Medical Interventions for Heart Attack
The three most common treatments for heart attack are:
Clot Buster Drugs– These drugs introduced in the 1980s are powerful clot dissolving agents that can re-establish the blood flow to endangered heart tissue. However, their effectiveness is related to the nature of the blockage. Studies have shown that other methods can have better long term results.
CABG – Coronary Artery Bypass Graft or open-heart surgery. This is the most invasive intervention and is very effective in restoring circulation to endangered heart tissue. Sometimes it is the only way to restore blood flow to a severely diseased heart. Most often however, coronary bypass operations are not the first choice to restore blood flow in an emergency such as a heart attack. This is because Coronary Bypass is major surgery and can be a lot for a person who is having a heart attack to endure. While it is true that there are special "less invasive" operations that are sometimes used in non-emergencies, these are not appropriate for patients actually having a heart attack. St. Mary Medical Center performs nearly 400 open-heart surgeries annually.
Balloon Angioplasty or PTCA – Percutaneous Transluminal Coronary Angioplasty. This is the procedure done in the cardiac catheterization lab. In non-emergencies, this is often done on an elective basis. In the case of a patient having a heart attack it can be used as a emergency lifesaving procedure to restore blood flow to endangered heart tissue. To perform the procedure, a small catheter is placed into a artery in the patient's upper leg. This is done using local numbing medication, and often with the use of sedating medication to help the patient relax. The catheter is advanced under x-ray guidance to an area just above the patient's heart, and directed into the opening of the coronary artery. A liquid that absorbs X-ray is then injected into the arteries, and motion picture X-rays are recorded. This makes it possible to "see" the inside of the coronary arteries. The blockage can then be identified and repaired. To do this a balloon catheter is advanced over a safety guide wire to the area of the blockage. The balloon is then inflated and the offending plaque is flattened against the walls of the coronary artery. The balloon is removed and the progress of the procedure is assessed by further x-ray recordings. Sometimes additional balloon inflation's are needed to obtain good result. Often, the doctor will elect to implant a stent. A stent is a small tubular device which resembles the spring inside a pen. It is expanded by a coronary balloon into the walls of the artery in the area of the blockage. The stent acts as a scaffolding to keep the artery open.