Early treatment for a heart attack can prevent or limit damage to the heart muscle. Acting fast, by calling 9–1–1 at the first symptoms of a heart attack, can save your life. Medical personnel can begin diagnosis and treatment even before you get to the hospital.

Immediate treatment:

Certain treatments are usually started right away if a heart attack is suspected, even before the diagnosis is confirmed. These include:

•           Aspirin to prevent further blood clotting;

•           Nitroglycerin to reduce your heart’s workload and improve blood flow through the coronary arteries;

•           Oxygen therapy;

•           Treatment for chest pain.

Your doctor may prescribe one or more of the following medicines:

•           ACE inhibitors. ACE inhibitors lower blood pressure and reduce strain on your heart. They also help slow down further weakening of the heart muscle.

•           Anticlotting medicines. Anticlotting medicines stop platelets from clumping together and forming unwanted blood clots. Examples of anticlotting medicines include aspirin and clopidogrel.

•           Anticoagulants. Anticoagulants, or blood thinners, prevent blood clots from forming in your arteries. These medicines also keep existing clots from getting larger.

•           Beta-blockers. Beta-blockers decrease your heart’s workload. These medicines are also used to relieve chest pain and discomfort and to help prevent another heart attack. Beta-blockers also are used to treat arrhythmias (irregular heartbeats).

•           Statin medicines. Statins control or lower your blood cholesterol. By lowering your blood cholesterol level, you can decrease your chance of having another heart attack or stroke.

You also may be given medicines to relieve pain and anxiety, and treat arrhythmias. Take all medicines regularly, as your doctor prescribes. Don’t change the amount of your medicine or skip a dose unless your doctor tells you to.

Once the diagnosis of a heart attack is confirmed or strongly suspected, doctors start treatments promptly to try to restore blood flow through the blood vessels supplying the heart. The two main treatments are clot-busting medicines and percutaneous coronary intervention, also known as coronary angioplasty, a procedure used to open blocked coronary arteries.

Other treatments for heart attack:

The treatment options for a heart attack depend on whether you've had an ST-segment elevation myocardial infarction (STEMI), or another type of heart attack.

An ST-segment elevation myocardial infarction (STEMI) is the most serious form of heart attack and requires emergency assessment and treatment. It's important you're treated quickly, to minimize damage to your heart after a STEMI.

If you have symptoms of a heart attack and an electrocardiogram (ECG) shows you have a STEMI, you'll be assessed for treatment to unblock your coronary arteries.

The treatment choice depends on the time when your symptoms started and on how soon you can access treatment.

•           If your symptoms started within the past 12 hours – you'll usually be offered primary percutaneous coronary intervention (PCI).

•           If your symptoms started within the past 12 hours, but you cannot access PCI quickly – you'll be offered medicine to break down blood clots.

•           If your symptoms started more than 12 hours ago – you may be offered a different procedure, especially if your symptoms have improved. The best course of treatment will be decided after an angiogram and may include medicine, PCI or bypass surgery.

•           If a PCI isn’t suitable for you – you may be offered a combination of medicines to prevent blood clots, called antiplatelet medicines.

Primary percutaneous coronary intervention (PCI):

Primary percutaneous coronary intervention (PCI) is the term for emergency treatment of a STEMI. It's a procedure to widen the coronary artery (coronary angioplasty).

Coronary angiography is done first, to assess your suitability for PCI.

You may also be given blood-thinning medicines to prevent further clots from forming, such as low-dose aspirin.

You may need to continue taking medicines for some time after PCI.

Coronary angioplasty:

Coronary angioplasty is a potentially complex procedure that requires specialist staff and equipment, and not all hospitals have the facilities.

This means you'll need to be taken urgently, by ambulance. During coronary angioplasty, a tiny tube with a sausage-shaped balloon at the end (a balloon catheter) is put into a large artery in your groin or arm. The catheter is passed through your blood vessels and up to your heart, over a fine guidewire, using X-rays to guide it.

Once the catheter is in the narrowed section of your coronary artery, the balloon is inflated to open it. Flexible metal mesh (a stent) is usually inserted into the artery to help keep it open afterward.

Medicines that prevent blood clots:

There are two types of medicines to prevent blood clots. These are called antiplatelets and anticoagulants and are usually taken as a tablet. They make blood flow through your veins more easily. This means your blood will be less likely to form a clot.

Medicines that break down blood clots:

Medicines used to break down blood clots, known as thrombolytics or fibrinolytics, are usually given by injection.

Thrombolytics, or fibrinolytics, target and destroy a substance called fibrin. Fibrin is a tough protein that makes up blood clots by acting as a sort of fiber mesh that hardens around the blood.

You may also be given a medicine called a glycoprotein IIb/IIIa inhibitor if you have an increased risk of experiencing another heart attack in the future.

Glycoprotein IIb/IIIa inhibitors do not break up blood clots, but they prevent blood clots from getting bigger. They're an effective method of stopping your symptoms from getting worse.

Coronary artery bypass graft:

Coronary angioplasty may not be technically possible if the anatomy of your arteries is different from normal. This may be the case if there are too many narrow sections in your arteries, or if there are lots of branches coming off your arteries that are also blocked.

In such circumstances, an alternative operation, known as a coronary artery bypass graft (CABG), may be considered.

A CABG involves taking a blood vessel from another part of your body (usually your chest, leg or arm) and attaching it to your coronary artery above and below the narrowed area or blockage. This new blood vessel is known as a graft.

The graft diverts blood around narrowed or clogged parts of your major arteries to improve blood flow and oxygen supply to your heart.

Treating non-ST segment elevation myocardial infarction (NSTEMI) and unstable angina:

If an ECG shows you have an NSTEMI or unstable angina (the "less serious" types of heart attack), blood-thinning medicine, including aspirin and other medicines, is usually recommended.

In some cases, further treatment with coronary angioplasty or coronary artery bypass graft (CABG) may be recommended in cases of NSTEMI or unstable angina, after initial treatment with these medicines.