Heart Attack Treatment Options - OmniMedicalSearch.com (Myocardial Infarction)

Conditions & Diseases: Cardiovascular System

Heart Attack (Myocardial Infarction)

Heart Attack Treatment

Once a heart attack diagnosis is established, the treatment procedure starts immediately. The primary goal of treatment is to restore the normal blood flow to the damaged portion of the heart muscle and preserve the ability to function normal for the rest of the myocardium. In some patients, a heart attack can cause arrhythmias (irregular heart rhythms), ventricular fibrillation (uncoordinated contraction of heart muscle in which the heart quivers uselessly), or sudden cardiac arrest which can lead to brain damage or death.

According to the severity of the heart attack and extent of heart tissue damage, the treatment procedure also involves medication and/or invasive medical procedures.

I. Medication. The medication prescribed after a heart attack is effective in breaking up blot clots, preventing new blood clots from forming, stabilizing the plaque, and preventing the death of new myocardial cells.

Anticoagulants. Anticoagulants decrease the blood's ability to coagulate preventing new blood clots from forming or preventing blot clots from becoming too large in size (which can lead to complications). The most common anticoagulants prescribed are: Fragmin (Dalteparin), Orgaran (Danaparoid), Lovenox (Enoxaparin), Innohep (Tinzaparin), or Coumadin (Warfarin).

Antiplatelet agents. Antiplatelet agents prevent new blood clots from forming and helps maintain the blood flow through a narrow artery. Some of the antiplatelet agents prescribed include: Aspirin, Ticlopidine, Clopidogel, or Dipyridamole. Aspirin is the most prescribed antiplatelet agent in patients with heart attack. If the aspirin is taken during the heart attack and continues to be administrated days after, it decreases the risk of dying by up to 25 percent.

Thrombolytics. Thrombolytics, also called clot-busters, dissolve the blood clot that is obstructing a narrow artery. When the thrombolytic drug is administrated early (within the first hours following a heart attack), the patient's survival chance increases and the extent of damaged myocardial tissue decreases. This type of drug is not prescribed in all cases of heart attack due to its risk of excessive bleeding (which increases the risk of stroke). Its used is based on the electrocardiogram results. Thrombolytics prescribed to patients that suffered a heart attack include: Activase (alteplase-tissue-type plasminogen activator), Eminase (Anistreplase), Retavase (Reteplase), or Streptase (Streptokinase).

Beta blockers. Beta blockers limit the heart workload by decreasing the heart rate, relaxing the heart muscle, decreasing the blood pressure, reducing the heart beat, and decreasing the overall myocardial demand for oxygen. Administrated during and after a heart attack, beta blockers significantly decrease the risk of recurrent heart attacks and death. Some of the beta blockers prescribed include: Sectral (Acebutolol), Tenormin (Atenolol), Kerlone (Betaxolol), Zebeta (Bisoprolol), or Cartrol (Carteolol).

Vasodilators. Vasodilators relax the blood vessels allowing an increased oxygen-rich blood to flow within them and reduce the heart workload. It is also used to treat chest pain. The most common vasodilators prescribed are: Nitroglycerin, Isordil (Isosorbide dinitrate), Natrecor (Nesiritide), Nitrates, or Minoxidil.

IIb/IIIa Inhibitors. IIb/IIIa inhibitors is a group of drugs that prevent platelets from sticking together and forming blood clots, and can dissolve existing blood clots. The most common drugs prescribed include: Integrelin (Eptifibatide), Aggrastat (Tirofinban), or ReoPro (Abciximab)

Angiotensin converting enzyme inhibitors. Angiotensin converting enzyme inhibitors help the heart to heal and improve the heart functioning. This group of drugs is recommended within the first 24 hours after the onset of heart attack symptoms and should be taken between 4 to 6 weeks. Although most patients tolerate this medication well, a small number of patients experience side effects such as: chronic nonproductive cough, sudden swelling of the lips, face, and cheeks. Some of the angiotensin converting enxyme inhibitors prescribed include: Lotensin (Benazepril), Capoten (Captopril), Vasotec (Enalapril), or Monopril (Fosinopril).

II. Invasive cardiac procedures.

Coronary angioplasty. Coronary angioplasty, also known as percutaneous transluminal coronary angioplasty, balloon angioplasty, or coronary artery balloon dilatation is a catheter-based procedure used to increase the blood flow through an obstruct artery. The procedure is performed under sedation or local anesthesia, and requests the use of a dye agent (iodine-based dye) which makes the arteries and the blockage visible on a special monitor. During this procedure, a special catheter with a balloon tip is inserted through the femoral artery (in the leg) or brachial artery (in the arm) into the blocked coronary artery. Once placed into the obstruction site, the balloon is inflated - causing the artery to open. In certain cases, the doctor may insert a metal mesh stent (to stretch open the artery) coated with medication to assure a normal blood flow to the heart muscle for a longer period of time. Mostly safe, coronary angioplasty can cause several complications, such as (1) allergic reactions to the dye agent (hives, rash, swelling, anaphylactic shock), (2) arrhythmia, (3) bleeding or infection to the insertion site, (4) kidney failure, (5) the artery ruptures, or (6) stroke.

Laser angioplasty. Laser angioplasty is another medical procedure used to open those coronary arteries blocked by plaque. This procedure uses a special catheter equipped with a laser tip which once positioned in the obstruction site, emits beams of lights which cause the plaque to evaporate.

Coronary artery bypass surgery. Coronary artery bypass surgery is a medical procedure used in some cases of heart attack to restore the blood flow to the affected portion of heart muscle. During this procedure, the arteries are sewed together above the obstruction site or narrowed portion of the artery to restore the blood flow.

Minimally invasive heart surgery. Minimally invasive heart surgery, also known as limited access coronary artery surgery, is an alternative to the standard bypass surgery. This procedure is used when only one or two arteries need to be bypassed, and is performed through several small incisions (ports) in the chest and a small incision made directly over the coronary artery that needs to be bypassed. During the procedure, one of the healthy arteries from inside the chest wall is detached and re-attached to the obstruct artery.

Article by Alina Morrow, MS
Medical Writer
OmniMedicalSearch.com