Emergency medical treatment is vital – getting to hospital quickly and receiving specialist care greatly improves your chance of survival. If you have some aspirin (acetylsalicylic acid), chew a single tablet, unless you know that you are allergic to it. Aspirin reduces blood clots and can help to prevent the clot that is blocking the artery from spreading.
If you are being transported to hospital in an ambulance, sit and rest in a position that is most comfortable until the paramedic (emergency medical technician) arrives. He or she may give you initial treatment and provide transport to a hospital quickly and safely for further treatment. You may also be given oxygen and medicines for pain relief.
During or after a heart attack, you may have an irregular heart beat, known as arrhythmia. The most serious form of this is called ventricular fibrillation. This is when the electrical activity of the heart becomes chaotic and the heart stops pumping, and quivers or ‘fibrillates’ instead. This is known as a cardiac arrest and the paramedic may need to use a defibrillator, which gives a large electric shock through the wall of your chest and can restore a regular heartbeat.
Your treatment will depend on how severe your heart attack was. Once you arrive at hospital, a doctor will decide on the best treatment for you.
There are two commonly used ways to restore blood flow in a blocked artery.
- Thrombolysis. This is an injection to break down the clot in your coronary artery. Your chance of making a full recovery from your heart attack is much better if the clot is dissolved. However, thrombolytic medicines can increase your risk of bleeding and having a stroke so you may not be given these if you are at an increased risk of this, for example if you have recently had surgery.
- A coronary angioplasty. This can be done as an emergency procedure (also known as a primary angioplasty) or as a planned procedure. A coronary angioplasty aims to widen your artery by inflating a balloon in your narrowed or blocked coronary artery. A wire mesh tube called a stent is usually inserted to hold the coronary artery open.
Sometimes a coronary angioplasty isn’t possible, for example if the blockages in your arteries are too long for a stent or they are difficult to get to, and you may be offered a coronary artery bypass graft (CABG) instead. CABG is an operation to bypass a narrowed section of your coronary artery using a blood vessel from your chest, leg or arm. This diverts the flow of blood around the narrowed or blocked coronary artery.
After treatment of a heart attack
After a heart attack, you may need to take medicines regularly for a long time. Medicines you may be prescribed include aspirin, antiplatelets (eg clopidogrel or prasugrel), statins (eg simvastatin), angiotensin-converting enzyme (ACE) inhibitors (eg ramipril), and beta-blockers (eg propranolol). A fish oil capsule may also be given.
Always ask your doctor for advice and read the patient information leaflet that comes with your medicine.
Your risk of further heart attacks can be reduced by taking these medicines. Always read the patient information leaflet that comes with your medicine.
You may be offered a cardiac rehabilitation programme to help you recover from your heart attack. These usually include an exercise regime devised by a physiotherapist (physical therapist – a health professional who specialises in maintaining and improving movement and mobility), along with advice on relaxation, lifestyle and treatment choices.
Availability and use of different treatments may vary from country to country. Ask your doctor for advice on your treatment options.