Heart Attack : Treatment

by National Institute on Aging

(Page 4 of 5)

Treatment for a heart attack may begin in the ambulance or in the emergency department and continue in a special area of the hospital called a coronary care unit.

The coronary care unit is specially equipped with monitors that continuously monitor your vital signs. These include

• an EKG which detects any heart rhythm problems
• a blood pressure monitor, and
• pulse oximetry, which measures the amount of oxygen in the blood.

In the hospital, if you have had or are having a heart attack, doctors will work quickly to restore blood flow to your heart and continuously monitor your vital signs to detect and treat complications.

Restoring blood flow to the heart can prevent or limit damage to the heart muscle and help prevent another heart attack. Doctors may use clot-busting drugs called thrombolytics and procedures such as angioplasty.

Clot-busters or thrombolytic drugs are used to dissolve blood clots that are blocking blood flow to the heart. When given soon after a heart attack begins, these drugs can limit or prevent permanent damage to the heart. To be most effective, these drugs must be given within one hour after the start of heart attack symptoms.

Angioplasty procedures are used to open blocked or narrowed coronary arteries. A stent, which is a tiny metal mesh tube, may be placed in the artery to help keep it open.

Coronary artery bypass surgery uses arteries or veins from other areas in your body to bypass your blocked coronary arteries.

Many medications are used to treat heart attacks. They include beta blockers, ACE inhibitors, nitrates, anticoagulants, antiplatelet medications, and medications to relieve pain and anxiety.

Beta blockers slow your heart rate and reduce your heart's need for blood and oxygen. As a result, your heart beats with less force, and your blood pressure falls. Beta blockers are also used to relieve angina and prevent second heart attacks and correct an irregular heartbeat.

Angiotensin-converting enzyme or ACE inhibitors lower your blood pressure and reduce the strain on your heart. They are used in some patients after a heart attack to help prevent further weakening of the heart and increase the chances of survival.

Nitrates, such as nitroglycerin, relax blood vessels and relieve chest pain. Anticoagulants, such as heparin and warfarin, thin the blood and prevent clots from forming in your arteries.

Antiplatelet medications, such as aspirin and clopidogrel, stop platelets from clumping together to form clots. They are given to people who have had a heart attack, have angina, or have had an angioplasty.

Glycoprotein llb-llla inhibitors are potent antiplatelet medications given intravenously to prevent clots from forming in your arteries.

Doctors may also prescribe medications to relieve pain and anxiety and oxygen therapy or medications to treat irregular heart rhythms which often occur during a heart attack.

While you are still in the hospital or after you go home, your doctor may order other tests, such as an echocardiogram. An echocardiogram uses ultrasound to make an image of the heart which can be seen on a video monitor. It shows how well the heart is filling with blood and pumping it to the rest of the body.

Your doctor may also order a stress test to see how well your heart works when it has a heavy workload. You run on a treadmill or pedal a bicycle or receive medicine through a vein in your arm to make your heart work harder. EKG and blood pressure readings are taken before, during, and after the test to see how your heart responds.

Often, an echocardiogram or nuclear scan of the heart is performed before and after exercise or intravenous medication. The test is stopped if chest pain or a very sharp rise or fall in blood pressure occurs. Monitoring continues for 10 to 15 minutes after the test or until your heart rate returns to baseline.

Quiz

1. Clot busters or thrombolytic drugs are used to dissolve blood clots and reduce or prevent permanent damage to the heart. To be most effective, these drugs need to be given

A. within a day or two of the heart attack.
B. within one hour after the start of heart attack symptoms.
C. after an x-ray is taken.

B is the correct answer. Thrombolytic drugs need to be given within one hour after the start of heart attack symptoms.

2. Following some heart attacks, coronary artery bypass surgery may be needed. This procedure

A. uses arteries or veins from other areas in your body to route blood around your blocked coronary arteries.
B. uses a tool to unclog arteries.
C. is used only in men.

A is the correct answer. Coronary artery bypass surgery uses arteries or veins from an arm or leg to bypass blood flow around one or more blocked arteries.

3. Many medications are used to treat a heart attack. These can

A. decrease the work load of the heart.
B. lower blood pressure and prevent or reduce clotting.
C. stop chest pain.
D. all of the above

D is the correct answer. There are many types of medications that your doctor may prescribe following your heart attack.

4. Angioplasty is a procedure that allows doctors to use a balloon to reopen clogged arteries. Many times, a device is placed inside the artery to hold open the narrowed walls. This device is called a

A. stent.
B. balloon.
C. mesh.
D. step.

A is the correct answer. A stent is placed inside the artery to hold open the narrowed walls.

About the Author

www.nia.nih.gov
NIA, one of the 27 Institutes and Centers of NIH, leads a broad scientific effort to understand the nature of aging and to extend the healthy, active years of life. In 1974, Congress granted authority to form NIA to provide leadership in aging research, training, health information dissemination, and other programs relevant to aging and older people.