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Heart Attack Treatments AHA Recommendation When a heart attack occurs, you must recognize the signals and respond immediately. Time is critical. When an artery to the heart (coronary artery) is blocked, the heart muscle doesn't die instantly. But damage increases the longer the artery stays blocked. Delay may increase heart damage and reduce your chance of survival. It also lessens the chance of preserving heart muscle. This increases the risk of disability. Anyone who has heart attack warning signs should call 9-1-1 immediately. People who pass out before reaching the emergency room should receive cardiopulmonary resuscitation (kar"de-o-PUL'mo-nair-e re-sus"ah-TA'shun) (CPR). Background Most communities have an emergency cardiovascular care system that can respond quickly. This prompt care dramatically reduces heart damage. In fact, most heart attack survivors can return to their usual work or activities. Therapies to restore blood flow or reperfusion (rep"er-FU'zhun) should be initiated promptly by calling 9-1-1 and getting transportation via ambulance to an emergency room. Reperfusion therapies include the use of drugs to dissolve clots (thrombolysis), balloon angioplasty (PCI [formerly called PTCA]) or surgery. The sooner medical attention is obtained, the sooner blood flow can be restored to the heart muscle and decrease disability after a heart attack. Thrombolysis (throm"bo-LI'sis) involves injecting a clot-dissolving agent, such as streptokinase, urokinase or tPA (tissue plasminogen activator), to dissolve a clot in a coronary artery and restore blood flow. For best effect, these drugs must be used within a few (usually three) hours of a heart attack. Percutaneous coronary intervention (PCI) is another important treatment for heart attack. PCI is often the first treatment of choice for a type of heart attack known as ST-elevation myocardial infarction (STEMI), which occurs when one of the coronary arteries is completely blocked. The goal of both thrombolysis and PCI is to prevent the death of heart muscle cells by restoring coronary blood flow to the heart. Surgical revascularization, also called coronary artery bypass graft surgery (CABG), may be required to improve the blood supply to the heart muscle when several coronary arteries have significant blockages that hinder blood flow. Related AHA publications
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