Last of three parts

In the last column, I wrote about the causes of heart attacks. In this last installment of a three-part series, we’ll discuss treatments for heart-attack victims.

Because of better care, most heart-attack victims survive today. There are improved tests, drugs and surgery to defend against heart attack.

Tests

An electrocardiogram (ECG) records the heart’s electrical activity. This test is done because injured heart muscle generates abnormal impulses. If the ECG picks up abnormalities, physicians will know that a patient has had a heart attack or that one may be in progress.

If you have a heart attack, there are heart enzymes that leak slowly into your blood. Physicians will draw blood to test for the enzymes.

A chest X-ray is done to evaluate the size and shape of your heart and its blood vessels.

A nuclear scan enables doctors to locate places where blood is not flowing properly to the heart. A radioactive material is injected into your bloodstream. Cameras detect the radioactive material as it flows through your heart and lungs.

An echocardiogram can tell if a part of the heart has been damaged by a heart attack.

Sound waves are bounced off your heart and converted to images.

An angiogram employs dye injected into your arteries. The dye makes the arteries visible to X-rays, which illustrate blockages.

A stress test on a treadmill or stationary bike while hooked up to an ECG machine measures how your heart and arteries react when you exert yourself.

Drugs

Drugs that help dissolve clots blocking blood to your heart are lifesavers. These drugs are known as thrombolytics or “clot-busters.” The earlier you are given a clot-buster, the better.

A “super-aspirin” is given with a clot-buster. The super-aspirin prevents new clots from forming.

Nitroglycerin is used to open arteries, improving blood flow to and from your heart.

Regular aspirin keeps blood moving through constricted arteries. Therefore, paramedics may give aspirin when they respond to an emergency to treat a heart-attack victim. Aspirin reduces mortality from heart attacks.

Beta blockers, which lower your pulse rate and blood pressure, can reduce damage to the heart.

Drugs to lower cholesterol may be helpful if given soon after a heart attack begins.

If you are in great pain, you may be given morphine.

Surgery

Angioplasty opens blocked coronary arteries. In this procedure, a catheter is run through an artery to the blockage. The catheter, which is a long thin tube, has a balloon tip that is inflated to open the blockage. In most cases, a mesh tube (stent) is also placed inside the artery to hold it open.

Coronary artery bypass surgery is not usually done when a heart attack occurs but it may be recommended after recovery. During the operation, surgeons take a segment of a healthy blood vessel from another part of the body and make a detour around the blocked part of the coronary artery.

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