Heart Attack

Treatment

Heart attacks are a leading killer of both men and women in the United States. The good news is that excellent treatments are available for heart attacks. These treatments can save lives and prevent disabilities.

Heart attack treatment works best when it's given right after symptoms occur.

(Watch the video to learn what to do in case of a heart attack. To enlarge the video, click the brackets in the lower right-hand corner of the video screen. To reduce the video, press the Escape (Esc) button on your keyboard.)

Act Fast

The signs and symptoms of a heart attack can develop suddenly. However, they also can develop slowly—sometimes within hours, days, or weeks of a heart attack.

Know the warning signs of a heart attack so you can act fast to get treatment for yourself or someone else. The sooner you get emergency help, the less damage your heart will sustain.

Call 9–1–1 for an ambulance right away if you think you or someone else may be having a heart attack. You also should call for help if your chest pain doesn't go away as it usually does when you take medicine prescribed for angina.

Treatment May Start Right Away

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

  • aspirin to prevent further blood clotting
  • nitroglycerin to reduce your heart’s workload and improve blood flow through the coronary arteries
  • oxygen therapy
  • treatment for chest pain.

Restoring Blood Flow to the Heart

Once the diagnosis of a heart attack is confirmed or strongly suspected, doctors start treatments promptly to try to restore blood flow through the blood vessels supplying the heart. The two main treatments are

  • clot-busting medicines and
  • percutaneous coronary intervention, also known as coronary angioplasty, a procedure used to open blocked coronary arteries.

Clot-Busting Medicines

Thrombolytic medicines, also called clot busters, are used to dissolve blood clots that are blocking the coronary arteries. To work best, these medicines must be given within several hours of the start of heart attack symptoms. Ideally, the medicine should be given as soon as possible.

Percutaneous Coronary Intervention

Percutaneous coronary intervention is a nonsurgical procedure that opens blocked or narrowed coronary arteries. A thin, flexible tube (called a catheter) with a balloon or other device on the end is threaded through a blood vessel, usually in the groin (upper thigh), to the narrowed or blocked coronary artery. Once in place, the balloon at the tip of the catheter is inflated to press the plaque and related clot against the wall of the artery and make them smaller. This restores blood flow through the artery.

During the procedure, the doctor may put a small mesh tube called a stent in the artery. The stent helps to keep the blood vessel open to prevent blockages in the artery in the months or years after the procedure.

Other Treatments: Medicines and Medical Procedures

Other treatments for a heart attack include medicines and medical procedures.

Medicines

Your doctor may prescribe one or more of the following medicines.

  • ACE inhibitors lower blood pressure and reduce strain on your heart. They also help slow down further weakening of the heart muscle.
  • Anticlotting medicines stop platelets from clumping together and forming unwanted blood clots. Examples of anticlotting medicines include aspirin and clopidogrel.
  • Anticoagulants, or blood thinners, prevent blood clots from forming in your arteries. These medicines also keep existing clots from getting larger.
  • Beta blockers decrease your heart’s workload. These medicines also are used to relieve chest pain and discomfort and to help prevent another heart attack. Beta blockers also are used to treat arrhythmias (irregular heartbeats).
  • Statins control or lower cholesterol in your blood. Lowering cholesterol can decrease the chance of having another heart attack or stroke.

Doctors may also prescribe medications to relieve pain and anxiety, or to treat irregular heart rhythms that often occur during a heart attack. Take all medicines regularly, as your doctor prescribes. Don’t change the amount of medicine or skip a dose unless your doctor tells you to.

Medical Procedures

A medical procedure called coronary artery bypass grafting also may be used to treat a heart attack. A surgeon removes a healthy artery or vein from your body. The artery or vein is then connected, or grafted, to bypass the blocked section of the coronary artery. The grafted artery or vein goes around the blocked portion of the coronary artery. This provides a new route for blood to flow to the heart.

Cardiac Rehabilitation

Your doctor may recommend cardiac rehabilitation (cardiac rehab) to help you recover from a heart attack and to help prevent another heart attack. Nearly everyone who has had a heart attack can benefit from rehab. Cardiac rehab is a medically supervised program that may help improve the health and well-being of people who have heart problems.

The cardiac rehab team may include doctors, nurses, exercise specialists, physical and occupational therapists, dietitians or nutritionists, and psychologists or other mental health specialists.

Cardiac rehab has two parts.

  • Education, counseling, and training. This part of rehab helps you understand your heart condition and find ways to reduce your risk for future heart problems.
  • Exercise training. This part helps you learn how to exercise safely, strengthen your muscles, and improve your stamina. Your exercise plan will be based on your personal abilities, needs, and interests.

For more on heart healthy lifestyle changes, see the chapter on "Lowering Your Risk."