If you or someone around you is experiencing signs of a heart attack, such as chest pain, shortness of breath, nausea, or discomfort in the arms, neck, jaw or back, call 911 immediately. Do not wait or try to drive yourself to the hospital. Every second counts, and emergency responders can begin life-saving treatment on the way to the hospital.
Cardiac arrest requires immediate medical treatment to get the heart beating again and restore blood flow. Emergency treatment includes:
- Providing cardiopulmonary resuscitation (CPR) to keep oxygen flowing in and out of the lungs
- Using an automated external defibrillator (AED) to restart the heart’s pumping function
- If appropriate, providing naloxone for cardiac arrest related to a possible overdose
After immediate lifesaving treatment, other treatment methods, such as extracorporeal membrane oxygenation (ECMO) therapy, oxygen therapy and targeted temperature management may be used to restore heart function and prevent further damage.
Once a person has started to recover after a cardiac arrest, medical providers will take steps to treat the underlying cause and prevent future cardiac events.
Having a cardiac arrest increases the risk of having another. Your provider may suggest implanting a device in your body or wearing one externally to detect future heart rhythm problems and shock the body into a normal rhythm. These devices include:
- Implanted cardioverter defibrillator (ICD): Surgically placed under the skin in the chest or abdomen, this device has a battery and is connected to the heart with wires. An ICD can detect abnormal rhythms and can also act as a pacemaker, pacing the heart as needed or shocking it back into a normal rhythm.
- Subcutaneous cardioverter device (SCD): A less invasive alternative to an ICD, an SCD is placed under the skin below the armpit. Your healthcare provider may recommend an SCD if you have a higher risk of infection.
- Wearable cardioverter device: This type of device is worn outside the body and usually used on a temporary basis while waiting for a permanent implant.
Percutaneous coronary intervention (PCI) is a procedure to open coronary arteries that are blocked or narrowed by plaque. The doctor inserts a catheter into a blood vessel through a small incision in the arm or groin. The catheter is maneuvered to the site of the blockage, and a balloon at the tip of the catheter inflates, compressing the plaque against the artery wall. A stent is a mesh tube that is used to hold an artery open following a ballooning procedure.
After stent placement, you may stay in the hospital overnight. When you return home, you should relax for a few days, but you can usually return to regular activities within a week. Your doctor will likely prescribe medications, including a blood thinning medication, to reduce your risk for clots.
You will need to speak with your doctor about the frequency of your follow-up visits; they will tell you how often you’ll need to come back for imaging tests to confirm that the stent is still in place and working properly.
- Angiotensin-converting enzyme (ACE) inhibitors: ACE inhibitors help lower blood pressure, reducing the risk of heart damage. They can be taken indefinitely to treat existing problems and can also be used to prevent cardiac problems from developing.
- Angiotensin receptor blockers (ARBs): ARBs help lower blood pressure, reducing the risk of heart damage. They can be taken indefinitely to treat existing problems and can also be used to prevent cardiac problems from developing.
- Antibiotics: When bacterial infection affects the heart, antibiotics help kill bacteria and create an environment in which it is difficult for bacteria to live. Antibiotics are typically prescribed in acute situations and will be taken for a limited amount of time.
- Beta blockers: These medicines are used to block the effects of adrenaline on the heart by slowing the heart rate and lessening the force of heart contractions. Beta blockers are used to treat many cardiovascular conditions, and they can be taken long-term. In adults ages 65 and older, they’re often prescribed indefinitely.
- Calcium channel blockers: These medicines block calcium channels to the heart cells, which slows the heart rate to help manage arrhythmia, an irregular heartbeat. Calcium channel blockers can be taken indefinitely.
- Nitrates: These medicines are prescribed to help your heart get more oxygen-rich blood to reduce or stop chest pain. Nitrates are taken as needed when you experience chest pain or tightness. You can also take them proactively before participating in an activity that may cause chest pain.
- Diuretics: These medicines, which can be used alone or with other medicines, help treat high blood pressure or fluid buildup in the tissues. Diuretics force the kidneys to produce excess urine. When you urinate, this removes extra salt and fluid. Diuretics are safe for long-term use.
- Sodium-glucose cotransporter-2 (SGLT-2) inhibitors: These medicines help manage heart failure by lowering blood pressure and body weight and improving blood sugar levels. SGLT-2 inhibitors can help prevent heart failure in patients with type 2 diabetes. They are safe to be taken long-term.
A coronary artery bypass grafting procedure, also known as a heart bypass, is an open-heart surgical procedure used to bypass arteries blocked by plaque.
During a CABG procedure, a patient is placed under general anesthesia and a heart/lung bypass machine takes over the function of these organs.
A cardiothoracic surgeon begins the procedure by surgically opening the chest and breaking the sternum to access the heart. From there, a blood vessel from another part of the body, often the leg, is placed into the heart and used to bypass, or replace, an artery blocked by plaque buildup. A single bypass procedure may be used to bypass multiple blocked arteries at one time.
Once the procedure is complete, the sternum is closed back up and wired together for stability. Then, the chest is stitched closed.
Following a heart bypass, the patient will be closely monitored in a cardiovascular intensive care setting for a day or two and then will be moved to a regular room for additional monitoring and recovery. Most patients can be discharged from the hospital within a few days to a week.
Recovery at home after a CABG procedure can take from several months to a year, and careful precautions are needed as the sternum heals.
