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How Is a Heart Attack Treated?

Early treatment for a heart attack can prevent or limit damage to the heart muscle. Acting fast, at the first symptoms of a heart attack, can save your life. Medical personnel can begin diagnosis and treatment even before you get to the hospital.

Certain treatments usually are started right away if a heart attack is suspected, even before the diagnosis is confirmed. These include:

  • Oxygen therapy
  • Aspirin to thin your blood and prevent further blood clotting
  • Nitroglycerin to reduce your heart's workload and improve blood flow through the coronary arteries
  • Treatment for chest pain

Once the diagnosis of a heart attack is confirmed or strongly suspected, doctors start treatments to try to promptly restore blood flow to the heart. The two main treatments are "clot-busting" medicines and percutaneous coronary intervention (PCI), sometimes referred to as coronary angioplasty, a procedure used to open blocked coronary arteries.

Clot-Busting Medicines

Thrombolytic medicines, also called "clot busters," are used to dissolve blood clots that are blocking the coronary arteries. To work best, these medicines must be given within several hours of the start of heart attack symptoms. Ideally, the medicine should be given as soon as possible.

Percutaneous Coronary Intervention

Percutaneous (per-ku-TA-ne-us) coronary intervention (PCI) is a nonsurgical procedure that opens blocked or narrowed coronary arteries. This procedure also is called coronary angioplasty.

A thin, flexible tube with a balloon or other device on the end is threaded through a blood vessel, usually in the groin (upper thigh), to the narrowed or blocked coronary artery.

Once in place, the balloon is inflated to compress the plaque against the wall of the artery. This restores blood flow through the artery.

During the procedure, the doctor may put a small mesh tube called a stent in the artery. The stent helps prevent blockages in the artery in the months or years after the procedure.

For more information, go to the Health Topics PCI article.

Other Treatments for Heart Attack

Medicines

  • Beta blockers. Beta blockers decrease your heart's workload. These medicines also are used to relieve chest pain and discomfort and to help prevent repeat heart attacks. Beta blockers also are used to treat arrhythmias (irregular heartbeats).
  • ACE inhibitors. ACE inhibitors lower blood pressure and reduce strain on your heart. They also help slow down further weakening of the heart muscle.
  • Anticoagulants. Anticoagulants, or "blood thinners," prevent blood clots from forming in your arteries. These medicines also keep existing clots from getting larger.
  • Anticlotting medicines. Anticlotting medicines stop platelets from clumping together and forming unwanted blood clots. Examples of anticlotting medicines include aspirin and clopidogrel.

You also may be given medicines to relieve pain and anxiety, treat arrhythmias (which often occur during a heart attack), or lower your cholesterol (these medicines are called statins).

Medical Procedures

Coronary artery bypass grafting (CABG) also may be used to treat a heart attack. During CABG, a surgeon removes a healthy artery or vein from your body. The artery or vein is then connected, or grafted, to the blocked coronary artery.

The grafted artery or vein bypasses (that is, goes around) the blocked portion of the coronary artery. This provides a new route for blood to flow to the heart muscle.

For more information, go to the Health Topics Coronary Artery Bypass Graftingarticle.

Treatment After You Leave the Hospital

Most people spend several days in the hospital after a heart attack. When you leave the hospital, treatment doesn't stop. At home, your treatment may include daily medicines and cardiac rehabilitation (rehab). Your doctor may want you to have a flu shot and pneumococcal vaccine each year.

Your doctor also may recommend lifestyle changes, including following a heart healthy diet, being physically active, maintaining a healthy weight, and quitting smoking. Taking these steps can lower your chances of having another heart attack.

Cardiac Rehabilitation

Your doctor may recommend cardiac rehab to help you recover from a heart attack and to help prevent another heart attack. Almost everyone who has had a heart attack can benefit from rehab.

Cardiac rehab is a medically supervised program that may help improve the health and well-being of people who have heart problems.

The cardiac rehab team may include doctors, nurses, exercise specialists, physical and occupational therapists, dietitians or nutritionists, and psychologists or other mental health specialists.

Rehab has two parts:

  • Exercise training. This part helps you learn how to exercise safely, strengthen your muscles, and improve your stamina. Your exercise plan will be based on your personal abilities, needs, and interests.
  • Education, counseling, and training. This part of rehab helps you understand your heart condition and find ways to reduce your risk of future heart problems. The rehab team will help you learn how to cope with the stress of adjusting to a new lifestyle and deal with your fears about the future.

For more information, go to the Health Topics Cardiac Rehabilitation article.

 
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December 17, 2013