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What happens when a heart attack is diagnosed?

As soon as a medical professional determines a patient is having a heart attack, the patient is placed on a cardiac monitor. This is to determine the risk of cardiac arrhythmias which can occur during a heart attack. Ventricular fibrillation, for example, can cause death in a few minutes if untreated. Patients also are given oxygen and intravenous lines are started. Nitroglycerin can help relieve the chest pain associated with a heart attack. If nitroglycerin is unable to relieve the pain, morphine is given. An aspirin is given at this time as well.

It is crucial that thrombolytic medications be given quickly, as soon as a heart attack is diagnosed. Thrombolytic medication dissolves blood clots in the coronary artery that caused the heart attack. If this medication is delayed, cell death will be permanent. Even if the clot is dissolved and blood flow is restored the cell death will be permanent. There is a common saying in medicine: "time is muscle," which means the longer the heart muscle is without blood, the more heart muscle dies.

These medications do have complications. Bleeding is the most common and usually occurs at I.V. sites. If bleeding occurs in the brain, the patient can have a stroke and possibly die.

Another heart attack treatment is angioplasty. The obstruction is mechanically opened by a balloon during cardiac catheterization. Many cardiologists think this therapy has advantages over thrombolytics. To be most effective, an angioplasty must be performed within an hour of the heart attack in a medical center that does a high volume of these procedures. Less than 20 percent of U.S. hospitals have this capability.

Following a heart attack, a patient requires several days of rest in a hospital. A cardiac rehabilitation program will be part of recovery and will include an exercise program and education about heart disease, including the risk factors. A stress test is often performed. If repeated episodes of chest pain occur, the patient might need a cardiac catheterization to determine if angioplasty or a coronary artery bypass is necessary.

Post-heart attack patients are usually given medications such as aspirin, beta-blockers and ACE inhibitors.

When a heart attack is diagnosed the physician works as hard as he can to try to stop the heart attack. This is called aborting a heart attack in which the doctor tries to restart the blood flow down the blocked artery. "Clot busters" such as TPA or streptokinase can be given in the vein of the patient to try to dislodge the clot in the arteries and restart the blood flow. Given recent data in the trials in the past 20 years we have now found that if a hospital is equipped with a cath lab, it is best to take the patient to the cath lab and actually look at their arteries using angiography. That way we can find out where the blockage is, how severe it is, and if the artery is totally blocked, try to open it. This involves placing a catheter into the coronary artery orifice, passing a guidewire down and then an aspiration catheter to actually vacuum the clot out of the artery, followed by a balloon or stent implantation to open up the artery and keep it open with the stent. This allows blood flow to be restarted down the artery. There are other drugs that can be used to help keep the blood flow going down the artery and keep the artery opened once it has been opened in the cath lab. This has led to a marked improvement in the treatment of heart attacks and a reduction in the mortality and the complications associated with heart attacks or "myocardial infarctions."

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.