Understanding Heart Attack: Diagnosis and Treatment
What Are the Treatments for Heart Attack? continued...
Heart Attack Treatment in the Hospital
At the emergency facility or hospital, a heart attack victim is rapidly given other drugs to prevent further blood clotting in the heart and decrease the strain on the heart. Treatment may also include a procedure to open up the blocked arteries.
Clot-busting drugs. These are given in the ER to open up blocked arteries. These powerful drugs are used if it will take too long to get a victim to the catheterization lab and to perform angioplasty and stenting.
Balloon angioplasty. This treatment can be performed, if needed, during a cardiac catheterization. A balloon-tipped catheter (thin, hollow tube) is inserted into the blocked artery in the heart. The balloon is inflated gently to press plaque outward against the walls of the artery, to open up the artery and improve blood flow.
Stent placement. In this procedure, a wire-mesh tube is inserted through a catheter into a blocked artery to "prop" it open. This procedure is often performed along with balloon angioplasty to help keep the artery open.
Bypass surgery. This surgical procedure allows a surgeon to re-route blood flow around a blocked artery to re-establish blood flow to part of the heart. A blood vessel from the person's leg or chest is usually used to bypass the blocked artery. Bypass surgery is typically done later, not as part of the emergency care of a heart attack. One, two, or more arteries can be bypassed.
In the Coronary Care Unit (CCU)
Heart attack patients are usually hospitalized in coronary care units (CCU) for at least 36 hours. Once past the critical phase, patients continue to receive a variety of drugs, including:
- Beta-blockers to slow the heart
- Nitrates to increase heart blood flow
- Blood thinners such as heparin, aspirin, Brilinta, Effient, or clopidogrel to prevent further clotting
- ACE inhibitors to help the heart muscle heal
- Statins -- cholesterol-lowering drugs such as simvastatin and atorvastatin -- are now given routinely to help the heart muscle heal and lower the risk of another heart attack.
While hospitalized, a patient has his or her heart constantly monitored by ECG (electrocardiogram), in case abnormal heart rhythms develop. If the heart starts beating too fast or too slow, various medications may be given. Some patients may need to be fitted with a pacemaker, a battery-powered device to help maintain a steady heart rhythm. If a patient experiences a dangerous arrhythmia known as ventricular fibrillation, an electric shock to the chest is administered. Patients who show signs of heart failure are given a variety of medications to decrease strain on the heart and to encourage the heart to beat more forcefully.