Treatment

Heart attack treatment at a hospital

Each minute after a heart attack, more heart tissue deteriorates or dies. Restoring blood flow quickly helps prevent heart damage.

Medications

Medications to treat a heart attack might include:

• Aspirin. The 911 operator might tell you to take aspirin, or emergency medical personnel might give you aspirin immediately. Aspirin reduces blood clotting, thus helping maintain blood flow through a narrowed artery.
• Thrombolytics. These drugs, also called clotbusters, help dissolve a blood clot that's blocking blood flow to your heart. The earlier you receive a thrombolytic drug after a heart attack, the greater the chance you'll survive and have less heart damage.
• Antiplatelet agents. Emergency room doctors may give you other drugs known as platelet aggregation inhibitors to help prevent new clots and keep existing clots from getting larger.
• Other blood-thinning medications. You'll likely be given other medications, such as heparin, to make your blood less "sticky" and less likely to form clots. Heparin is given by IV or by an injection under your skin.
• Pain relievers. You might be given a pain reliever, such as morphine.
• Nitroglycerin. This medication, used to treat chest pain (angina), can help improve blood flow to the heart by widening (dilating) the blood vessels.
• Beta blockers. These medications help relax your heart muscle, slow your heartbeat and decrease blood pressure, making your heart's job easier. Beta blockers can limit the amount of heart muscle damage and prevent future heart attacks.
• ACE inhibitors. These drugs lower blood pressure and reduce stress on the heart.
• Statins. These drugs help control your blood cholesterol.

Surgical and other procedures

In addition to medications, you might have one of these procedures to treat your heart attack:

• Coronary angioplasty and stenting. In this procedure, also known as percutaneous coronary intervention (PCI), doctors guide a long, thin tube (catheter) through an artery in your groin or wrist to a blocked artery in your heart. If you've had a heart attack, this procedure is often done immediately after a cardiac catheterization, a procedure used to find blockages.

  The catheter has a special balloon that, once in position, is briefly inflated to open a blocked coronary artery. A metal mesh stent almost always is inserted into the artery to keep it open long term, restoring blood flow to the heart. Usually, you get a stent coated with a slow-releasing medication to help keep your artery open.

• Coronary artery bypass surgery. In some cases, doctors perform emergency bypass surgery at the time of a heart attack. If possible, however, you might have bypass surgery after your heart has had time — about three to seven days — to recover from your heart attack.

  Bypass surgery involves sewing veins or arteries in place beyond a blocked or narrowed coronary artery, allowing blood flow to the heart to bypass the narrowed section.

  You'll likely remain in the hospital for several days after blood flow to your heart is restored and your condition is stable.

Cardiac rehabilitation

Most hospitals offer programs that might start while you're in the hospital and continue for weeks to a couple of months after you return home. Cardiac rehabilitation programs generally focus on four main areas — medications, lifestyle changes, emotional issues and a gradual return to your normal activities.

It's extremely important to participate in this program. People who attend cardiac rehab after a heart attack generally live longer and are less likely to have another heart attack or complications from the heart attack. If cardiac rehab is not recommended during your hospitalization, ask your doctor about it.