There are two aims in treatment. The first is to support the failing heart and the next is to limit the size of the damaged area within the heart. Supporting the failing heart requirescardiopulmonary resuscitation, doing cardiac massage and mouth to mouth breathing. The aim is to keep circulation going long enough for medical intervention. If the person has not collapsed but is just getting chest pain the most important thing is to give them an aspirin. This apparently simple measure immediately reduces the tendency for more blood clots to form on any existing blood clot within the heart and is well worth doing, even if there is doubt about the diagnosis. Within a hospital setting treatment would then be with drugs that dissolve the blood clot within the heart. The most widely used one iscalled streptokinase.
Other measures may beto perform emergency coronary artery angiography with a viewto either immediate replacement of severelydiseased blood vessels or for widening critically narrowed blood (called angioplasty). Longer term treatment after a heart attack would include some selection of the following:1. Everyone should be on a low dose of aspirin, probably for the rest of their lives, unless there is some contra-indication to taking aspirin.2. Drugs called beta-blockers, elsewhere used for treating high blood pressure, are now known to improve heartfunction and should reduce the risk of serious heart rhythm abnormalities for up to year following a heart attack.3. Drugs called ACE-inhibitors, which arealso used in the treatment of hypertension, further strengthen the heart and may be taken for three months to a year after a heart attack.4. Sufferers will be advised to look at their lifestyle and to reduce their risks of further heart attacks by attention to high blood pressure, reducing smoking and weight andincreasing exercise.
Rehabilitation
Many areas provide cardiac rehabilitation classes where sufferers receive exercise under supervision. This is most important in restoring confidence about increasing exertion as well as ensuring that individualstone up their heart muscles again. Most people are fit to resumetheir previous life somewhere between two to three months following a heart attackand this includes physical exertion, sex, strenuous hobbies and recreational activities.
