Early treatment can prevent or limit damage to the heart muscle. Once the diagnosis of heart attack is confirmed or strongly suspected, treatments to try to restore blood flow to the heart are started as soon as possible. Treatments include medications and medical procedures.
Diagnosis of coronary artery disease
The diagnosis of coronary artery disease is based on patient’s symptoms, personal, family and medical history. The General Practitioner will listen to the description of your symptoms and will carry out a physical examination. If your General Practitioner thinks something should be investigated in greater depth, he may refer you to a cardiologist in order to conduct more specific tests, such as:
- Blood tests. Blood tests can detect the amount of some markers in the bloodstream, which are released during a heart attack. Higher than normal levels of these proteins in the bloodstream is evidence of a heart attack. Commonly used blood tests include troponin tests, CK or CK-MB tests, and serum myoglobin tests.
- An echocardiogram. This test uses sound waves to produce images of the inside of patient’s heart
- Chest x-ray
- An electrocardiogram (ECG). This test detects and records the electrical activity of the heart. The highly sensitive electrocardiograph machine detects heart’s irregularities, disease and damage by measuring the heart’s rhythm and electrical impulses.
- Coronary angiography. Coronary angiography is a procedure using x-rays to examine the heart and blood vessels and is part of a procedure called cardiac catheterization. Cardiac catheterization is an invasive procedure imaging that allows the evaluation of the heart functioning. A long, narrow tube called catheter is inserted trough a plastic introducer sheath. Then the catheter is guided through the blood vessels and advanced up to the coronary arteries with the aid of an x-ray machine. A contrast dye that can be detected on x-ray is injected into the blood stream trough the tip of the catheter. The x-ray machine then takes a series of images (angiograms), producing a detailed look of the inside of the heart. If the angiograms show the presence of a stenosis, which cannot be treated with oral medications, then another procedure, called angioplasty, may be used to restore the blood flow trough the artery.
Treatments of coronary artery disease
There are three ways to treat atherosclerotic disease: medications, minimally invasive interventional procedures such as percutaneous transluminal coronary angioplasty (PTCA), stent implantation, and surgery.
Medical therapy
Most patients with heart disease receive medication to help prevent a heart attack. A number of different kinds of medicines may be used to treatheart attack.
- Thrombolytic medicines are used to dissolve blood clots that are blocking the coronary arteries.
- Beta Blockers decrease the workload on the heart. Beta blockers also are used to relieve chest pain or discomfort and to help prevent additional heart attacks. Beta blockers also are used to correct arrhythmias (irregular heartbeats).
- Angiotensin-Converting Enzyme (ACE) Inhibitors lower blood pressure and reduce the strain on the heart. They also help slow down further weakening of the heart muscle.
- Anticoagulants thin the blood and prevent clots from forming in your arteries.
- Antiplatelets (such as aspirin and clopidogrel) stop platelets (a type of blood cell) from clumping together and forming unwanted clots.
While medications do not eliminate the narrowing of arteries, they can help improve the efficiency of the heart and reduce symptoms such as chest pain (angina).
PTCA (Percutaneous Transluminal Coronary Angioplasty)
Coronary angioplasty (also called percutaneous coronary intervention PCI) is a medical procedure used to restore blood flow through coronary arteries that are narrowed or blocked by a blood clot.
CABG
Coronary artery bypass grafting is a surgery in which arteries or veins are taken from other areas the body and sewn in place to bypass blocked coronary arteries providing a new route for blood flow to the heart muscle.