhart presented his vision to Berg at a meeting in mid -June 1970. The concept was logical to Perg, who drew the similar clusters of the legs of the leg by a blood clot, which requires rapid surgical awareness to avoid amputation. He agreed to consult the surgery of warfare in the emergency situations of infarction patients in one case: they will document and publish their work scientifically. In March 1971, Dr. Kendall performed the first emergency in the vein emergency to obtain acute myocardial infarction in Spokan. When the coronary artery opened to connect the illegitimate graft, a new stroke “has emerged”, amazingly confirming that blood clots explode an infarction at the beginning of a heart attack.

The patient was not honored very well. The function of the heart returned to normal when depicting the frequent vessels after a few weeks. At the following hospital status conference, doctors were excited to hear the retrieval of a blood clot and the immediate improvement in the patient’s condition. Within a few years, surgical treatment for heart attacks has become the level of care in Spokan. But everywhere else in the United States, the awareness was harmful. It was believed that bleeding in the dead heart muscle that was reported in experimental animals after restoring the flow expansion. The third mistake may be established.

Among the pathologists, consensus remained about the frequency of coronary clots in the heartfelt seizures in the workshop organized by the National Institute of Health in 1973. The workshop concluded that the importance of coronary clots “must rely on the evidence that caused hatred either a possibility as a preliminary scourge or as follows as a secondary effect.”

Evidence of accumulation in Spokan provided answers. Coronary vascular imaging revealed a complete blockage of the artery associated with infarction in 81 % of 118 patients. Surgeons faced clots when the artery opened an infarction in a third of their cases and recovered them. Moreover, re -awareness was not harmful; It improves heart function. Hospital deaths were 5.6 % between 71 patients managed compared to 21 % among patients who were treated medically.

Everhart presented this data at the World Conference on Heart Diseases in Buenos Aires, Argentina, in September 1974, and at the US College of Vascular College meeting in San Juan, Puerto Rico, in February 1975.

It has been printed by the “Survey of Surrectional Cardi muscle” in the 1974 supplement for the blood circulation. However, the reaction of the doctors ’audiences negatively to the new results, which should have been correcting scientific errors that dominate the research and hinder clinical treatment. Everhart was called a fool. He presented annual summaries to American national heart disease meetings. None of them was accepted. Everhart Spokan left at the end of 1977.

Berg focused his display at the annual meeting of the American Association of Surgical Surgery in April 1975 on reducing infarction deaths that were achieved with deduction surgery. Dr. Eldred Mondth, Boston, who is concerned about the extension of the infarction, warned of Spokan’s approach.

However, the Berg show, published as a card, created an international interest. Dr. Philips in De Main, Iowa, repeated the results of the death group in 75 patients. In 1979, the circulatory paper confirmed the high rate of fully blockage of the artery, and reported that the stroke was retrieved during almost all cases. However, the opening article accompanying this paper, ignoring important vascular results and retrieving the stroke.

He suggested that the low death rate was due to the choice of patients with low risk, although 16 of them were unable to maintain normal blood pressure before surgery! The accuracy of the errors of the heart doctors in the mistakes of the cardiologist was to install great scientific evidence, Peter again Notes.