Treatment of Heart Attack

The treatment options for a heart attack depend on the type of heart attack you have had. It may be ST segment elevation myocardial infarction (STEMI) or any another ones.

Updated: August 17, 2020

The treatment options for a heart attack depend on the type of heart attack you have had.  It may be ST-segment elevation myocardial infarction (STEMI) or any other ones. The quicker you are treated when having a heart attack, the greater the chances of success, and damage to your heart can be minimized.  A person's survival depends largely on how quickly they reach the hospital. The most serious form of a heart attack that requires emergency assessment and treatment is a STEMI. If an electrocardiogram (ECG) shows you have a STEMI, you will be assessed for treatment to unblock the coronary arteries. The treatment plan will depend on when your symptoms started, how long it sustains, and how soon you can access treatment.

  • Primary percutaneous coronary intervention (PCI) is recommended if your symptoms started within the past 12 hours.
  • Medication is recommended to break down blood clots if your symptoms started within the past 12 hours but you can not access PCI quickly.
  • If your symptoms started more than 12 hours ago and the symptoms seem to be improved a different procedure is recommended. The treatment plan will be decided after an angiogram which could be either medication, PCI, or bypass surgery.


Primary percutaneous coronary intervention (PCI):

Primary PCI is a procedure to widen the coronary artery. This is an emergency treatment of STEMI. To assess your suitability for PCI, at first, coronary angiography is performed. Some blood-thinning medication is recommended to prevent further clots from developing which include:

  • aspirin
  • clopidogrel
  • prasugrel
  • heparin
  • bivalirudin 
  • ticagrelor

After PCI also some of these medications may be continued for a period of time.


Coronary angioplasty:

Coronary angioplasty is a complex type of procedure where a tiny tube known as a balloon catheter with a sausage-shaped balloon at the end is put into a large artery in your groin or arm. The catheter is passed up to your heart through your blood vessels over a fine guidewire. Before being moved into the narrowed section of your coronary artery it uses X-rays for the guidance. When it reaches the position, the balloon is inflated inside the narrowed part of the coronary artery to open it wide. A flexible metal mesh called a stent is then inserted into the artery to help keep it open afterward.


Medication to break down blood clots:

Thrombolytics or fibrinolytic are injections used to break down blood clots. Reteplase, alteplase, and streptokinase are examples of some medication to break down blood clots. These medicines act on fibrin, a tough protein that makes up blood clots to destroy it. If you have an increased risk of experiencing another heart attack at some point in the near future, a glycoprotein IIb/IIIa inhibitor will be described. Glycoprotein IIb/IIIa inhibitors prevent blood clots from getting bigger instead of breaking up blood clots. They help to stop your symptoms from getting worse.


Coronary artery bypass graft:

If there are too many narrow sections in your arteries or if there are lots of branches coming off your arteries that are also blocked, a coronary angioplasty may not be possible. Coronary artery bypass graft (CABG) is then suggested in such cases. A blood vessel from another part of your body such as from your chest or leg is taken to use as a graft in this procedure. The graft bypasses any hardened or narrowed arteries in the heart. A new blood vessel will be attached to the aorta and the other to the coronary artery beyond the narrowed area or blockage.


Treating NSTEMI or unstable angina:

If your ECG show you have a non-ST segment elevation myocardial infarction (NSTEMI) or unstable angina, then blood-thinning medication such as aspirin will be recommended initially. Further, the treatment may be followed by coronary angioplasty or coronary artery bypass graft.





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