Health Conditions

The main treatment goals of the survivors of heart attack are to prevent another heart attack, and to decrease the symptoms that arise from heart failure and narrowing of the coronary arteries. A related goal is to minimize the need to use coronary bypass surgery. In this procedure, surgeons graft a vein, usually taken from the patient's leg, from the aorta to the coronary artery, thus skipping over, or bypassing, the obstructed area.

A step approach to reaching the goals of heart attack therapy is based on considerations of research, cost effectiveness and an assessment of the risk status of the patient.

In all patients, the first step is modifying lifestyle-related risk factors. Patients should quit smoking, lose weight if necessary, exercise regularly, follow a diet that is high in fiber and low in fat, and keep stress to a minimum.

All patients who have suffered a heart attack should be started on daily aspirin therapy unless contraindicated or intolerable. In addition, all heart attack patients should receive beta blockers unless contraindicated.

Patients with decreased heart function after a heart attack are at high risk for developing congestive heart failure and should receive an ACE inhibitor. Finally, because of documented efficacy in preventing a recurrent heart attack, all patients with elevated LDL-cholesterol levels should be given lipid-lowering therapy with an HMG CoA reductase inhibitor, also known as a statin. The goal of statin therapy is to decrease the b"ad cholesterol" (LDL-cholesterol) by 50% or to less than 100 mg/dl (see Treating Hypercholesterolemia). In patients that are "very high risk" (those with established heart disease and multiple major risk factors including diabetes, metabolic syndrome, and current smokers), a more aggressive LDL goal of <70 mg/dL may be encouraged

Sometimes surgery remains as the only option for patients who have suffered a heart attack. Procedures include a bypass operation (described above) or numerous methods to open up the clogged artery such as angioplasty or coronary stent placement. In angioplasty, surgeons insert a balloon-tipped catheter into the arterial system. Once it reaches the blocked coronary artery, the doctor inflates the balloon so that it flattens the plaque against the wall of the artery. A similar procedure involves the placement of a coronary stent (a small tubular object which resembles the spring in a ball-point pen) in the area of the artery which was occluded. The stent gives the artery stability and helps to prevent reocclusion.

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Note: The above information is intended to supplement, not substitute for, the expertise and judgment of your physician, pharmacist, or other healthcare professional. It is not intended to diagnose a health condition, but it can be used as a guide to help you decide if you should seek professional treatment or to help you learn more about your condition once it has been diagnosed.