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Acute Myocardial Infarction: Treatment, Procedure, Cost and Side Effects

Last Updated: Oct 18, 2021

What is the treatment?

Acute myocardial infarction is also known as heart attack. It is also known as cardiac infarction, cardiopulmonary arrest, congestive heart failure and coronary infarction.

What happens in Acute Myocardial Infarction?

Acute Myocardial Infarction is a life-threatening condition in which the blood flow decreases or stops to a segment of the heart leading to damage in the heart muscles. It is characterized by left-sided chest pain radiating to the shoulders and arms and shortness of breath.

The pain continues for more than a few minutes and occurs recurrently. Other symptoms that are experienced include pressure in the chest, tachycardia, sweating, anxiety, nausea, vomiting, cough, and dizziness. Symptoms and severity of the symptoms vary from person to person.

What causes Acute Myocardial Infarction?

The main cause of acute Myocardial Infarction involves a decreased or a deceased blood flow to the heart leading to the damage of the heart muscle. This is caused by the complete blockage of a coronary artery or the arteries that supply blood to the heart. Coronary artery disease is the main factor responsible, along with high blood pressure, smoking, diabetes, obesity, high blood cholesterol, poor diet, etc. serves as the additive factors.

How is the treatment done?

Acute myocardial infarction is a medical emergency that brings life threatening conditions to the patients. This occurs when the blood flow decreases or stops and starts to clot and thus, blocks the flow of blood into the heart. Without blood, tissues start to lose oxygen and die. Myocardial infarction can also occur because of blockage in the coronary arteries caused by the build-up of plaque, a substance mostly made of fat, cholesterol, and cellular waste products.

The first and most common symptom of heart attack or myocardial infarction is chest pain. Patients with heart attack experience a tightness in the chest, neck, back or arms, as well as fatigue, light headedness, abnormal heartbeat and anxiety. Common symptoms of cardiac arrest are shortness of breath, sweating, nausea, vomiting, anxiety, cough, dizziness etc. The symptoms relating this condition are more noted in the left part of the patient’s body.

Treatment of myocardial infarction can range from lifestyle changes and cardiac rehabilitation to medication, stents and bypass surgery. Defibrillation method of treatment involves the use of an electric shock. This shock helps to correct the rapid and irregular heartbeat and also helps to restore the normal heart rhythm. For people with shortness of breath due to attack, the oxygen therapy is provided. This provides extra oxygen to the lungs so that the patient can ease the breathlessness. Medicines are also prescribed by the doctors, in case of minor attacks or pre-symptoms of attack. Blood thinner drugs can help to prevent blood from clotting and also dissolve the existing clots. This will lower the risks of attack. Heart medications and narcotics are used to provide relief from the pain. Beta blockers are used to slow the heart rate and decrease the blood pressure. If the myocardial infarction is found to be caused by deposition of fats, then statin can be used. This helps to decrease the liver’s production of harmful cholesterol. Inhibitors can help the blood vessels to relax and also lower the pressure. Medical procedures like Coronary stent and Coronary angioplasty can also be used. Coronary artery bypass surgery restores the blood flow to the heart with the use of a healthy artery or vein to bypass a blocked artery.

Who is eligible for the treatment? (When is the treatment done?)

In order to determine a heart attack, the doctor will first listen to the heart beat to check for any irregularities in it. They may also measure the blood pressure. If a heart attack is suspected, doctors prescribe a number of tests and procedures. An electrocardiogram (ECG) may be done to measure the heart’s electrical activity. Blood tests are also prescribed to check for proteins that are associated with heart damage, such as troponin. Other similar diagnostic tests include a stress test to see how the heart responds to certain situations, such as exercise, an angiogram with coronary catheterization that looks for areas of blockage in the arteries and an echocardiogram that also helps to identify areas of the heart that aren’t functioning properly.

Heart attacks are a life threating medical condition that call for immediate treatment. Treatment and procedures for heart attack are mostly done in the emergency rooms of the hospitals. A minimally invasive procedure to treat acute myocardial infarction, called angioplasty, may be used to unblock the blocked and clotted arteries that supply blood to the heart. During an angioplasty, surgeon will insert a long, thin tube which is called a catheter through the artery to reach the blockage. Then, a small balloon attached to the catheter is inflated so that it can reopen the artery, allowing blood flow to resume normally again. The surgeon may also place a small, mesh tube called a stent at the site of the blockage. The stent can prevent the artery from being closed or blocked again. Surgical methods may also be used for the treatment of acute myocardial infarction. This procedure is called the coronary artery bypass graft (CABG). In this procedure, veins and arteries are rerouted using surgical operations so that the blood can flow around the blockage. A number of different medications are also available which assist in the treatment of heart attack. Drugs for thinning the blood, such as aspirin, are often used to break up blood clots and improve blood flow through narrowed arteries. Another drug thrombolytics are also often used to dissolve clots. Antiplatelet drugs, such as clopidogrel, can be prescribed by the doctors to prevent new clots from forming and the existing clots from growing further. Nitroglycerin can be used to widen the blood vessels. Beta-blockers and ACE inhibitors help to lower the blood pressure and relax the heart muscles. This can help to lower the severity of damage caused to the heart. Pain relievers may be used to reduce any discomfort associated with heart attack.

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Who is not eligible for the treatment?

People who face sudden signs and symptoms of heart attack must consult a doctor immediately. Even if the symptoms are not severe, and occurs just once or twice for a short span, people should consult a doctor for medical assistance. Chest pain and breathlessness can be indicative of heart attack. Hence, these precursor symptoms must be taken seriously and consulted with a specialist. Additionally, there are certain factors which increase the risk of heart attack in people. These include high cholesterol, high blood pressure, high triglyceride levels, diabetes, obesity etc. Age and family history are also controlling factors of this medical condition.

What can you do to prevent Acute Myocardial Infarction?

The most important thing one can do to prevent acute Myocardial Infarction is to eliminate its causative factors and it can be achieved only by a change in the individual’s lifestyle.

Quitting the habit such as smoking and drinking alcohol, diet modifications such as reduction in the intake of trans fat, saturated fat, and cholesterol-rich foods, moreover switching over to healthier foods such as fruits, vegetables, whole grains, fish, legumes, etc. reduction in sugar intake and red meats, stress reduction, physical activity and maintaining blood pressure and diabetes.

Are there any side effects?

People with normal heart functions, proper and healthy life style and no signs and symptoms of myocardial infarction do not need to undergo medical treatment.

What are the post-treatment guidelines?

There are some side effects of the medicines used in the treatment of acute myocardial infarction. Medicines provided to the patients have a major proportion of nitrates in it. Nitrates are widely used to provide relief from chest pain and pulmonary congestion in patients with acute coronary syndromes and heart failure. The most commonly noted side effect is headache. Streptokinase (SK) is also used extensively as thrombolytic agent for the management of patients with acute myocardial infarction (AMI). This also is known to have certain adverse effects on patients. Side effects are severe life threatening hypotension or even death.

How long does it take to recover?

Survival and recovery from a heart attack after treatment will depend on the damage caused and the potential of the patient to come around. Many patient who have had heart attacks experience anxiety and depression. It is very important post treatment to provide immense mental support and strength to the patient for his/ her speedy recovery. Depression may, in turn, increase the risk of a greater attack. Apart from taking proper medications and following doctor’s advice, it is also important to have a healthy diet and adequate sleep. Also, patients after treatment should get back with their normal lives as early as possible as this speeds up recovery and reduces the chances of further attack.

What is the price of the treatment in India?

Recovery from treatment of acute myocardial infarction may take around few weeks to 2 or 3 months, depending on the condition of the patient. A complete return to normal life habits depend on how the body and also the mind respond to the treatment. Faster the patients get into their normal life style, higher and sooner they heal.

Are the results of the treatment permanent?

Treatment of acute myocardial infarction is very expensive. The cost range can vary from Rs 10 lakhs to 35 lakhs.

What are the alternatives to the treatment?

The treatment results are usually permanent. In the case of mild attacks, the risk factor for further recurrence of secondary attacks can be lowered if proper care and treatment are done. In case of acute attacks of cardiac arrest, there is always a risk associated. But, with immediate and proper treatment methods and medications and a healthy lifestyle, people can achieve permanent results. Nonetheless, secondary attacks can occur, because of which patients are kept under strict observance post-treatment.

Summary: Acute Myocardial Infarction is a life-threatening condition in which the blood flow decreases or stops to a segment of the heart leading to damage in the heart muscles. It is characterized by left-sided chest pain radiating to the shoulders and arms with shortness of breath. Quitting habits such as smoking and drinking alcohol, diet modifications such as reduction in the intake of trans fat, saturated fat, and cholesterol-rich foods, moreover switching over to healthier foods such as fruits, vegetables, whole grains, fish, legumes are some of the ways for control and management of the condition.

References

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Written ByDr. Pankaj Verma ACLS,POST GRADUATE COURSE IN RHEUMATOLOGY,Fellowship in Diabetes,MBBS,Post Graduate Course In Rheumatology,MD - Medicine,Masters in Psychotherapy and CounsellingInternal Medicine
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