$Unique_ID{BRK01535}
$Pretitle{Circulatory System}
$Title{The High Cost of Heart Attack Injections}
$Subject{heart attack treatment cost}
$Volume{G-3}
$Log{}

Copyright (c) 1991   Tribune Media Services, Inc.


The High Cost of Heart Attack Injections


------------------------------------------------------------------------------

QUESTION:  Recently my brother, age 62, had a severe chest pain and was
immediately rushed to a local hospital.  There they started an intravenous
tube in the emergency room and gave him an injection through the tube.  All
the other things were also done, cardiogram etc.  And he did recover quite
rapidly.  When he saw his bill, he almost had another heart attack for that
one injection cost over $2000.  What gives here?  Does this seem right to you?
I hope you will try to explain it to us.

------------------------------------------------------------------------------

ANSWER:  It makes all the sense in the world, and probably is the state of the
art in the emergency care of an acute heart attack.  To understand just what
happened, you must first know a bit about the mechanics of a heart attack.
Most heart attacks occur when a clot forms inside of one of the coronary
arteries, cutting off the flow of oxygen rich blood to the heart muscles.
Without the required oxygen, and other nutrients carried by the blood, these
muscle cells suffocate, and die.  If a large enough section of heart muscle is
damaged, death may occur.  However, when the patient arrives at the hospital
early enough, if possible within a half hour after the attack, a "clotbuster"
can be administered with the hopes of dissolving the clot and opening the
passage to the flow of blood once again.  About 1.5 million Americans suffer a
heart attack each year, and almost 300,000 die before reaching a hospital.
Most of those who arrive alive are possible candidates for this treatment.
Three types of medication may be used, Tissue Plasminogen Activator (or TPA),
Anistreplase, and Streptokinase.  The cost of a single vial of TPA is about
$ 2,000 dollars and is considered by many American physicians to be a
faster working treatment than the other two.  Anistreplase costs about
$1,700 a dose while streptokinase, the oldest of the three (it was approved
for use in 1982) costs about $200 a dose.  TPA also has fewer complications,
such as internal bleeding or allergic reactions, but current thinking is that
the best possible treatment for an acute attack is to get the patient to the
hospital as quickly as possible and use whatever clot dissolving drug can be
administered most promptly.
ÿ
----------------

The material contained here is "FOR INFORMATION ONLY" and should not replace 
the counsel and advice of your personal physician.  Promptly consulting your 
doctor is the best path to a quick and successful resolution of any medical 
problem.
