Heart Attack, Part Two: A Patient Guide


The Heart Attack Patient Guide describes what you are likely to experience when having a heart attack, as well as your recovery and treatment. This guide describes the various stages of recovery, from the first few days in the cardiac care unit to months and years later. Details about bypass and angioplasty recovery, discharge from the hospital, cardiac rehabilitation, exercise, long-term recovery, medication, depression, and lifestyle modifications are included. Part One of the guide reviews basics of heart function, heart attack symptoms, emergency care, medications, tests, and treatments performed in the hospital.

I. Recovery

The cardiac care unit (CCU) or medical intensive care unit (MICU)

If you have had or are suspected of having a heart attack, you will usually be taken from the emergency room (ER) to the cardiac care unit (CCU) or medical intensive care unit (MICU). Within the first day of your CCU stay, you may not receive anything to eat by mouth (i.e., made fasting) or be placed on a clear liquid diet. The reason for these dietary restrictions is to reduce the risk of vomiting after the heart attack and to empty the upper gastrointestinal tract prior to the performance of any urgent invasive cardiac procedures (i.e., cardiac catheterization). Once it is deemed safe for you to resume eating solid food, you will be prescribed a diet that is low in saturated fats, cholesterol, and sodium (and processed sugars, if diabetes is present). Diets might consist of fish or lean chicken (protein), fruits and vegetables (fiber and carbohydrates, antioxidants), and breads and light pastas (carbohydrates). Bananas, orange juice, and grapefruit juice might be used because they serve as plentiful sources of potassium and magnesium and are low in sodium.

Anxiety is common during the first 24 to 48 hours and may be treated with benzodiazepines (e.g., lorazepam or oxazepam), low-dose narcotics (e.g., morphine), or haloperidol. While these medications overall are very safe, each has its own set of side effects or adverse reactions that could occasionally dissuade its use in individual patients. You may become temporarily confused and disoriented to time (termed delirium, or ICU psychosis) in the CCU because you are receiving multiple new medications, severely sleep-deprived, or unaccustomed to your new surrounding. Patients with multiple complex medical problems and the elderly are at greatest risk for this condition. Fortunately, ICU psychosis is usually tempered with medications (e.g. haloperidol), discontinuation of problematic medications, or discharge from the CCU to a quieter floor. You may also be given sleeping pills to maintain as normal a day-night schedule as possible. Stool softeners are used to prevent constipation and straining.

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