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Early treatment to restore blood flow to the heart muscle can prevent or limit the amount of damage when a heart attack happens

Once diagnosis of a heart attack is confirmed, medical staff can start treatment to open up the artery and restore blood flow to the heart. There are several treatments that can help to restore blood flow to the heart: Thrombolysis, angioplasty and coronary artery bypass graft.

Read more about these treatments by clicking on the names below.

THROMBOLYSIS

Thrombolysis

Also called a ‘clot busting’ medication, these drugs work quickly by dissolving a major clot that is blocking the artery. The medication is injected into a vein (usually in your hand or arm) and administered slowly to dissolve the blood clot. This helps restore blood to flow to the heart and aids in reducing long term damage to the heart muscle. Bleeding is the most common risk of thrombolytic therapy. It can be life threatening. Further tests following thrombolysis are frequently performed in specialist cardiology (heart) units to identify the degree of blockage. This may be treated with angioplasty and stents and occassionally coronary artery bypass graft surgery (CABG).

ANGIOPLASTY

Angioplasty

A blocked artery can be opened by a procedure where a thin, flexible wire and balloon is threaded through a blood vessel, usually in the wrist or groin (upper thigh), to the narrowed or blocked coronary artery. Once in place, the balloon is inflated to compress the plaque against the wall of the artery. This restores blood flow through the artery. During the procedure, the doctor may put a small mesh tube called a stent in the artery. The stent helps prevent further blockages in the artery in the months or years after the procedure.

This procedure is not available in all hospitals in New Zealand and if you live in an area without cardiology services, you may be transferred to another hospital for these procedures.

The risks associated with coronary angioplasty are very small and include:

  • Bleeding at the insertion site;
  • Damage to blood vessels;
  • Allergic reaction to the Xray dye;
  • Heart attack/stroke.

It is important to note that in some types of heart attack people do not receive either of these two treatments because they will not benefit from them.

CORONARY ARTERY BYPASS GRAFT

Coronary artery bypass graft

A coronary artery bypass graft (CABG) may be performed after a heart attack. It is a major operation during which a blood vessel from another part of the body is grafted (inserted) to link the aorta (the main artery leading from the heart) and the coronary artery, or arteries.

The grafted artery or vein bypasses (that is, goes around) the blocked portion of the coronary artery. This provides a new route for blood to flow to the heart muscle. The procedure takes around three hours, but may take longer depending on how many grafts need to be done. If blood vessels from your leg or arm are being used for grafts, your surgeon will remove and prepare these first.

Your surgeon will then make a cut, about 25cm (10 inches) long, down the middle of your breastbone (sternum) and will open your ribcage to reach your heart. Your surgeon may attach the new grafts while your heart is still beating, but it’s more common to temporarily stop your heart. Your blood is then diverted to a heart-lung (bypass) machine. This takes over from your heart and lungs to add oxygen to your blood and maintain your circulation.

The grafts will be attached and your heart will be restarted. Your sternum will be rejoined using wires and the skin on your chest will be closed with dissolveable stitches.

Possible risks associated with coronary artery bypass graft surgery include, but are not limited to:

  • Bleeding during or after the surgery
  • Blood clots that can cause heart attack, stroke, or lung problems
  • Infection at the incision site
  • Pneumonia
  • Breathing problems

Medication following a heart attack?

You are likely to have several new medicines started before you go home to reduce your chances of further heart problems and help the heart muscle to function more effectively.

Click on the medications below to discover more.

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BETA BLOCKERS
Beta blockers stop your heart from having to work so hard. These tablets also reduce angina pains and reduce the risk of more heart attacks. Beta blockers are also used to treat irregular heartbeats. Examples include Metoproplol, Bisoprolol and Carvedilol.
ACE (angiotensin-converting enzyme) INHIBITORS
ACE inhibitors relax the blood vessels and reduce the strain on your heart, making it easier for the heart to pump blood to all the body’s tissues. These medications lower the risk of heart problems in the future including Heart Failure. Examples include Cilazapril, Accupril, and Enalapril.
ANTIPLATELET MEDICATION
Antiplatelet medication make blood less sticky. They lower the risk of further heart attacks. Examples include aspirin, Clopidogrel and Ticagrelor.
STATINS
Statins reduce cholesterol. They reduce the likelihood of further heart attacks. Examples include Atorvastatin (Lipitor/Zarator), Pravastatin (Cholvastin and Pravachol), Rosuvastatin, (Crestor) and Simvastatin (Arrow-Simva, Lipex).
GTN SPRAY
Angina pains can occur after a heart attack. You will be advised on how to treat these with GTN spray and on an action plan for prolonged pain.

To find out more about heart medication we have in-depth information available on the My Heart Pills page of this site.

Did you know?

For most people who have had a heart attack, the benefits of taking medication far outweigh the risks of harm associated with not taking medication.

Continue the journey

What causes a heart attack?
Find out what can increase your risk of heart attack
Read more
Do you know the warning signs?
Discover the signs and symptoms of heart attack
Read more

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