The next step is percutaneous transluminal coronary angioplasty (PTCA). In PTCA, a different catheter that has a small deflated balloon is threaded past the blockage, and the balloon is inflated to crush the clot and plaque. Most balloon catheters also have a wire mesh, called a stent, over the balloon. After the balloon is inflated to unclog the blocked artery, the stent remains in place to keep the artery open. Newer drugs called IIb/IIIa receptor inhibitors reduce clotting even more powerfully than aspirin. These drugs have been shown to be beneficial in patients who are about to undergo PTCA or stent placement. They include abciximab (ReoPro) and tirofiban (Aggrastat).

Reperfusion therapy can also be done with clot-dissolving drugs called thrombolytic agents. These include tissue plasminogen activator (tPA), streptokinase (Streptase), and anisoylated plasminogen streptokinase activator complex (APSAC). These drugs are often used if it would take too long to transfer a patient to a hospital where an angioplasty could be performed.

Much of the additional treatment for heart attack depends on whether the patient developed any complications. For example, additional drugs may be needed to treat dangerous cardiac arrhythmias (abnormal heartbeats), low blood pressure, and congestive heart failure.