Treatment Standards for Heart Attack

A heart attack (also called an acute myocardial infarction, or AMI) occurs when arteries supplying blood to the heart are blocked. Without blood and oxygen, part of the heart starts to die. Quick treatment can restore blood flow to the heart and save a life.

It is important for heart attack patients to receive all the recommended treatments at appropriate times. These recommended treatments are the basis for the national standards.

Patients who have had a heart attack should receive certain medications and treatment when they arrive or shortly after they arrive at the hospital. The measures listed below describe standard treatments that should be given to all patients who enter the hospital with symptoms of a heart attack.

Standard: Give aspirin within 24 hours of heart attack.

  • Patients who receive an aspirin within 24 hours of the heart attack, before or after hospital arrival, are not as likely to develop blood clots. The aspirin can also help dissolve blood clots that can cause heart attacks.

Standard: Give ACE (angiotensin-converting enzyme) inhibitors and ARBs (angiotensin receptor blockers) — medicines used to treat heart attacks, heart failure or a decreased function of the heart.

  • These drugs block an enzyme that causes blood vessels to narrow, and they help lower blood pressure by reducing the amount of salt and water in the body. Years of research have shown that giving these medications to patients as soon as possible after a heart attack improves their chances of surviving the attack.

Standard: Give a beta-blocker within 24 hours of hospital arrival.

  • Beta-blockers are drugs that lower blood pressure, treat chest pain (angina) and heart failure, and help prevent a heart attack. Giving a beta-blocker within 24 hours after hospital arrival can reduce the severity and complications of a heart attack.

Standard: Give thrombolytic medicine or percutaneous coronary interventions (PCI) within two hours of arrival.

  • Thrombolytic (“clot-busting”) drugs and PCI procedures are used to open blocked blood vessels that cause heart attacks. Doctors may perform a PCI procedure or give medicine to open the blockage; in some cases they do both. These treatments are most effective when they are given within two hours of the heart attack.
  • Patients who have been hospitalized for a heart attack should receive certain education and medications when they are discharged.

Standard: Give advice on how to quit smoking.

  • Smoking is a major risk factor for heart attack. Patients who receive advice and encouragement about how to stop smoking are more likely to quit. In many cases, when patients quit smoking they reduce their chances of having another heart attack.

Standard: Prescribe aspirin at discharge.

  • Continued use of aspirin after discharge has been shown to reduce the risk of long-term problems and death.

Standard: Prescribe beta blocker medication at discharge.

  • Continued use of beta blockers after discharge has been shown to reduce the risk of long-term problems and death.