The best choice is to go to the hospital in an ambulance. The paramedics can begin lifesaving treatments even before you arrive at the hospital. If you cannot reach emergency services, have someone drive you to the hospital right away. Do not drive yourself unless you have absolutely no other choice.
If you think you are having unstable angina but you are not sure, follow the steps listed above. Unstable angina can lead to a heart attack or death, so you need to have it checked right away.
How is a heart attack treated?
If you go to the hospital in an ambulance, treatment will be started right away to restore blood flow and limit damage to the heart. You may be given medicines, including:
Aspirin (if you have not already taken some) and other medicines to prevent blood clots.
Medicines that break up blood clots (thrombolytics). To work, these must be given within a few hours of the start of the heart attack.
Medicines to decrease the heart's workload, ease pain, and treat abnormal heart rhythms, which can be life-threatening.
At the hospital, you will have tests, such as:
Electrocardiogram (EKG or ECG). An EKG can detect signs of poor blood flow, heart muscle damage, abnormal heartbeats, and other heart problems.
Blood tests, including tests to see whether cardiac enzymes are high. Having these enzymes in the blood is usually a sign that the heart has been damaged.
If these tests show that you may be having a heart attack, you may have a cardiac catheterization. For this test, the doctor puts a thin, flexible tube (called a catheter) through an artery in the groin or arm and carefully guides it into the heart. (See a picture of catheter placement.) A dye is injected that makes the coronary arteries show up on a computer screen. The doctor then can see if the coronary arteries are blocked and how your heart is working.
If cardiac catheterization shows that an artery is blocked, the doctor may do angioplasty right away. The doctor guides the catheter into the narrowed artery, and a small balloon at the end of it is inflated. This widens the artery to help restore blood flow. Often a small wire-mesh tube called a stent is placed to keep the artery open. See a picture of angioplasty with stent placement.
Angioplasty, with or without a stent, is the preferred treatment for a heart attack. But if angioplasty is not available or cannot be done for some reason, “clot-busting” thrombolytic medicines may be used. Or the doctor may do emergency bypass surgery to redirect blood around the blocked artery.
After these treatments, medicines are given to prevent clots, reduce the heart’s workload, and lower cholesterol. These can help prevent another heart attack and heart failure. Most people who have had a heart attack take these and sometimes other medicines for the rest of their lives.
After you have had a heart attack, the chance that you will have another one is higher. Taking part in a cardiac rehab program helps lower this risk. A cardiac rehab program is designed for you and supervised by doctors and other specialists. It can help you learn how to eat a balanced diet and exercise safely to reduce your risk of more heart problems.
It is common to feel worried and afraid after a heart attack. But if you are feeling very sad or hopeless, ask your doctor about treatment. Getting treatment for depression may help you recover from a heart attack.
Can you prevent a heart attack?
Heart attacks are usually the result of heart disease, so taking steps to delay or reverse coronary artery disease can help prevent a heart attack. Heart disease is the number one killer of both men and women in the United States, so these steps are important for everyone.
To improve your heart health:
Don't smoke, and avoid secondhand smoke. Quitting smoking can quickly reduce the risk of another heart attack or death.
Eat a heart-healthy diet that includes plenty of fish, fruits, vegetables, beans, high-fiber grains and breads, and olive oil.
Get regular exercise on most, preferably all, days of the week. Your doctor can suggest a safe level of exercise for you.
Control your cholesterol and blood pressure.
If you have diabetes, keep your blood sugar as close to normal as possible.
Lower your stress level. Stress can damage your heart.
Take a daily aspirin if your doctor advises it.
Get a flu shot every year.
Take all of your medicines correctly. Taking medicine can lower your risk of having another heart attack or dying from coronary artery disease.
:Symptoms
The most common symptom of a heart attack is severe chest pain, although this sensation is not always present. In one study of people treated for a heart attack, almost half of them came to the emergency room because they had symptoms other than chest pain. These symptoms included shortness of breath, dizziness, weakness or fainting, and abdominal pain. 1 Women, older adults, and people with diabetes are less likely to have chest pain during a heart attack and more likely to have other symptoms.
It is possible to have a "silent heart attack" without any symptoms, but this is rare. Most people have chest pain and at least one other symptom, such as:
A feeling of choking or a "tight throat," a lump in the throat, or a need to keep swallowing.
A cold sweat.
Nausea.
A sense of impending doom.
Difficulty breathing or breathlessness.
Palpitations, or feeling your heart beat rapidly or irregularly. (Palpitations are very common and are usually harmless in a healthy heart, but they may signal coronary artery disease if brought on by exertion.)
Numbness or discomfort in either arm or hand.
Weakness.
People who are having a heart attack often describe their chest pain in various ways. The pain:
May feel like pressure, heaviness, weight, tightness, squeezing, discomfort, burning, a sharp ache (less common), or a dull ache. People often put their fist to their chest when describing the pain.
May radiate from the chest down the left shoulder and arm (the most common site) and also to other areas, including the left shoulder, middle of the back, upper portion of the abdomen, right arm, neck, and jaw. See a picture of the areas where you might have pain during a heart attack.
May be diffuse—the exact location of the pain is usually difficult to point out.
Is not made worse by taking a deep breath or pressing on the chest.
Usually begins at a low level, then gradually increases over several minutes to a peak. The discomfort may come and go. Chest pain that reaches its maximum intensity within seconds may represent another serious problem, such as an aortic aneurysm.
Women are more likely to have symptoms such as shortness of breath, heartburn, nausea, jaw pain, back pain, or fatigue.
If you think you are having unstable angina but you are not sure, follow the steps listed above. Unstable angina can lead to a heart attack or death, so you need to have it checked right away.
How is a heart attack treated?
If you go to the hospital in an ambulance, treatment will be started right away to restore blood flow and limit damage to the heart. You may be given medicines, including:
Aspirin (if you have not already taken some) and other medicines to prevent blood clots.
Medicines that break up blood clots (thrombolytics). To work, these must be given within a few hours of the start of the heart attack.
Medicines to decrease the heart's workload, ease pain, and treat abnormal heart rhythms, which can be life-threatening.
At the hospital, you will have tests, such as:
Electrocardiogram (EKG or ECG). An EKG can detect signs of poor blood flow, heart muscle damage, abnormal heartbeats, and other heart problems.
Blood tests, including tests to see whether cardiac enzymes are high. Having these enzymes in the blood is usually a sign that the heart has been damaged.
If these tests show that you may be having a heart attack, you may have a cardiac catheterization. For this test, the doctor puts a thin, flexible tube (called a catheter) through an artery in the groin or arm and carefully guides it into the heart. (See a picture of catheter placement.) A dye is injected that makes the coronary arteries show up on a computer screen. The doctor then can see if the coronary arteries are blocked and how your heart is working.
If cardiac catheterization shows that an artery is blocked, the doctor may do angioplasty right away. The doctor guides the catheter into the narrowed artery, and a small balloon at the end of it is inflated. This widens the artery to help restore blood flow. Often a small wire-mesh tube called a stent is placed to keep the artery open. See a picture of angioplasty with stent placement.
Angioplasty, with or without a stent, is the preferred treatment for a heart attack. But if angioplasty is not available or cannot be done for some reason, “clot-busting” thrombolytic medicines may be used. Or the doctor may do emergency bypass surgery to redirect blood around the blocked artery.
After these treatments, medicines are given to prevent clots, reduce the heart’s workload, and lower cholesterol. These can help prevent another heart attack and heart failure. Most people who have had a heart attack take these and sometimes other medicines for the rest of their lives.
After you have had a heart attack, the chance that you will have another one is higher. Taking part in a cardiac rehab program helps lower this risk. A cardiac rehab program is designed for you and supervised by doctors and other specialists. It can help you learn how to eat a balanced diet and exercise safely to reduce your risk of more heart problems.
It is common to feel worried and afraid after a heart attack. But if you are feeling very sad or hopeless, ask your doctor about treatment. Getting treatment for depression may help you recover from a heart attack.
Can you prevent a heart attack?
Heart attacks are usually the result of heart disease, so taking steps to delay or reverse coronary artery disease can help prevent a heart attack. Heart disease is the number one killer of both men and women in the United States, so these steps are important for everyone.
To improve your heart health:
Don't smoke, and avoid secondhand smoke. Quitting smoking can quickly reduce the risk of another heart attack or death.
Eat a heart-healthy diet that includes plenty of fish, fruits, vegetables, beans, high-fiber grains and breads, and olive oil.
Get regular exercise on most, preferably all, days of the week. Your doctor can suggest a safe level of exercise for you.
Control your cholesterol and blood pressure.
If you have diabetes, keep your blood sugar as close to normal as possible.
Lower your stress level. Stress can damage your heart.
Take a daily aspirin if your doctor advises it.
Get a flu shot every year.
Take all of your medicines correctly. Taking medicine can lower your risk of having another heart attack or dying from coronary artery disease.
:Symptoms
The most common symptom of a heart attack is severe chest pain, although this sensation is not always present. In one study of people treated for a heart attack, almost half of them came to the emergency room because they had symptoms other than chest pain. These symptoms included shortness of breath, dizziness, weakness or fainting, and abdominal pain. 1 Women, older adults, and people with diabetes are less likely to have chest pain during a heart attack and more likely to have other symptoms.
It is possible to have a "silent heart attack" without any symptoms, but this is rare. Most people have chest pain and at least one other symptom, such as:
A feeling of choking or a "tight throat," a lump in the throat, or a need to keep swallowing.
A cold sweat.
Nausea.
A sense of impending doom.
Difficulty breathing or breathlessness.
Palpitations, or feeling your heart beat rapidly or irregularly. (Palpitations are very common and are usually harmless in a healthy heart, but they may signal coronary artery disease if brought on by exertion.)
Numbness or discomfort in either arm or hand.
Weakness.
People who are having a heart attack often describe their chest pain in various ways. The pain:
May feel like pressure, heaviness, weight, tightness, squeezing, discomfort, burning, a sharp ache (less common), or a dull ache. People often put their fist to their chest when describing the pain.
May radiate from the chest down the left shoulder and arm (the most common site) and also to other areas, including the left shoulder, middle of the back, upper portion of the abdomen, right arm, neck, and jaw. See a picture of the areas where you might have pain during a heart attack.
May be diffuse—the exact location of the pain is usually difficult to point out.
Is not made worse by taking a deep breath or pressing on the chest.
Usually begins at a low level, then gradually increases over several minutes to a peak. The discomfort may come and go. Chest pain that reaches its maximum intensity within seconds may represent another serious problem, such as an aortic aneurysm.
Women are more likely to have symptoms such as shortness of breath, heartburn, nausea, jaw pain, back pain, or fatigue.
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