Immediately clearing the blockage from the artery improves the chances of survival for some patients.

Angioplasty and stent placement, in which the artery is widened from within and a metal coil is left in place to keep it open, may be performed. If angioplasty isn't available, doctors may administer thrombolytic or fibrinolytic ("clot-busting") drugs such as streptokinase, tenectoplase, reteplase, or alteplase intravenously. These drugs may be given up to 12 hours after the patient arrives at the hospital. However, because these drugs can cause bleeding, they aren't appropriate for every heart attack patient.

Coronary artery bypass grafting (CABG) surgery may be preferred to angioplasty or clot-busting drugs for some patients, including those who have a bleeding disorder or who have had recent surgery or a stroke, and those with very severe arterial disease.

Drug Treatment
At the hospital, a number of different drugs may be administered.

• Aspirin helps reduce the size of the clot
• Clopidogrel, another blood thinner, may be given instead of, or in addition to, aspirin
• Anticoagulants, such as heparin, prevent the formation of additional blood clots
• Oxygen helps minimize tissue damage
• Beta-blockers slow the heart down so it doesn't have to work so hard
• Morphine has a calming effect and reduces the workload of the heart
• Nitroglycerin relieves pain by reducing the heart's workload and possibly by dilating the arteries
• ACE inhibitors can reduce heart enlargement by lowering blood pressure.

Complications
Heart Failure and Pumping Problems
The complications of heart attacks depend on how much and how long the coronary artery was blocked. The scar tissue that replaces dead heart muscle tissue can't pulsate the way normal heart tissue does. If a large amount of muscle tissue dies, the heart will no longer be able to pump effectively. If more than half of the heart tissue is damaged or dies, severe disability or death is likely.

A damaged heart may become larger to compensate for the decrease in its pumping ability. In most muscles, enlargement means greater strength, but this is not the case with the heart. An enlarged heart is weaker and more stressed, and it's more likely to have arrhythmias, or abnormal heart rhythms.

Arrhythmias
Arrhythmias occur in more than 90% of people who have had a heart attack, caused by damage to part of the heart's electrical system. Arrhythmias may cause the heart to beat too slowly, too quickly, or irregularly. They can even cause the heart to stop beating altogether (cardiac arrest).

Other possible complications are:

• Pericarditis, or inflammation of the membranes around the heart
• Rupture of the heart muscle
• Ventricular aneurysm, a bulge in the wall of the ventricle
• Blood clots
• Low blood pressure
• Shock

More on this topic

Understanding Heart Attacks (VIDEO)
Your Heart Needs Blood
Your Beating Heart
Atherosclerosis & Cholesterol
Angina & Coronary Heart Disease
Heart Attack Symptoms
What Is a Heart Attack?
Risk Factors & Diagnosis
Treating Heart Attacks
Restoring Blood Flow
Rehabilitation

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Aneurysm and Stent, Angioplasty, Arrhythmia, Cardiovascular Continuum, Cholesterol and Atherosclerosis, Coronary Bypass Surgery, Heart Attack and Angina, Hypertension, Stroke, Thrombosis and Embolism, Women and Cardiovascular Health