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Health care providers typically use a combination of medication and mechanical intervention as treatment for a myocardial infarction, more commonly referred to as a heart attack. Immediate treatment involves restoring blood and oxygen flow as soon as possible, providing pain relief, and preventing or treating complications. Physicians frequently use anticoagulant, vasodilating, and thrombolytic medications, which improve blood flow back into and through the heart. Patients often receive a narcotic analgesic for pain relief. Mechanical methods frequently employed by cardiologists include percutaneous coronary intervention (PCI), but a coronary artery bypass may be needed if other methods of treatment fail.
Infarction usually occurs when there is a disruption of the blood supply to the heart muscle, generally caused by a coronary artery blockage by a blood clot, a plaque, or a combination of both. Without adequate oxygen, the heart tissue begins to die, or undergoes necrosis. The longer the heart tissue is deprived of adequate blood flow and oxygenation, the greater the amount of heart muscle necrosis. When individuals experience angina, chest pain, or other symptoms possibly related to heart attack, health care providers generally recommend chewing one adult aspirin. The aspirin prevents further accumulations around an existing clot and allows less sticky blood to flow through a partially blocked or occluded artery.
Treatment for a myocardial infarction might also include the administration of nitroglycerin, angio-converting enzyme (ACE), inhibitors and beta-blockers. These medications usually act to relax the smooth muscle of blood vessels and promote blood flow. They generally inhibit chemicals that produce vasoconstriction or that inhibit neurotransmitters from causing vasoconstriction. With vessels relaxed, blood flow increases and supplies much needed oxygen. These medications also tend to reduce pulse and blood pressure, and as the heart’s workload decreases, so does the need for increased oxygen.
Physicians generally continue anticoagulant therapy as part of the treatment for a myocardial infarction, using medications that interfere with platelet formation or that prevent platelets from sticking together. Treatment for a myocardial infarction also typically includes thrombolysis, the breaking up or dissolving of the blood clot. Health care providers often use medications known as clot busters to degrade fibrin, a protein that forms a microscopic mesh that traps blood cells and forms clots.
In 2011, cardiologists increasingly use mechanical means of treatment for a myocardial infarction, which usually involves PCI to remove clots. The procedure is performed in a catheterization lab, where cardiologists access the occluded vessel and loosen or break up the clot by injecting saline solution or thrombolytic medication into the problem area. Once the clot loosens or dissolves, its remnants are generally suctioned out of the vessel.