Treatment during a heart attack.
The key to a succesful outcome is rapid treatment to restore the blood supply and thus minimise the damage to the heart muscle. This is why it is really important to phone 999 if you suspect that you or someone you know is having a heart attack.
Cardio-Pulmonary Resuscitation (CPR)
CPR should be started if the person is not breathing, moving, coughing or responding to being touched and spoken to.
CPR consists of giving 30 chest compressions to massage the heart for every two mouth-to-mouth resuscitation breaths. The Mayo Clinic recommends a rate of 100 compressions per minute.If the heart attack has caused the heart to stop beating then the medical team with try to restart it using a defibrillator. This device provides an electric shock across the chest in an attempt to re-start the heart.
Aspirin
A 300mg dose of aspirin is given. This helps to prevent the blood clot in the coronary artery from getting any bigger. It is usually chewed or given in dispersed form to help get it into the bloodstream quickly.
Thrombolytics
Thrombolytics are otherwise known as "clot-busters". Ideally, these should be given within one hour of the symptoms starting- their function is to dissolve the clot in the coronary artery thereby restoring blood flow to the affected heart muscle. Thrombolytics are given by injection.
Morphine is sometimes given to help relieve the pain and to help reduce anxiety.
Treatment following a heart attack.
Anti-platelets
Antiplatelets (aspirin and clopidogrel) prevent platelets forming and thus help to reduce the risk of clotting in the coronary arteries. Doctors prefer to use low dose aspirin following a heart attack. A dose of 75mg or 150 mg is given daily for the first month. The dose is 75mg per day after the first month. Clopidogrel is used for those people who are unable to take aspirin.
Beta-blockers
Beta-blockers are beneficial as they slow down the rate at which the heart beats and make it beat with less force. They also stabilise the heart's electrical activity.
ACE Inhibitors.
These open up the blood vessels and lower blood pressure. They also seem to have a direct protective effect on the heart. People who are about to commence ACE inhibitors must undergo a blood test to check the state of their kidneys. This is because this medication can affect the kidneys of a small number of people who take them. Once people are taking the ACE inhibitors, kidney function is checked at least once per year.
Statins.
Statins reduce the amount of blood cholesterol in the liver and thus reduce the risk of a further build up of fatty matter in the coronary arteries.
Surgery
Angioplasty.
This is done to open up a coronary artery. A vey thin wire with a small balloon at the end is inserted into either the arm or groin. It is then passed via the blood vessels to the heart and then into the narrowed artery. The balloon is then inflated to open the artery wide again. A flexible metal mesh (stent) is usually inserted into the artery to help keep it open.
Coronary Artery Bypass Graft.
This is surgery to bypass an artery blockage by grafting in healthy blood vessel segments which are taken from other parts of the body.
Segments of vein from the legs or chest are used to create a new channel through which the blood can be directed past the blocked part of the artery.
