Patient information Your heart attack procedure explained i Important information for all patients. Golden Jubilee National Hospital Agamemnon Street Clydebank, G81 4DY (: 0141 951 5000 www.nhsgoldenjubilee.co.uk Reviewed: June 2015 Next review: June 2016 Version 5
About this booklet The purpose of this booklet is to give you information about the heart attack (or myocardiac infarction) that you have suffered. Our role is to treat your blocked artery as quickly as possible before sending you back to your local hospital for recovery. What is myocardiac infarction? Most heart attacks occur as a result of coronary heart disease (CHD). Coronary heart disease occurs when the coronary arteries (the arteries that supply blood and oxygen to the heart muscle) become narrowed by a gradual build-up of fatty materials within their walls. This fatty material is called atheroma or plaque. If the plaque becomes unstable, it may lead to a blood clot forming. If the blood clot blocks the coronary artery, the heart muscle is starved of blood and oxygen, and may become permanently damaged. This is called a heart attack. A heart attack is sometimes called acute coronary syndrome, myocardial infarction or coronary thrombosis. A Coronary artery (supplies blood and oxygen to heart muscle) Coronary artery B Blocked blood flow Plaque buildup in artery Healthy heart muscle Blood clot blocks artery Heart muscle Dead heart muscle 2
Sometimes clot busting drugs called thrombolytics are given to dissolve the clot. However, it is now more common to be treated with coronary angioplasty also known as Percutaneous Coronary Intervention (PCI) to open the artery and get the blood flow back to the heart muscle. When PCI is performed in an emergency situation like this, it is called Primary PCI. If the initial treatment has involved thrombolytic drugs and they have not worked effectively, you may undergo Rescue PCI to ensure the artery is effectively opened. Both of these emergency heart attack PCI procedures will be carried out in a specialised area called the Cardiac Catheterisation Laboratory (Cath Lab) by a team of doctors, nurses, radiographers and cardiac physiologists. What is PCI? Percutaneous Coronary Intervention (PCI) with or without a stent is a treatment to widen or unblock the artery. The procedure is performed via the radial artery (in your arm) or femoral artery (at the top of your leg) using specialist equipment designed to deal with coronary artery disease. Heart Plaque Balloon/stent positioned Balloon/stent expanded 3
Other treatments you may have: The doctors or nurses may also give you a combination of drugs which could include: Statins Beta-blockers, or ACE inhibitors. The ambulance staff or hospital doctors will already have given you aspirin. You will also be prescribed a drug to take regularly to reduce the risk of blood clots. It is very important that you take these tablets as prescribed by your cardiologist. This combination of Primary or Rescue PCI and drug treatment will help to: improve the blood supply through your coronary artery; ease your chest pain; and reduce the risk of ongoing damage to your heart muscle. Transfer to your local hospital You will usually be transferred back to your local hospital within 12-24 hours of your procedure and can expect to stay there for a further day or two. Before you go home, you will be referred to a cardiac rehabilitation programme. Cardiac Rehabilitation Some people think that, because they were in and out of hospital so quickly, their heart attack was not a serious event and they need not attend the cardiac rehabilitation programme. All heart attacks are serious and it is important that you attend the programme so that you can make any changes to your lifestyle to help to protect your heart in the future. 4
Driving By law, you must not drive for up to four weeks following your heart attack. You should only start driving again when your doctor tells you that it is safe to do so. The following link will provide you with more information: https://www.gov.uk/government/uploads/ system/uploads/attachment_data/file/232964/at_a_glance.pdf Coming to terms with a heart attack A heart attack can be a frightening experience, especially if you have, until now, enjoyed excellent health. While in hospital, many people react with fear and anxiety, possibly made worse by pain and the distress of being surrounded by machines in an unfamiliar environment. When the early hours of the heart attack are safely over, most people usually feel less anxious. Some people may start to feel anxious again when they are transferred to their local hospital. At your local hospital, there are many new people to get to know and there may not be the same intense observation by hospital staff. But moving to your local hospital means doctors feel that the period of danger has passed and that the treatment has been effective. Many people feel worried when it is time to go home, especially if they are discharged from hospital after a very short time, as is likely after Primary PCI. Away from medical care, you may worry about being left alone, or about what to do if the pain comes back. This early period at home may also be difficult for partners, who have to strike a balance between wrapping you up in cotton wool and allowing you to do too much. 5
Make sure that you have detailed talks with the hospital staff, cardiac rehabilitation team, your GP and the district/cardiac nurses, so that you know what you are allowed or encouraged to do. Everyone is different and you must get advice which is relevant to you. Cardiac rehabilitation is an extremely important part of your ongoing care, giving you support, reassurance and advice on how to reduce your risk of further heart disease. Your personal information All of the hospitals in Scotland, which carry out cardiac catheterisation, store the patient details on the same computer database. Your information is used to record the care you are given and also to compare and hopefully improve the results of treatment in different hospitals. All medical records are confidential. Only the doctor and other healthcare professionals looking after you will be allowed to look at your medical records. Any information given by you is gathered together centrally to allow us to compare our practice with other hospitals. The results are gathered anonymously, your records cannot be identified as you. This type of information collection is carried out in accordance with the Data Protection Act. If you do not want your information stored in this way you have the right to refuse permission. Taking part in Research As a regional centre for the West of Scotland in the treatment of heart disease, the Golden Jubilee National Hospital participates in a number of research studies. During your stay here, you may be approached by a member of the Research Team and invited to take part in such a study. Participation in research is entirely voluntary and will not affect the standard of care you receive. 6
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(: 0141 951 5513 Please call the above number if you require this publication in an alternative format Golden Jubilee National Hospital Charity Number: SC045146 HL09