Heart Attack Treatment

对被诊断患有艾滋病的人的治疗 heart attack can be complex. We hope this section on heart attack treatments will help you talk with your health care team about your treatment plan.

一定要说出你可能有的任何问题或担忧.

常见的心脏病发作类型和治疗方法

心脏病发作的类型(也称为心肌梗塞), (MI)决定了你的医疗团队会推荐的治疗方法. A heart attack occurs when a blockage in one or more heart (coronary) arteries reduces or stops blood flow to the heart, 哪一种使部分心肌缺氧.

堵塞可能是完全的或部分的:

• A complete blockage of a coronary artery means you suffered a “STEMI” heart attack or ST-elevation MI.
• 部分阻塞是一种“非stemi”心脏病发作或非st段抬高型心肌梗死.

Treatments differ for a STEMI versus NSTEMI heart attack, although there can be some overlap.

Hospitals use techniques to restore blood flow to the part of the heart muscle damaged during your heart attack:

• 你可能会接受溶血栓药物(溶栓), balloon angioplasty, 手术或综合治疗.
• 然而，并不是所有的美国医院.S. are equipped to use a procedure called percutaneous coronary intervention (PCI), 一种治疗心脏病发作的机械方法. 

在一家能做PCI的医院, you would likely be sent to an area that specializes in cardiac catheterization, sometimes called a “cath lab.” There, a diagnostic angiogram can examine blood flow to your heart and reveal how well your heart is pumping. 取决于手术的结果, 你可能会接受以下三种治疗之一:药物治疗, PCI或冠状动脉旁路移植术.

A hospital that is not equipped to perform PCI might transfer you to one that is. Or your medical team may decide to administer drugs to break down a clot and restore blood flow. You might be given an angiogram ‒ an imaging technique used to see inside your arteries, veins and heart chambers. 接下来可能会进行手术以恢复心脏的血液循环.

如果医疗团队确定你有非stemi心脏病发作, 他们通常使用两种治疗策略中的一种. 两者都可能涉及到一个称为 cardiac catheterization 检查你的内心:

• The ischemia-guided strategy uses blood thinners to stop a blood clot from forming.
• The early invasive strategy starts with the use of blood thinners to stop blood clot from forming, 但也可能进行药物治疗, PCI支架植入或冠状动脉旁路移植术(CABG), 其次是某些类型的院后护理.

你的医疗团队可以向你解释治疗心脏病的方法. 他们可以回答你可能有的任何具体问题.

心脏病发作后的常见医疗程序

你会发现这里列出了许多治疗心脏病的常见医疗程序. 有关这些治疗方法的更详细解释，请参阅我们专门用于 cardiac procedures.

• Angioplasty: Special tubing with an attached deflated balloon is threaded up to the coronary arteries. The balloon is inflated to widen blocked areas where blood flow to the heart muscle has been reduced or cut off.
• Laser angioplasty: Similar to angioplasty except the catheter has a laser tip that opens the blocked artery.
• Heart valve surgery: 修复不正常或患病的心脏瓣膜或用健康的瓣膜代替.
• Atherectomy: Similar to angioplasty except the catheter has a special tool on its tip to cut away plaque from the artery.
• Bypass surgery: Treats blocked heart arteries by creating new pathways around the clot so blood can flow to your heart muscle.
• 微创心脏手术: 使用小切口的标准搭桥手术的替代方案.
• Stent procedure: A stent is a wire mesh tube that is placed during angioplasty to hold open an artery and restore blood flow.
• 心肌血管重建术(TMR): A laser is used to drill a series of holes from the outside of the heart into the heart’s pumping chamber.

除了以上的治疗方法，你可能还听说过 implantable medical devices 用于治疗增加心脏病发作风险的某些疾病.

Types of medications

心脏病发作的治疗涉及多种药物. 下面的列表提供了常见类型的概述. You can also learn about cardiac medications in more detail.

Your health care team will recommend the best combination of medications for your situation.

• Anticoagulant: Sometimes called blood thinners, these medicines make it harder for clots to form and also keep existing blood clots from getting larger.
• Antiplatelet agent: Keeps blood clots from forming by preventing blood platelets from sticking together.
• 血管紧张素转换酶(ACE)抑制剂 Relaxes blood vessels and allows them to expand while decreasing resistance by lowering levels of angiotensin II. Allows blood to flow more easily and makes the heart’s work easier or more efficient.
• Angiotensin II receptor blocker: These medicines inhibit angiotensin II from having effects on the heart and blood vessels. 这可以防止血压升高.
• 血管紧张素受体奈普利素抑制剂; Neprilysin is an enzyme that breaks down natural substances in the body that open narrowed arteries. By inhibiting neprilysin, those natural substances can have their normal effect. 这样可以促进动脉张开和血液流动, 减少钠(盐)潴留，减少对心脏的压力.
• Beta blocker: 使心跳更慢，力更小，从而降低血压.
• Combined alpha and beta blocker: Combined alpha and beta blockers may be used as an IV drip for people in hypertensive crisis. They may be prescribed for outpatient high blood pressure use if the person is at risk for heart failure.
• Calcium channel blocker: Interrupts the movement of calcium into the cells of the heart and blood vessels. 可能会降低心脏的泵送强度和放松血管.
• Cholesterol-lowering medications: 各种药物可以降低血液中的胆固醇水平, 但他汀类药物是最好的首选药物. When statins don’t work, 或者如果一个人有严重的他汀类药物治疗副作用, other drugs may be recommended.
• Vasodilator: Relaxes blood vessels and increases the supply of blood and oxygen to the heart while reducing its workload. Available as pills to be swallowed, chewable tablets and as a topical application (cream).

Dual Antiplatelet Therapy (DAPT)

有些人有心脏病, 在冠状动脉中植入支架, or undergo coronary artery bypass graft surgery (CABG) are treated with two types of antiplatelet agents at the same time to prevent blood clotting. 这被称为双重抗血小板治疗(DAPT).

One antiplatelet agent is aspirin. 很多人患有冠状动脉疾病, 包括那些心脏病发作过的人, 支架或冠脉搭桥的患者在他们的余生中都要服用阿司匹林. 第二种类型的抗血小板药物，称为P2Y₁₂ inhibitor, is usually prescribed for months or years in addition to the aspirin therapy.

The type of medication and the duration of your treatment will vary based on your condition and other risk factors. The risks and benefits of DAPT should be discussed with your health care professional.

如果你心脏病发作，植入了冠状动脉支架, 或者你正在接受药物治疗(没有支架), clot buster or surgery), in addition to aspirin, you should speak with your health care professional about taking a P2Y₁₂ inhibitor for 6-12 months. 在某些情况下，建议使用更长线上电子游戏飞禽走兽的DAPT. 

医生可能会给你开以下药物之一:氯吡格雷, ticlopidine, prasugrel, ticagrelor or cangrelor. You will be prescribed the drug that is best for you, based on your risk of blood clots and bleeding. The choice of what type of medication and duration of treatment will be determined in discussions with your health care professional.