The primary treatment for heart attack is to open the blocked artery as soon as possible. Today, this is predominantly accomplished by coronary angioplasty and/or stenting. Cardiac bypass surgery can be an option in case angioplasty and/or stenting is unsuccessful. In facilities that do not have the ability to perform angrioplasty or stenting in a timely manner, clot dissolving medications called thromblytics may be used.
Prescription drugs are used routinely in concert with invasive procedures. These medicines can relieve heart pain, reduce muscle injury, and increase the change of survival. Medications used to treat or prevent heart attack include:
- ACE inhibitors to decrease blood pressure and ease the heart’s workload
- Aspirin to thin blood and reduce the risk of blood clots
- Beta-blockers to lower blood pressure and slow the heart down, decreasing its need for oxygen
- Calcium channel blockers to blood pressure and relax arteries to increase blood flow
- Nitroglycerin to relieve chest pain and improve the flow of blood to the heart
- Heparin to thin the blood in order to prevent further blood clot formation
- Morphine and other pain medication
- Oxygen therapy to help keep heart muscle as oxygenated as possible
- Fibrinolytic therapy to intravenously deliver medication to the heart than can dissolve a blood clot
- Antithrombin/antiplatelet therapy to keep blood from clotting further
- Statins and other medications used to lower blood fat and cholesterol levels
- Coronary angioplasty involves inserting a catheter in the groin artery and threading it to the affected area of the coronary artery. A balloon is inserted through the catheter, then inflated to reopen the artery.
- Coronary artery stent, a small piece of expandable mesh coil, is inserted in an arterial wall to reinforce it and keep it from narrowing again following a coronary angioplasty.
- Atherectomy uses specially designed equipment inserted through the catheter to shave or scrape plaque off the artery wall
- Laser angioplasty uses a laser to dissolve an arterial blockage.
Coronary artery bypass surgery uses pieces of blood vessel harvested from other parts of the body (usually the leg, wrist, or chest) to create a “detour” around the blocked portion of the artery. The harvested blood vessel is grafted to the affected artery on either side of the blockage. Blood is then able to bypass the blockage through this graft.