Heart Attack Treatment

If you believe that you are having the symptoms of a heart attack, please call 911 immediately.

When a heart attack strikes, the key thing to remember is that time equals muscle. The longer the delay in seeking medical care, the more heart muscle will be damaged. There is a window of opportunity to restore blood supply to the heart muscle by unblocking the affected heart artery. Treatments must be done in a hospital and include administration of clot-busting drugs to dissolve the clot at the site of the ruptured plaque and heart catheterization and angioplasty (in which the blood vessel is opened by balloon, often with adjunctive placement of a stent), or both.

Self-Care at Home

• The first step to take when chest pain occurs is to call 911 and activate the Emergency Medical System. First responders, EMTs and paramedics can begin treating a heart attack enroute to the hospital, alert the Emergency Department that the patient is on the way, and treat some of the complications of a heart attack should they occur.
  
  
• Step two is to take an aspirin. Aspirin makes platelets less sticky and can minimize blood clot formation and prevent further blockage of the artery.
  
  
• Step three is to rest. When the body does work, the heart has to pump blood to supply oxygen to the muscles and clear the waste products of metabolism. When heart function is limited because it doesn't have an adequate blood supply itself, asking it to do more work may cause more damage and risk further complications.

Medical Treatment

Hospitals have established treatment plans to minimize the time to diagnose and treat people with heart attack. National guidelines suggest that an electrocardiogram (EKG) be done within 10 minutes of the patient's arrival in the ER.

Many things will occur at the same time as the EKG being completed. The doctor will take a history and complete a physical exam while the nurses start an intravenous line, place heart monitor lines on the chest, and administer oxygen.

Medications are used to try to restore blood supply to the heart muscle. If it wasn't taken prior to arrival in the ER, aspirin will be used for its anti-platelet action. Nitroglycerin will be used to dilate blood vessels. Heparin or enoxaparin (Lovenox) will be used to thin the blood. Morphine can also be used for pain control.

There are two options (depending on the resources at the hospital) if the EKG shows an acute heart attack (myocardial infarction), and if there are no contraindications.

Heart catheterization

The favored treatment is heart catheterization. Tubes are threaded through the femoral artery in the groin or through the brachial artery in the elbow, into the coronary arteries, and the area of blockage is identified.