Chewable aspirin 325mg tablet, if not taken previously.
Loading dose of clopidogrel tablets (another antiplatelet drug like aspirin).
Vitals are checked periodically (Blood pressure, pulse, respiration).
If there are no contraindications, then patient is immediately put on blood thinning treatment viz: streptokinase after obtaining due consent.
Sometimes ancillary treatment like artificial ventilators/IABP may also be required depending on the condition.
Blood thinners try to dissolve the clot in the occluded coronary artery. Practically they achieve success in only 25-30% of cases and there is always a chance of clot reformation which can lead to second heart attack.
Sometimes blood thinners can lead to bleeding cmplications also, some of which can be serious also like bleeding in brain.
ACUTE HEART ATTACK
Treatment in hospital Cardiac centre:
Patient should preferably be taken to a heart hospital if it is possible without losing time.
Reason for this is that heart hospital can provide definitive therapy in the form of primary angioplasty.
What is Primary angioplasty ?
Primary angioplasty means patient is taken up for coronary angiogram immediately with intention to open up 100% blocked coronary artery. Special catheter systems are available for clot (thrombus) removal. Then the baseline plaque (blockage) is compressed with a balloon which is dilated at the site of blockage and task usually needs to be finished by deploying a stent (small coiled wire mesh) which prevents the narrowing of artery again.
Requirements-24 hours cath lab and surgeon support.
24 hours dedicated cardiologist services.