Heart attack

This therapy is also very dangerous in women who are currently pregnant, and in people who use blood thinners such as Coumadin.

text continues below

Use of thrombolytic therapy can be complicated by significant bleeding.

A cornerstone of therapy for a heart attack is antiplatelet medication. Such medication can prevent the collection of platelets at a site of injury in a blood vessel wall -- like a crack in an atherosclerotic plaque. Platelets collecting and accumulating is the initial event that leads to clot formation. One antiplatelet agent widely used is aspirin. Two other important antiplatelet medications are ticlopidine (Ticlid) and clopidogrel (Plavix).

OTHER MEDICATIONS

Beta-blockers (like metoprolol, atenolol, and propranolol) are used to reduce the workload of the heart.
ACE Inhibitors (like ramipril, lisinopril, enalapril, or captopril) are used to prevent heart failure.

SURGERY AND OTHER PROCEDURES

Emergency coronary angioplasty may be required to open blocked coronary arteries. This procedure may be used instead of thrombolytic therapy, or in cases where thrombolytics should not be used. A device called a stent is often inserted into the artery during angioplasty, tohelp ensure that the newly opened coronary artery remains open after surgery. Emergency coronary artery bypass surgery (CABG) may be required in some cases.

Recent evidence supports the use of angioplasty and stenting as the first-line therapy to reopen a clogged heart artery if this procedure can be performed in a timely manner in an experienced center. If this procedure is not available, the use of thrombolytic therapy is warranted.

Support Groups:

For additional information and resources, see heart disease -- resources.

Expectations (prognosis):

The expected outcome varies with the amount and location of damaged tissue. The outcome is worse if there is damage to the electrical conduction system (the impulses that guide heart contraction).

Approximately one-third of cases are fatal. If the person is alive 2 hours after an attack, the probable outcome for survival is good, but may include complications.

Uncomplicated cases may recover fully; heart attacks are not necessarily disabling. Usually the person can gradually resume normal activity and lifestyle, including sexual activity.

Complications:

Arrhythmias such as ventricular tachycardia, ventricular fibrillation, heart blocks
Congestive heart failure
Cardiogenic shock
Infarct extension: extension of the amount of affected heart tissue
Pericarditis (inflammation around the lining of the heart)
Pulmonary embolism (blood clot in the lungs)
Complications of treatment (For example, thrombolytic agents increases the risk of bleeding.)

Calling your health care provider:

Call your local emergency number (such as 911) if crushing chest pain or other symptoms suggestive of heart attack occur.