How are heart attacks treated?

Hi I'm Sukh Vijay and I'm an interventional cardiologist working in central London and I specialize in the treatment of heart attacks. Heart attacks are a really important condition in which one of the heart arteries has blocked suddenly causing central chest tightness and pressure and it needs to be treated by opening up the heart artery. Patients should call for an ambulance and should be taken to a heart attack assessment center directly. There we will assess you to see the type of heart attack that you're having and to identify what treatments we need to give you. Treatments can include giving you spray of GTN or glycerol trinitrate underneath your tongue, giving you medicines which thin the blood like aspirin and often a second blood thinner like clopidogrel, prazugrel or ticagrelol and then we make an assessment for whether you need to have an angioplasty immediately or which can be delayed within a few hours or days. In the case of those heart attacks where the artery has blocked completely there are certain changes on the ECG that we refer to as ST elevation and it's essential to have an ECG done promptly at the time of symptoms so we can stratify and identify those patients as fast as possible. If we do need to perform an angiogram procedure that's something that we do immediately and we will talk to you about it and offer that to you and we generally recommend that if you're suitable for having it that this does represent the best type of treatment that we have available to stop heart attacks. It typically involves passing a tube up from the wrist up into the heart and then taking a look at the heart arteries and identifying the blockage. We can do this very quickly under local anaesthesia and it doesn't require you to be under a general anaesthetic and it's a procedure that you can even watch on the computer screen while we're doing it. We will pass a tube that will feel slightly uncomfortable as it passes through the arm but beyond the elbow most patients don't feel very much. Once we get into the heart, we then inject very small amounts of dye into the heart arteries so we can see the blood vessels and see what the problem is, which artery has blocked. Once we've identified which vessel is causing the trouble, we will then pass very thin wires through the artery to unblock the artery, then use balloons to stretch the artery and then place a stent to keep the artery open. Once a procedure is performed, we typically then place a bandage on the wrist or in the small number of cases that we have to go through the leg then we may use a special device to stop the bleeding from the leg. You'll then go up to a coronary care unit which is a special place in the hospital in which we have highly specialist nurses that are used to treating patients who've had a heart attack and will need to monitor your heart on a special ECG monitor for at least 24 hours. After a heart attack most patients need a lot of different medications and they all serve different purposes and explain that to you. After a heart attack patients need to have cardiac rehabilitation which is a gradual reintroduction into normal life and activity and we will talk you through that process. Most heart attack patients need some follow-up and that really depends on the type of heart attack you've had and your progress. In many cases in the modern era we're actually able to get patients back into a fully active and normal life even after a significant heart attack. So, if you think you're having a heart attack, remember to pick up the phone and call for 999. The modern treatment of heart attack requires you to have prompt blood thinning medications and, if appropriate, immediate procedure called angiogram and an angioplasty to open up the blocked artery. Thanks for listening.