What is a heart attack?

A heart attack, also called myocardial infarction or MI, happens when blood flow to a part of the heart is suddenly blocked or a blood vessel in the heart suddenly squeezes and cuts off blood flow (called a spasm). The blood carries sugar (glucose) and oxygen to the heart muscle. As you get older, your heart arteries get narrowed by the buildup of plaque. Plaque is made up mostly of fat and cholesterol that sticks to the inside walls of the arteries. When the plaque breaks open, a blood clot forms, which blocks the flow of blood to the heart muscle. When blood doesn’t reach the heart muscle, the muscle is damaged. Usually, part of the heart muscle dies. How much of your heart muscle dies depends on how long the blood flow was blocked and where.

What can I expect in the hospital?

You need to stay in the hospital because heart attacks require immediate treatment.

Several things may be done while you are in the hospital to monitor, test, and treat your condition. They include:

Monitoring:

• You will be checked often by the hospital staff.
• A heart (cardiac) monitor will be used to keep track of your heartbeat. If you have an irregular rhythm that might be dangerous, it will be treated right away.
• Your blood oxygen level will be monitored by a sensor that is attached to your finger or earlobe.
• Your heart rate, blood pressure, and temperature will be checked regularly.
• Your fluid intake may be monitored closely by keeping track of everything you eat and drink and any IV fluids you receive.
• You may have a small tube (catheter) placed into your bladder through the urethra (the opening from the bladder to the outside of the body) to measure the amount of urine in and drain urine from the bladder.

Testing:

Testing may include:

• Blood tests to check the level of certain proteins in the blood to find out if your heart muscle has been damaged
• A chest X-ray to check if your heart is bigger than normal and if there is extra fluid or other problems in your lungs
• An ECG (also called an EKG or electrocardiogram), which measures and records your heartbeat
• Ultrasound (echocardiogram), which uses sound waves and their echoes passed through your body from a small device (called a transducer) that is held against your skin to create pictures of the inside of your heart to look at your heart valves, blood flow, and how well your heart muscle is pumping
• Heart catheterization (coronary angiogram), which is a series of X-rays taken after your healthcare provider places a long, thin, flexible tube (catheter) into a blood vessel in your groin and up to your heart. A special dye is injected into your blood vessels to look for areas where the dye may be leaking out of a blood vessel or to find out if blood vessels are blocked and how bad the blockage is
• Stress test, which is an ECG while you exercise on a treadmill. If you are unable to exercise, you will be given a medicine that increases the work of your heart in order to measure your heart’s response. This test will help your provider decide what treatments and exercise are best for you or may be needed in the future.

Treatment:

The exact treatment you receive depends on your symptoms, how much heart muscle is damaged, how much the arteries in your heart are blocked or narrowed, your overall health, and any complications you may have.

• You will have a small tube (IV catheter) inserted into a vein in your hand or arm. This will allow medicine to be given directly into your blood and to give you fluids, if needed.
• You will receive oxygen through a small tube placed under your nose or through a mask placed over your face.
• Your provider may prescribe medicine to:
  • Treat or prevent pain
  • Dissolve or break down blood clots
  • Prevent blood clots
  • Relax and widen blood vessels and allow blood to flow through them easier
  • Reduce blood pressure, slow the heart rate, and reduce the workload of the heart
  • Control cholesterol levels
  • Reduce fluid build-up and swelling in the body
  • Reduce straining with a bowel movement
• You may need surgery to treat the heart attack. Surgery may include:
  • Percutaneous coronary intervention (PCI): A procedure in which your healthcare provider inserts a flexible tube called a balloon catheter into a blocked artery in your heart to unblock it. It opens up your artery without major surgery and allows blood to flow. A metal mesh device called a stent is usually left in the artery to help keep the blood vessel open.
  • Coronary artery bypass graft surgery (CABG): Surgery in which a blood vessel from another part of your body is used to create a new route for blood to flow around a blockage in a heart artery caused by coronary artery disease

What can I do to help?

You will need to tell your healthcare team if you have any of these symptoms:

• Chest pain or pressure, squeezing, or fullness in the center of your chest that lasts more than a few minutes, or goes away and comes back (may feel like indigestion or heartburn)
• Pain or discomfort in one or both arms or shoulders, or in your back, neck, jaw, or stomach
• Trouble breathing
• Breaking out in a cold sweat for no known reason
• Along with the previous symptoms, feeling very tired, faint, or sick to your stomach
• Feeling like your heart is beating too fast, too slow, or skipping beats
• Dizziness or lightheadedness
• Swelling in your feet, ankles, or legs, or abdominal bloating, or swollen hands or face
• Signs of infection around your surgical wound if you had surgery. These include:
  • The area around your wound is more red or painful
  • Your wound area is very warm to touch
  • You have blood, pus, or other fluid coming from the wound area
  • You have chills or muscle aches
• Signs of a problem when you are taking blood thinners, such as:
  • Unusual bruising
  • Red or black bowel movements
  • Cuts that do not stop bleeding

Ask questions about any medicine or treatment or information that you do not understand.

How long will I be in the hospital?

How long you stay in the hospital depends on many factors. The average amount of time to stay in the hospital after a heart attack is 3 to 5 days. For part of that time, you will probably be in a special intensive care unit for heart patients.

You may need to go to a rehabilitation facility to continue your cardiac (heart) rehabilitation program before going home.