Cardiology & Vascular Research
Open AccessChest Strikes to treat STEMI? Exploring the Platinum Seconds of Reperfusion
Authors: Andrew K Hoffmann.
Abstract
ST Elevation Myocardial Infarction is a deadly disease, and opening the acutely thrombosed epicardial coronary vessel quickly with good reflow, are the main determinants for a positive outcome. This paper outlines a new first line, emergency treatment hypothesis, whereby a patient, once experiencing symptoms of a heart attack, preferably following confirmation of ST Elevation by a surveillance wearable, would, along with a 911 call, immediately begin beating their chest to the left and right of the sternum. With this, the patient could also simultaneously provide deep Valsalva-like coughing, and even more preferably, while comfortably seated or standing fling their backside repeatedly against a solid back rest, or wall. Data is presented showing how these percussive and compressive maneuvers, herein described as "Thrombo-Agitative Percussion" (TAP), when delivered with enough force can transmit and cause substantial mechanical displacements to the epicardium of the heart, where the coronaries are located. Also presented is evidence from an open canine model showing how gentle tapping or shaking of a hyper-acutely thrombosed coronary artery (while the clot is still a loosely bound, weakly adherent platelet aggregate) is known to lead to immediate and complete reflow to the vessel. Hence is hypothesized that TAP, by causing an agitative, percussive, shaking and compressive effect of the coronary vessels, could quite plausibly lead to immediate to near-immediate reflow (within seconds) to the culprit vessel. There are many potential added risks to TAP in a STEMI patient, which are discussed in this paper.
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