Treatment for someone diagnosed with a heart attack can be complicated. We hope this section on heart attack treatment helps you discuss your treatment plan with your health care team.
If you have any questions or concerns, be sure to voice them.
Common heart attack types and treatments
The type of heart attack (also called myocardial infarction or MI) that occurred determines the treatment your medical team recommends. A heart attack occurs when a blockage in one or more cardiac (coronary) arteries reduces or stops blood flow to the heart, leaving parts of the heart muscle starved of oxygen.
The blockage may be complete or partial.
- A complete blockage of a coronary artery means you have had a “STEMI” heart attack or ST-elevation MI.
- Partial occlusion is an “NSTEMI” heart attack or non-ST elevation MI.
Treatments for STEMI and NSTEMI heart attacks are different, but there is some overlap.
Hospitals use techniques to restore blood flow to parts of the heart muscle that are damaged during a heart attack.
- You may receive thrombolytic drugs (thrombolytic therapy), balloon angioplasty, surgery, or a combination of these treatments.
- But not all hospitals in the United States are equipped to use a procedure called percutaneous coronary intervention (PCI), which is a mechanical means of treating heart attacks.
In hospitals that can perform PCI, you will likely be sent to an area that specializes in cardiac catheterization, also known as a “cath lab.” There, a diagnostic angiogram can test the blood flow to the heart and reveal how well the heart is beating. Depending on the results of that procedure, he may be transferred to one of three treatments: drug therapy alone, PCI, or coronary artery bypass grafting (CABG).
If a hospital does not have the equipment to perform PCI, you may be transferred to a hospital that has the equipment to perform PCI. Alternatively, your medical team may decide to give you drugs to break up the blood clot and restore blood flow. You may also have an angiogram, an imaging technique used to see inside the arteries, veins, and heart chambers. Surgery may then be performed to restore blood circulation within the heart.
If your medical team determines that you have had an NSTEMI heart attack, they usually use one of two treatment strategies. In either case, a procedure called cardiac catheterization may be needed to examine the inside of the heart.
- Ischemia-inducing strategies use anticoagulants to prevent blood clot formation.
- Initial invasive strategies begin with the use of blood thinners to prevent blood clot formation, followed by PCI with drug therapy, stenting or coronary artery bypass grafting (CABG), followed by certain types of post-discharge care. You may also proceed to
Your medical team will explain treatments for your heart attack. They can answer any specific questions you may have.
Common medical procedures after a heart attack
Many common medical treatments for heart attacks are listed here. For a detailed description of these treatments, please see our page dedicated to cardiac surgery.
- Angioplasty: A special tube with a deflated balloon is passed into the coronary artery. The balloon is inflated to widen the blocked area where blood flow to the heart muscle is reduced or blocked.
- Laser angioplasty: It is similar to angioplasty except that a laser is attached to the tip of the catheter to open the blocked artery.
- Heart valve surgery: Repair or replace abnormal or diseased heart valves with healthy heart valves.
- Atherectomy: It is similar to angioplasty, except the catheter has a special tool at the end to remove plaque from the artery.
- Bypass surgery: Treats blocked heart arteries by creating new channels around the blood clot, allowing blood to flow to the heart muscle.
- Minimally invasive cardiac surgery: An alternative to standard bypass surgery that uses small incisions.
- Stent steps: A stent is a wire mesh tube that is placed during angioplasty to keep an artery open and restore blood flow.
- Transmyocardial revascularization (TMR): A laser is used to drill a series of holes from the outside of the heart into the heart’s pumping chambers.
In addition to the treatments listed above, you may hear that implantable medical devices are used to treat certain conditions that increase your risk of heart attack.
Type of medicine
A variety of medications are required to treat heart attacks. The following list provides an overview of common types. You can also learn more about heart medications.
Your medical team will recommend the best combination of medicines for your situation.
- Anticoagulant: These drugs, also called blood thinners, make it harder for blood clots to form and prevent existing blood clots from growing larger.
- Antiplatelet agents: It prevents platelets from sticking together and prevents blood clots from forming.
- Angiotensin-converting enzyme (ACE) inhibitors: By lowering the levels of angiotensin II, it relaxes and dilates blood vessels while decreasing resistance. Blood flows more easily and the heart works easier or more efficiently.
- Angiotensin II receptor antagonists: These drugs block the effects of angiotensin II on the heart and blood vessels. This suppresses the rise in blood pressure.
- Angiotensin receptor neprilysin inhibitor: Neprilysin is an enzyme that breaks down a natural substance in the body that widens narrowed arteries. By inhibiting neprilysin, these natural substances can achieve their normal effects. This improves arterial opening and blood flow, reduces sodium (salt) retention, and reduces strain on the heart.
- Beta blocker: The heart beats slower and weaker, and blood pressure drops.
- Combined alpha and beta blockers: A combination of alpha and beta blockers may be used as an intravenous infusion for people at risk of high blood pressure. It may be prescribed for outpatient hypertension treatment if you are at risk for heart failure.
- Calcium channel blockers: It prevents the movement of calcium into the cells of the heart and blood vessels. It can reduce the heart’s pumping power and relax blood vessels.
- Drugs that lower cholesterol: Although various drugs can lower blood cholesterol levels, statins are the best initial treatment. If statins do not work, or if statin therapy causes serious side effects, other drugs may be recommended.
- Vasodilator: It relaxes the blood vessels, increasing the supply of blood and oxygen to the heart while reducing the load on the heart. It is available as a pill to swallow, a chewable tablet, and a topical application (cream).
Dual antiplatelet therapy (DAPT)
Some people who have had a heart attack, have a stent placed in their coronary artery, or undergo coronary artery bypass grafting (CABG) may take two antiplatelet drugs at the same time to prevent blood clots. Some people receive treatment. This is called dual antiplatelet therapy (DAPT).
One antiplatelet drug is aspirin. Many people with coronary artery disease, including those who have had a heart attack, stent, or CABG, are treated with aspirin for the rest of their lives. A second type of antiplatelet drug called P2Y12 In addition to aspirin therapy, inhibitors are usually prescribed for several months or years.
The type of medication and length of treatment depend on your condition and other risk factors. The risks and benefits of DAPT should be discussed with your health care professional.
If you have had a heart attack and have a coronary stent placed or are receiving medication (no stents, clot removers, or surgery)you should talk to your health care professional about taking P2Y in addition to aspirin.12 Take inhibitors for 6-12 months. In some cases, using DAPT for a longer period of time may be recommended.
One of the following may be prescribed: clopidogrel, ticlopidine, prasugrel, ticagrelor, or cangrelor. The most appropriate medication will be prescribed based on the risk of blood clots and bleeding. The choice of drug type and duration of treatment is determined in discussion with your health care professional.
