What happens in the first few days after a heart attack
The severity of a heart attack and the recovery from it depends on the extent of the damage to your heart muscle. This is indicated by your ECG and troponin test results.
- It is important during the first 24 - 48 hours to be carefully observed and to have enough 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, your 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 your heart. Small amounts more often should meet all your needs.
For most people, after a couple of days, your heart will settle down, 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.
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 it is advisable 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 may have been inactive for a while and partly because of the shock.
You may have one or all of the following tests before discharge:
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:
- Beta blockers
- ACE inhibitors