How Is a Heart Attack Treated?

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

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

• Oxygen
• Aspirin to prevent further blood clotting
• Nitroglycerin, to reduce the workload on the heart and improve blood flow through the coronary arteries
• Treatment for chest pain

Once the diagnosis of heart attack is confirmed or strongly suspected, treatments to try to restore blood flow to the heart are started as soon as possible. Treatments include medicines and medical procedures.

Medicines

A number of different kinds of medicines may be used to treat heart attack. They include the following.

Thrombolytic Medicines

These medicines (also called clot busters) are used to dissolve blood clots that are blocking the coronary arteries. To be most effective, these medicines must be given within 1 hour after the start of heart attack symptoms.

Beta Blockers

These medicines decrease the workload on your heart. Beta blockers also are used to relieve chest pain or discomfort and to help prevent additional heart attacks. Beta blockers also are used to correct arrhythmias (irregular heartbeats).

Angiotensin-Converting Enzyme (ACE) Inhibitors

These medicines lower blood pressure and reduce the strain on your heart. They also help slow down further weakening of the heart muscle.

Anticoagulants

These medicines thin the blood and prevent clots from forming in your arteries.

Antiplatelet Medicines

These medicines (such as aspirin and clopidogrel) stop platelets (a type of blood cell) from clumping together and forming unwanted clots.

Other Medicines

Medicines may also be given to relieve pain and anxiety, and to treat arrhythmias, which often occur during a heart attack.

Medical Procedures

If medicines can’t stop a heart attack, medical procedures—surgical or nonsurgical—may be used. These procedures include the following.

Angioplasty

This nonsurgical procedure can be used to open coronary arteries that are blocked by a blood clot. During angioplasty, a catheter (a thin, flexible tube) with a balloon on the end is threaded through a blood vessel to the blocked coronary artery. Then, the balloon is inflated to push the plaque against the wall of the artery. This widens the inside of the artery, restoring blood flow.

During angioplasty, a small mesh tube called a stent may be put in the artery to help keep it open. Some stents are coated with medicines that help prevent the artery from becoming blocked again.

Coronary Artery Bypass Grafting

Coronary artery bypass grafting is a surgery in which arteries or veins are taken from other areas of your body and sewn in place to bypass (that is, go around) blocked coronary arteries. This provides a new route for blood flow to the heart muscle.

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 recommend lifestyle changes, including quitting smoking, losing weight, changing your diet, and increasing your physical activity, to lower your chances of having another heart attack.

Cardiac Rehabilitation

Your doctor may prescribe 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. The heart is a muscle, and the right exercise will strengthen it.

But cardiac rehab isn’t only about exercise. It also includes education, counseling, and learning about reducing your risk factors. Rehab will help you learn the best way to take care of yourself after having a heart attack and how to prevent having another one.

The cardiac rehab team may include doctors (your family doctor, a cardiologist, and/or a surgeon), nurses, exercise specialists, physical and occupational therapists, dietitians, and psychologists or other behavioral therapists.