Heart Information

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You are in: Home > Heart Information > Living With Heart Conditions > Heart Attack > Assessment And Treatment > Treatment

Treatment

• Emergency treatment
• The first few days
• Discharge home

Emergency treatment

There are two immediate aims to the initial treatment for a heart attack:

• To restore blood flow and minimise the amount of heart muscle damage
• To relieve pain and shock

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Treatment to restore blood flow and minimise the amount of heart muscle damage

Early treatment can help to minimise the amount, and extent, of damage to the heart muscle. This usually involves:

• Antiplatelet therapy: an initial dose of aspirin either in the ambulance or as soon as you get to hospital. This is to start the process of getting rid of the clot that is blocking a coronary artery as quickly as possible.

  You may receive other anti platelet drugs depending on the results of your initial tests.

• Reperfusion therapy: reperfusion means restoring the blood flow to an organ or tissue. After a heart attack, an immediate goal is to quickly open blocked arteries and reperfuse the heart muscles. Emergency reperfusion treatment will be given if you have had the type of heart attack known as a STEMI.

  Early reperfusion minimises the extent of heart muscle damage and preserves the pumping function of the heart. This can be achieved by either percutaneous coronary intervention (PCI) or thrombolysis.

• Anticoagulant therapy
• Beta blockers

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Treatment to relieve pain and shock

This can include:

• Injections of strong pain relieving drugs such as morphine. This also helps to relax your breathing and ease anxiety.
• Oxygen therapy: to help with your breathing.
• Drugs to stop sickness (anti-emetics).

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The first few days

The severity of a heart attack and the recovery from it depends on the extent of the damage to the heart muscle. It is very important during the first 24 – 48 hours to be carefully observed and to have complete rest, especially after a STEMI.

This period is often spent in a Coronary Care Unit (CCU), a specialised intensive care unit for heart patients, or in an acute medical ward where the heart function can be monitored closely. This is to help prevent any further damage to the heart and if possible to reverse the damage that has already occurred.

Your blood sugar level will also be closely monitored as, after a heart attack, some people need treatment to reduce a high blood sugar level.

Depending on the extent of the damage, the heart may not be able to pump efficiently or there may be damage to the control of the electrical activity of the heart. Usually these problems settle quite quickly and go back to working normally.

It is normal to tire easily, so initially any visiting should only be by immediate family and be brief. Meals are intentionally light as your digestive system increases demand on the heart after a heavy meal. Eating smaller meals reduces the work of the heart. Small amounts more often should meet all your needs.

For most people, after a couple of days, the heart settles down and the risk of another heart attack lessens and intensive monitoring can be discontinued. From the CCU you will be transferred to a ward, where you will have time to recover from the shock of having a heart attack, get some rest and take stock of what has happened to you. Here you will gradually increase what you do for yourself and have any other tests the doctor might feel necessary.

Any underlying problems such as high blood pressure, high blood sugar levels / diabetes or high cholesterol can also be assessed and treatment started if necessary. It also gives the team a chance to identify any life style risk factors that apply to you and provide you with information about what you can do about them.

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Discharge home

How long you stay in hospital for will depend upon your individual circumstances as well as what treatment you receive.

You may find that you don't really remember a lot of what the doctors and nurses told you, especially during the first few days. Don't be afraid to ask questions of staff and talk to your family about what has been happening.

If you live alone you might want to arrange to stay with friends or family for a few days as you may still feel a bit shaky and weak. This is partly because you have been inactive for a while and partly from the shock.

You may also have a heart scan before discharge.

You may have one or all of the following tests before discharge:

• Angiogram
• Exercise tolerance test (exercise ECG)
• Heart scan ('echo')

It is likely that you will be prescribed some drugs for your heart to help minimise the risk of another heart attack. The most common drugs to take after a heart attack are:

• Aspirin
• Beta blokers
• ACE inhibitors
• Statins

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