Treatment for heart attack should begin as immediately as possible to minimize the damage done to the heart and to prevent death.
If you think you are having a heart attack, seek immediate medical attention. Call 911 right away. Do not drive yourself to the hospital or have someone else drive you. Wait for the ambulance to arrive and take you to the hospital. Treatment will begin as soon as emergency medical personnel arrive and will continue in the ambulance on the way to hospital.
If you are not allergic, taking aspirin after your have called 911 may help maintain blood flow through a blocked artery. If you have had angina (chest pains precursory to a heart attack, but not an actual heart attack) and have been given medication for that, take this medication as recommended.
Medical treatment of a heart attack or heart attack-like symptoms will begin before a definite diagnosis is determined. General treatment includes oxygen therapy through a tube in the nose or a face mask. Also medications will be given such as pain medication, aspirin, antiplatelet drug, clot-dissolving medication, or any combination of these. The goal of the medication is to break up clots, prevent further clots from forming, prevent platelets from gathering and sticking to the plaque, and to stabilize the plaque.
An IV of nitroglycerin may also be given to improve the blood flow to the heart. This medication relaxes the coronary arteries.
Other drugs may be given after a heart attack to less the work your heart has to do to keep blood flowing, to improve the function of the heart, to widen blood vessels, to thin the blood and decrease the chance of clotting, to decrease pain, and to decrease the chance of irregular heartbeats. Medication may be given to prevent another heart attack. This kind is especially useful for people with diabetes and those with a weakened heart muscle after the initial heart attack. All of these medications will be prescribed your doctor.
The sooner the medication is given, the great the chance that they will help. If more than twelve hours have passed since symptoms have begun, the drugs will be less helpful. It is best if the drugs are given within thirty minutes to work to their maximum potential.
Once at the hospital, other emergency medical treatments will take place.
Angioplasty is the most direct method of removed blockage in a coronary artery. A long, thin tube called a catheter is inserted in an artery in the groin or the arm. The catheter is threaded through the arteries to the coronary artery where the blockage is located. Once the catheter is in position, a tiny balloon that has been placed at the end of the catheter is inflated, which pushes aside the plaque or blood clot that is the blocking the artery. Blood is then allowed to flow more freely.
Another type of treatment is stenting. This is when a small metal device called a stent is inserted into the coronary artery, usually after angioplasty. The stent is inserted where the balloon was to hold the artery open. This is a more effective way to keep the artery from narrowing than angioplasty alone.
Atherectomy is when the plaque on the artery walls is too hardened or rigid to be opened by the angioplasty balloon. Instead, the plaque is removed by being cut out with a laser or small rotary blade.
Surgery may be necessary in some cases. Standard coronary artery bypass grafting is performed if too many of the arteries are blocked or narrowed. This is also known as open heart surgery, meaning that the chest wall is opened. During this surgery, a bypass pump is connected to the heart to do the work of the heart while surgeons work on it. It is a very safe surgery and has a low rate of complications.
Off-pump bypass surgery is when open heart surgery can be performed without the use of the bypass pump because the heart continues to beat on its own throughout the surgery. This type of surgery has even fewer complications but it is not always possible.
Minimally invasive coronary bypass surgery is when just the front or right artery needs bypass. The surgery is performed by through just a small incision made on the chest, not a large one as in standard bypass surgery.