Heart Attack



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Click here for Multimedia Lecture on Heart Attack!

What is a heart attack?

How common is a heart attack?
What are the symptoms of a heart attack?
What should be done if a heart attack is suspected?
What happens when a heart attack patient arrives in the ER?
How does "clot buster" treatment compare with angioplasty?
Why is primary angioplasty and stent not used in every case?
What happens after the patient is admitted to the hospital?
What happens after the first day?
What are the complications of a heart attack?
What medications will be prescribed after discharge?

What happens in the hospital after the first 24 hours of a heart attack? Depending upon how well the patient is doing, transfer to a "telemetry" floor is usually arranged on the second day. Unstable patients may remain in the CCU for one or more additional days.
If the patient is recovering nicely, he or she is ambulated in the hallway and may be seen by the cardiac rehabilitation team. The patient and spouse or family are provided with information that helps them understand what happened during the heart attack and what preventive measures are needed to avoid a second one. Instructions about dietary restrictions and an exercise regimen are also given. Depending upon the severity of the heart attack and promptness with which treatment was received, many patients are discharged in 2 to 4 days. Smokers are encouraged to quit tobacco use and supportive measures are recommended.

What medications are prescribed after a heart attack? Many of the patient's home medicines (for example those used to treat high blood pressure, diabetes, etc) are continued. Traditionally, the majority of patients also receive daily aspirin and nitroglycerine for "PRN" or as needed use. If there are no contraindications, most patients are also discharged on a "beta-blocker" medicine. This helps reduce the risk of a second heart attack and sudden death. However, a beta-blocker may not be used in patients with very slow heart beat, asthma and heart failure. Instead, patients with heart failure or reduced heart function may be sent home on a medicine known as an "ACE inhibitor" that helps reduce the workload of the heart. Patients with a high cholesterol level may be sent home on a medication to help control this problem.
Upon discharge, the patient will be given a follow-up appointment with the physician.

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