Heart attack

• A
• B
• C
• D
• E
• F
• G
• H
• I
• J
• K
• L
• M
• N
• O
• P
• Q
• R
• S
• T
• U
• V
• W
• X
• Y
• Z

Acute MI	Anterior heart arteries	Heart, front view	Heart, section through the middle
Heart attack symptoms	Posterior heart arteries	Post myocardial infarction ECG wave tracings	Progressive build-up of plaque in coronary artery

Myocardial infarction; MI; Acute MI

A heart attack is a medical emergency! Hospitalization is required and possibly intensive care. Continuous ECG monitoring is started immediately, because life-threatening arrhythmias (irregular heart beats) are the leading cause of death in the first few hours of a heart attack.

The goals of treatment are to stop the progression of the heart attack, to reduce the demands on the heart so that it can heal, and to prevent complications.

Medications and fluids will be inserted directly into a vein using an intravenous (IV) line. Various monitoring devices may be necessary. A urinary catheter may be inserted to closely monitor fluid status.

Oxygen is usually given, even if blood oxygen levels are normal. This makes oxygen readily available to the tissues of the body and reduces the workload of the heart.

PAIN CONTROL MEDICATIONS

Intravenous nitroglycerin or other medicines are given for pain and to reduce the oxygen requirements of the heart. Morphine and similar medicines are potent pain killers that may also be given for a heart attack.

BLOOD THINNING MEDICATIONS

If the ECG recorded during chest pain shows a change called "ST-segment elevation," thrombolytic therapy (blood-thinning drugs) may be started within 12 hours of when chest pain began. This initial clot-dissolving therapy will be administered as an IV infusion of streptokinase or tissue plasminogen activator, and will be followed by an IV infusion of heparin.

Heparin therapy, designed to prevent the formation of new clots, will last for 48 to 72 hours. Additionally, warfarin (Coumadin), taken orally, may be prescribed to prevent further development of clots.

Thrombolytic therapy is not appropriate for people who have had:

• Bleeding inside their head known as an intracranial hemorrhage
• Brain abnormalities such as tumors or blood vessel malformations
• Stroke within the past 3 months (or possibly longer)
• Head injury within the past 3 months

Additionally, thrombolytic therapy is extremely dangerous in those who have had: