Myocardial Infarction

WHAT YOU SHOULD KNOW:

• A myocardial infarction (MI) is a heart attack. A heart attack happens when the blood vessels that supply blood to your heart (coronary arteries) are blocked. This causes areas of your heart muscle to die.
  
  
• Chest pain is the most common symptom. Your chest may feel tight or heavy. You may feel pressure, crushing, squeezing, or burning. The discomfort may spread to your neck, jaw, shoulders, back, or arms. You may also have heartburn, shortness of breath, and you may feel sweaty. Women, older adults, and people with diabetes or a history of heart failure may not have typical chest pain or pressure. They may have shortness of breath and no other symptoms. Some people have no symptoms at all. This is called a silent MI.

AFTER YOU LEAVE:

Medicines:

Ask your cardiologist about these and other medicines you may need:

• Angiotensin-converting enzyme inhibitors: These medicines are called ACE inhibitors. They help relax your blood vessels so your heart can get the blood it needs. You may need angiotensin II receptor blockers (ARBs) if you cannot take ACE inhibitors.
  
  
• Aldosterone antagonists: These medicines helps remove extra fluid from your body and protects your heart from more damage.
  
  
• Beta blockers: These medicines help you have a steady and regular heartbeat.
  
  
• Calcium channel blockers: These medicines help slow your heartbeat. They also help open up small blood vessels. This can relieve chest pain, control an abnormal heartbeat, and decrease blood pressure.
  
  
• Nitroglycerin: This medicine may also be called nitro.
  
  
  • Nitroglycerin opens the arteries to your heart so the heart gets more oxygen. After taking nitroglycerin, your pain may get better or go away. Nitroglycerin may give you a headache or make you dizzy. Make sure you are sitting or lying down when you take your nitroglycerin. Also, get up slowly after taking nitroglycerin.
    
    
  • You may get your nitroglycerin as a pill. It also can be put on your body as a patch or paste. If you are taking nitroglycerin pills, put the nitroglycerin pill under your tongue. It slowly melts and moves into your blood. If you are using a nitroglycerin patch or paste, put the patch or paste on your chest, arm, or back. The medicine soaks through your skin and goes into your blood.
  
  
• Aspirin: You may need to take an aspirin a day to help prevent heart problems. Aspirin helps to prevent blood clots from forming and causing blood flow problems in the heart. If caregivers want you to take aspirin daily, do not take acetaminophen or ibuprofen instead. Do not take more or less aspirin than caregivers say to take. If you are on other blood thinner medicine, ask your caregiver before you take aspirin for any reason.
  
  
• Blood thinners: Blood thinners are medicines that help prevent blood clots from forming. Clots can cause strokes, heart attacks, and death. Blood thinners make it more likely for you to bleed or bruise. If you are taking a blood thinner:
  
  
  • Watch for bleeding from your gums or nose. Watch for blood in your urine and bowel movements. Use a soft washcloth on your skin and a soft toothbrush on your teeth. This can keep your skin and gums from bleeding. If you shave, use an electric shaver. Do not play contact sports, such as football.
    
    
  • Be aware of what medicines you take. Many medicines cannot be used when taking medicine to thin your blood. Tell your dentist and other caregivers that you take blood-thinning medicine. Wear or carry medical alert information that says you are taking this medicine.
    
    
  • Take this medicine exactly as your primary healthcare provider tells you. Tell him right away if you forget to take the medicine, or if you take too much. You may need to have regular blood tests while on this medicine. Your primary healthcare provider uses these tests to decide how much medicine is right for you.
    
    
  • Talk to your primary healthcare provider about your diet. This medicine works best when you eat about the same amount of vitamin K every day. Vitamin K is found in green leafy vegetables and other foods, such as cooked peas and kiwifruit.
  
  
• Cholesterol medicine: This medicine decreases the amount of plaque in the blood.
  
  
• Take your medicine as directed. Call your primary healthcare provider if you think your medicine is not helping or if you have side effects. Tell him if you are allergic to any medicine. Keep a list of the medicines, vitamins, and herbs you take. Include the amounts, and when and why you take them. Bring the list or the pill bottles to follow-up visits. Carry your medicine list with you in case of an emergency.

Cardiac rehabilitation:

Cardiac rehabilitation (rehab) is a program run by specialists who will help you safely strengthen your heart and prevent more heart disease. The plan includes exercise, relaxation, stress management, and heart-healthy nutrition. Caregivers will also check to make sure any medicines you are taking are working. The plan may also include instructions for when you can drive, return to work, and do other normal daily activities.

Follow up with your primary healthcare provider or cardiologist within 14 days:

Ask for information about continuing care, treatments, and home services. Write down your questions so you remember to ask them during your visits.

Lifestyle changes:

• Eat a heart healthy diet: Get enough calories, protein, vitamins, and minerals to help prevent poor nutrition and promote muscle strength. You may be told to eat foods low in cholesterol or sodium (salt). You also may be told to limit saturated and trans fats. Eat foods that contain healthy fats, such as walnuts, salmon, and canola and soybean oils. Eat foods that help protect the heart, including plenty of fruits and vegetables, nuts, and sources of fiber.
  
  
• Do not smoke: Smoking increases your risk of blood vessel disease and an MI. Smoking causes lung cancer and other long-term lung diseases.
  
  
• Return to daily activities as directed: Talk to your cardiologist (heart specialist) before you drive. Ask him when you can go back to work and when you can have sex. Ask when you can climb stairs, do house or yard work, and how much you can lift.
  
  
• Get vaccinated: Get an influenza (flu) vaccine every year as soon as it is available. The vaccine will help prevent the flu. Ask about other vaccinations you may need.
  
  
• Exercise as directed: Exercise makes your heart stronger, lowers blood pressure, and helps prevent an MI. Begin with easy exercises, such as walking. Avoid intense exercise. The goal is 30 to 60 minutes a day, 5 to 7 days a week.
  
  
• Manage your weight: If you are overweight or obese, you may need to lose weight. Weight loss can decrease your risk of an MI. The goal for women is a waist size less than 35 inches around. The goal for men is a waist size less than 40 inches around. Ask your cardiologist if you need to lose weight and how much you should lose. Ask him about the best plan for you to lose weight.
  
  
• Manage your stress: Stress may slow healing and lead to illness. Learn ways to control stress, such as relaxation, deep breathing, and music. Talk to someone about things that upset you.

For support and more information:

• American Heart Association
  7272 Greenville Avenue
  Dallas , TX 75231-4596
  Phone: 1- 800 - 242-8721
  Web Address: http://www.heart.org
  

• National Heart, Lung and Blood Institute
  Health Information Center
  P.O. Box 30105
  Bethesda , MD 20824-0105
  Phone: 1- 301 - 592-8573
  Web Address: http://www.nhlbi.nih.gov/health/infoctr/index.htm
  

Contact your primary healthcare provider or heart specialist if:

• You have trouble taking your heart medicine.
  
  
• You have questions or concerns about your condition or care.

Seek care immediately or call 911 if:

• Call 911 or an ambulance if you have any signs of a heart attack:
  
  
  • Discomfort in the center of your chest that feels like squeezing, pressure, fullness, or pain, that lasts for more than a few minutes or keeps returning
    
    
  • Discomfort or pain in your back, neck, jaw, stomach, or one or both of your arms
    
    
  • Feeling sick to your stomach
    
    
  • Having trouble breathing
    
    
  • A sudden cold sweat, particularly in combination with chest discomfort or trouble breathing
    
    
  • Feeling very lightheaded or dizzy, particularly in combination with chest discomfort or trouble breathing
  
  
• You are tired and cannot think clearly.
  
  
• Your heart is beating faster than usual.
  
  
• You are bleeding from your gums or nose.
  
  
• You see blood in your urine or bowel movements.
  
  
• You urinate less than usual or not at all.
  
  
• You have new or increased swelling in your feet or ankles.

Learn more about Myocardial Infarction (Discharge Care)