Heart Attack and Unstable Angina

Do not wait if you think you are having a heart attack. Getting help fast can save your life.

Emergency treatment gets blood flowing back to the heart. This treatment is similar for Reference unstable angina Opens New Window and heart attack.

• For unstable angina, treatment prevents a heart attack.
• For a heart attack, treatment limits the damage to your heart.

Ambulance and emergency room

Treatment begins in the ambulance and emergency room. The goal of your health care team will be to prevent permanent heart muscle damage by restoring blood flow to your heart as quickly as possible. Treatment includes:

• Oxygen and pain relief. Reference Oxygen therapy Opens New Window and Reference morphine are typically given.
• Reference Nitroglycerin. It opens up the arteries of the heart to help blood flow back to the heart.
• Reference Beta-blockers. These drugs lower the heart rate, blood pressure, and the workload of the heart.

You also will receive medicines to stop blood clots. These are given to prevent blood clots from getting bigger so blood can flow to the heart. Some medicines will break up blood clots to increase blood flow. You might be given:

• Reference Aspirin, which you chew as soon as possible after calling 911 .
• Reference Antiplatelet medicine, such as clopidogrel.
• Reference Anticoagulants, such as heparin.
• Reference Glycoprotein IIb/IIIa inhibitors to help prevent blood clots from forming.
• Reference Thrombolytics to break up or dissolve blood clots.

Angioplasty or surgery

Reference Angioplasty. Doctors try to do angioplasty as soon as possible after a heart attack. Angioplasty might be done for unstable angina, especially if there is a high risk of a heart attack.

Angioplasty gets blood flowing to the heart. It opens a coronary artery that was narrowed or blocked during the heart attack.

But angioplasty is not available in all hospitals. Sometimes an ambulance will take a person to a hospital that provides angioplasty, even if that hospital is farther away. If a person is at a hospital that does not do angioplasty, he or she might be moved to another hospital where angioplasty is available.

If you are treated at a hospital that has proper equipment and staff, you may be taken to the Reference cardiac catheterization lab Opens New Window Reference Opens New Window. You will have Reference cardiac catheterization, also called a coronary angiogram. Your doctor will check your coronary arteries to see if angioplasty is right for you.

Reference Bypass surgery. If angioplasty is not right for you, emergency coronary artery bypass surgery may be done. For example, bypass surgery might be a better option because of the location of the blockage or because of numerous blockages.

Other treatment in the hospital

After a heart attack, you will stay in the hospital for at least a few days. Your doctors and nurses will watch you closely. They will check your heart rate and rhythm, blood pressure, and medicines to make sure you don't have serious complications.

Your doctors will start you on medicines that lower your risk of having another heart attack or having complications and that help you live longer after your heart attack. You may have already been taking some of these medicines. They include:

• Reference Angiotensin-converting enzyme (ACE) inhibitors.
• Reference Aspirin.
• Reference Antiplatelet medicines.
• Reference Beta-blockers.
• Reference Statins.

You will take these medicines for a long time, maybe the rest of your life.

After you go home from the hospital, take all of your medicines correctly. Do not stop taking your medicine unless your doctor tells you to. If you stop taking your medicine, you might raise your risk of having another heart attack.

Cardiac rehabilitation

Reference Cardiac rehabilitation might be started in the hospital or soon after you go home. It's an important part of your recovery after a heart attack. Cardiac rehab teaches you how to be more active and make lifestyle changes that can lead to a stronger heart and better health. Cardiac rehab can help you feel better and reduce your risk of future heart problems.

If you don't do a cardiac rehab program, you will still need to learn about lifestyle changes that can lower your risk of another heart attack. These changes include quitting smoking, eating heart-healthy foods, and being active.

Reference Quitting smoking is part of cardiac rehab. Medicines and counseling can help you quit for good. People who continue to smoke after a heart attack are much more likely than nonsmokers to have another heart attack. When a person quits, the risk of another heart attack decreases a lot in the first year after stopping smoking.

Go to your doctor visits

Your doctor will want to closely watch your health after a heart attack. Be sure to keep all your appointments. Tell your doctor about any changes in your condition, such as changes in chest pain, weight gain or loss, shortness of breath with or without exercise, and feelings of depression.

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