Treatment for a heart attack should be administered as soon as possible. Damage to heart tissue can be minimized with prompt treatment, improving the chance of survival. Heart attack medications are designed to restore blood flow, lower blood pressure, and dissolve blood clots. Medications such as beta blockers, calcium channel blockers, and ACE inhibitors reduce blood pressure, while aspirin and heparin thin the blood and reduce the risk of blood clot formation.
Beta Blockers and Heart Attack Medication
Beta blockers relax the heart by lowering the heart rate and reducing arterial blood pressure. Both of these actions reduce the heart’s demand for oxygen. By lowering the heart’s oxygen requirements, beta blockers reduce the amount of heart tissue that is damaged during an acute myocardial infarction (AMI). Beta blockers have also been shown to prevent future heart attacks.
Not everyone can take beta blockers, however. People with asthma, bradycardia (low heart rate), and heart block should not take beta blockers.
ACE Inhibitors (angiotensin converting enzyme inhibitors) reduce strain on the heart by reducing blood pressure. Because of this property, ACE inhibitors are often used to treat heart failure. ACE inhibitors are also sometimes prescribed after heart attacks and have proven to increase the chances of survival. ACE inhibitors are not recommended, however, for use by patients with renal failure or hypotension (low blood pressure).
Calcium Channel Blockers
Calcium channel blockers also lower blood pressure and prevent coronary artery spasm. By relaxing the artery muscle walls, calcium channel blockers dilate arteries and promote blood flow.
Aspirin and Blood Flow
Aspirin thins the blood, lowering the risk of blood clots. Some medical professionals even recommend aspirin as an early treatment for a heart attack. People with coronary artery disease are often prescribed a low daily dose of aspirin to prevent clotting and maintain blood flow. Although it is available as an over-the-counter medication, aspirin should only be used for heart disease on the advice of a doctor. Aspirin can exacerbate some medical conditions and cause adverse reactions with other drugs.
Heparin promotes blood flow by preventing and dissolving blood clots. It is used along with some thrombolytic medications, described below. It is also used in patients at very high risk of developing clots after an AMI. Heparin works quickly, but must be administered intravenously and carefully monitored. In most cases, patients on heparin must be hospitalized.
When an AMI is detected very early, it may be treated with a “clot buster” drug that quickly dissolves the clot and restores blood flow to the heart. Only heart attacks caused by blood clots will benefit from this type of thrombolysis medication. Medications such as tPA and streptokinase are thrombolytics. These medications are best administered within thirty minutes of a heart attack. Thrombolytic medications are not suitable for a patient with gastrointestinal bleeding, a recent operation, uncontrolled hypertension, or history of a hemorrhagic stroke. Thrombolytic medications thin the blood which would aggravate the conditions listed here.
Medication can only do so much: advanced heart disease may require surgical interventions. Coronary bypass surgery and percutaneous (through the skin) coronary artery interventions are sometimes required to lower the risk of heart attacks.