Heart-Attack-Blues
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Time Is Muscle





When the blood supply to the heart is cut off there is a  “wave” of cell death begins at the inside part of the heart muscle wall and progresses to the outside part of the wall.





Time Is Muscle

For many decades, cardiologists thought that once a coronary artery was totally occluded during a heart attack, all the heart muscle cells supplied by that vessel would die instantly and simultaneously. 

In the mid 1970s, animal studies suggested that this was not the case. Experiments were performed where the coronary arteries of dogs were occluded for variable periods of time. The results showed that death of the muscle cells develops at different time-related stages. A “wave” of cell death begins at the inside part of the heart muscle wall and progresses to the outside part of the wall. So, even though the inner wall dies early, the outer wall can survive for up to six hours, or sometimes even longer, following total blockage of the blood flow. 


Further animal studies suggested that if coronary blood flow is promptly restored in the setting of a heart attack— reperfusion—a substantial amount of heart muscle can be preserved. These observations also suggested that a substantial amount of heart muscle could be salvaged even hours after the start of the heart attack.

Experiments also showed that the sooner the blood flow is restored, the more muscle is preserved. That led to the saying we use now when treating heart attacks: Time is muscle. 

The research was the basis for a new approach to heart attacks: Prompt therapy to restore coronary blood flow as soon as possible in order to limit the size of the heart muscle damage and save lives. 

This was the beginning of the Reperfusion Era with the ultimate goal of restoring coronary blood flow in order to limit heart damage.