There are clearly defined treatment steps that most hospitals follow when treating heart attack. These steps have been proven to provide people suffering from this condition with the best chance at survival and preservation of heart muscle when performed within an appropriate time frame. Typically, these steps begin with some form of emergency medical treatment to alleviate symptoms and distress, and may be followed by a procedure to address the underlying cause of the heart attack.
Emergency Medical Treatment
Even before reaching the hospital, emergency personnel may begin treatment of a suspected heart attack with:
- Aspirin, clopidogrel, heparin, or other anticlotting agents to prevent new clots
- Thrombolytic drugs to dissolve existing clots ("clot-busting" drugs such as tPA)
- Oxygen to protect heart tissue
- Nitroglycerin to widen coronary vessels
- Drugs to decrease the heart's workload and pain, relieve anxiety, or regulate heart rhythm
Procedures, Devices & Surgery
In many cases, a minimally invasive procedure can be used to restore blood flow to the heart muscle (sometimes in combination with medication to dissolve clots). Examples of these procedures include:
- Balloon angioplasty is used to open blocked coronary vessels. During this minimally invasive procedure, a catheter (a long, thin flexible tube) is guided into the blocked artery and a tiny balloon is inflated to clear the way so that blood flow is restored. A small mesh tube (stent) is often inserted to keep the artery open.
- Atherectomy is a blade or laser that is used in combination with a catheter to clear out plaque build-up in a blood vessel.
- Bypass surgery is a common approach that surgeons use to create new routes through which blood can flow around blocked or narrowed arteries. These “bypasses” are created using healthy vessels taken from the chest, arms or legs.
Follow-Up Treatment
After you leave the hospital, you may feel weak or a little depressed or anxious. This is common and your medical team will work with you to help overcome these problems. Often, this involves lifestyle changes and medications aimed at reducing your risk of another heart attack.
Lifestyle
Changes in lifestyle, such as dieting, quitting smoking and losing weight, can help you reduce the risk of a repeat heart attack. You should talk with your doctor about an exercise plan that is safe for you. In some cases, your doctor may recommend that you take part in a formal cardiac rehabilitation program which provides exercise training and counseling.
Medications
After a heart attack, your doctor may recommend that you start taking medication to help reduce your risk of heart attack and improve cardiovascular function. These could include:
- aspirin or anticoagulants (to prevent blood clots)
- beta blockers, calcium channel blockers, or ACE inhibitors (to improve blood flow, slow the heart rate, and/or reduce the strain on the heart)
- anti-diabetic medications (to control blood sugar)
- statins (to reduce cholesterol)
- beta blockers, ACE inhibitors, or diuretics (to reduce blood pressure)
- nitrates (to reduce angina)