Heart attacks are extremely serious medical emergencies that require urgent care in order to maximize the potential for a good prognosis. These attacks occur where the supply of blood to the heart is blocked, usually by a blood clot stemming from narrowed arteries. Patients who experience a heart attack are typically offered one of three available treatments, and it is the purpose of this article to outline these treatments so you know what to expect.
Overview of Available Treatments
The treatment options available for you if you suffer a heart attack depend on the type of attack you experienced. The most serious form of heart attack, which requires immediate medical attention, is an ST segment elevation myocardial infarcation (or STEMI for short). With STEMIs, it is important that you seek treatment quickly in order to minimize the damage dealt to your heart.
Although STEMI heart attacks are the most severe, it is difficult for you to gauge the type of attack experienced and so it's vitally important that you seek immediate attention following any form of attack. When you visit an emergency center, experienced Doctors will carry out an electrocardiogram (ECG). If the results of this test indicate a STEMI, you will be clinically assessed for treatment to unblock your coronary arteries.
The specific course of treatment administered will depend on when your symptoms started:
- Within the past 12 hours: You will be offered primary percutaneous coronary intervention (PCI).
- Within the past 12 hours with no immediate access to PTI: You will be offered medication that will break down the clots.
- More than 12 hours ago: You will be offered a different procedure if your symptoms have improved. The specific treatment administered depends on an angiogram and may include a mixture of medication, bypass surgery or PCI.
Primary Percutaneous Coronary Intervention (PCI)
PCI is typically administered as the emergency treatment for STEMI heart attacks and uses invasive surgery to widen to coronary artery under a process known as coronary angioplasty. Before and after the process you will usually be given blood-thinning medication such as aspirin or ticagrelor in order to regulate your blood flow and aid your heart to function without additional pressure.
Coronary angioplasty is a very complex type of surgery, requiring specialist surgeons and equipment to facilitate the process. However, not all hospitals throughout the country are fully equipped for this purpose and as such, you may have to be moved by ambulance to a treatment center with the correct equipment in place.
During the operation, a catheter will be placed into your arm with a balloon attached on to the device. Once inside, the catheter will be navigated towards your coronary artery where the balloon will be used to widen the narrowed part of the artery. This aims to regulate blood flow and allow the free circulation of blood within your system.
The specific medication administered will be used to break down blood clots, and are typically given by injection. The two main types of medication used are known as thrombolytics or fibrinolytics, which destroy a substance called fibrin. This tough protein is the building block of blood clots, acting like a hard fiber mesh that lines the arteries.
If your Doctor believes you are at risk of suffering a future heart attack, you may be offered additional medication known as glycoprotein inhibitors. These inhibitors don't break up blood clots, but they do prevent the clots from growing uncontrollably.
Coronary Artery Bypass Graft
An angioplasty may not be possible if your arteries are damaged significantly, or the anatomy of your arteries differ from normal. This might be the case where your arteries consist of various narrow sections, or if there are many branches coming off your arteries that are blocked.
Under these circumstances, your doctor may offer a coronary artery bypass graft (CABG) (more info). The CABG is similar to other types of graft in that your Doctor will take a blood vessel from another part of your body and use it as a graft in the damaged area. This graft allows blood to bypass any hardened arteries in the heart, regulating blood flow and allowing the free circulation of blood.