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Heart Attack Treatment

What are the treatment options for a heart attack?

The goal of treatment for a heart attack is to relieve pain, preserve the heart muscle function, and prevent death.

Treatment in the emergency department may include:

  • Intravenous therapy, such as nitroglycerin or morphine
  • Continues monitoring of the heart and vital signs
  • Oxygen therapy to improve oxygenation to the damaged heart muscle
  • Pain medicine to decrease pain.
  • Cardiac medicine such as beta-blockers to promote blood flow to the heart, improve the blood supply, prevent arrhythmias, and decrease heart rate and blood pressure
  • Fibrinolytic therapy. This is the intravenous infusion of a medicine that dissolves the blood clot, restoring blood flow.
  • Antithrombin or antiplatelet therapy with aspirin or clopidogrel. This is used to prevent further blood clotting.
  • Antihyperlipidemic - these medicines lower lipids (fats) in the blood particularly low-density lipid (LDL) cholesterol and bile acid sequestrants and nicotinic acid (niacin) to lower cholesterol levels.

Procedures to restore blood flow to the heart include:

One of the following procedures may be needed to restore blood flow to the heart:

  • Coronary Angioplasty
    With this procedure, a balloon is used to create a bigger opening in the vessel to increase blood flow. This is often followed by inserting a stent into the coronary artery to help keep the vessel open. Although angioplasty is done in other blood vessels elsewhere in the body, percutaneous coronary intervention (PCI) refers to angioplasty in the coronary arteries. This lets more blood flow into the heart. PCI is also called percutaneous transluminal coronary angioplasty (PTCA). There are several types of PTCA procedures:
    • Balloon Angioplasty - a small balloon is inflated inside the blocked artery to open the blocked area.
    • Coronary Artery Stent - a tiny coil is expanded inside the blocked artery to open the blocked area. The stent is left in place to keep the artery open
    • Atherectomy - the blocked area inside the artery is cut away by a tiny device on the end of a catheter.
    • Laser Angioplasty - a laser used to "vaporize" the blockage in the artery.

  • Coronary Artery Bypass
    This surgery is most commonly referred to as simply bypass surgery or CABG (pronounced "cabbage"). It is often done in people who have chest pain (angina) or coronary artery disease. During the surgery, the surgeon makes a bypass by grafting a piece of a vein above and below the blocked area of a coronary artery. This lets blood flow around the blockage. The surgeon usually takes veins from a leg, but he or she may also use arteries from the chest or an arm. Sometimes, you may need more than one bypass to restore blood flow to all areas of the heart.