Heart attack

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Overview Symptoms Treatment Prevention

Heart attack

A heart attack is a medical emergency! Hospitalization is required and possibly intensive care. Continuous ECG monitoring is started immediately, because life-threatening arrhythmias (irregular heart beats) are the leading cause of death in the first few hours of a heart attack.

The goals of treatment are to stop the progression of the heart attack, to reduce the demands on the heart so that it can heal, and to prevent complications.

Medications and fluids will be inserted directly into a vein using an intravenous (IV) line. Various monitoring devices may be necessary. A urinary catheter may be inserted to closely monitor fluid status.

Oxygen is usually given, even if blood oxygen levels are normal. This makes oxygen readily available to the tissues of the body and reduces the workload of the heart.

PAIN CONTROL MEDICATIONS

Intravenous nitroglycerin or other medicines are given for pain and to reduce the oxygen requirements of the heart. Morphine and similar medicines are potent pain killers that may also be given for a heart attack.

BLOOD THINNING MEDICATIONS

If the ECG recorded during chest pain shows a change called "ST-segment elevation," thrombolytic therapy (blood-thinning drugs)may be started within12 hours of when chest pain began. This initial clot-dissolving therapy will be administered as an IV infusion of streptokinase or tissue plasminogen activator, and will be followed by an IV infusion of heparin.

Heparin therapy, designed to preventthe formation of new clots, will last for 48 to 72 hours. Additionally, warfarin, taken orally, may be prescribed to prevent further development of clots.

Thrombolytic therapy is not appropriate for people who have had:

• Bleeding inside their head known as an intracranial hemorrhage
• Brain abnormalities such as tumors orblood vesselmalformations
• Stroke within the past 3 months (or possibly longer)
• Head injury withinthe past 3 months

Additionally, thrombolytic therapy is extremely dangerous in those who have had:

• Severe high blood pressure
• A major surgery or major trauma within the past 3 weeks
• Internal bleeding within the past 2-4 weeks
• Peptic ulcer disease

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