Heart Attack

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A heart attack (also called an acute myocardial infarction) happens when the arteries leading to the heart become blocked and the blood supply is slowed or stopped. When the heart muscle can’t get the oxygen and nutrients it needs, the part of the heart tissue that is affected may die. Every year, about one million people suffer a heart attack. It is among the leading causes of hospital admission for Medicare beneficiaries, age 65 and older. The symptoms of a heart attack can include:

• chest pain (often described as a crushing, squeezing or burning pain in the center of the chest and may radiate to your arm or jaw)
• shortness of breath
• dizziness or faintness
• sweating
• nausea
• cold or clammy skin
• a gray or very ill appearance

Sometimes there may be no symptoms, especially if you have diabetes. Women sometimes have different symptoms, such as a different kind of chest pain and/or abdominal pain. More information about heart health:

• American Heart Association's website
• National Library of Medicine and the National Institutes of Health website

Key Indicators
Scientific evidence indicates that the following measures represent the best practices for the treatment of a heart attack. Higher scores are better.

• Aspirin at arrival
  Early treatment with aspirin significantly reduces mortality from a heart attack. Chewing an aspirin as soon as symptoms of a heart attack begin may help reduce the severity of the attack. It is not applicable to those patients who are allergic to aspirin.

• Aspirin at discharge
  The long-term use of aspirin after a heart attack can significantly reduce the risk of another heart attack or stroke. Aspirin can have side effects like stomach inflammation, bleeding, or allergic reactions, so talk to your doctor before using aspirin on a regular basis to make sure it’s safe for you.

• ACE inhibitor or ARB for left ventricular systolic dysfunction
  ACE (angiotensin converting enzyme) inhibitors and ARBs (angiotensin receptor blockers) medications are very beneficial in those patients with heart failure and decreased function of the left side of the heart. Early treatment with ACE inhibitors and ARBs in patients who have heart failure symptoms or decreased heart function after a heart attack can reduce mortality from future heart attacks. Due to different functionality of two types of drugs, your doctor will decide which drug is most appropriate for you.

• Beta Blocker at arrival
  Beta blocker medications are used to lower blood pressure, treat chest pain (angina) and heart failure, and to help prevent a heart attack. Early administration of beta blockers reduces the magnitude of infarction, associated complications and the rate of reinfarction. Most heart attack patients should be given a beta blocker within 24 hours of arriving at the hospital.

• Beta Blocker at discharge
  Beta blocker medications are used to lower blood pressure, treat chest pain (angina) and heart failure, and to help prevent a heart attack. The use of beta blocker after a heart attack is associated with a lower risk of long-term morbidity and mortality.

• Fibrinolytic medication received within 30 minutes of hospital arrival
  Fibrinolytic drugs are medicines that can help dissolve blood clots in blood vessels and improve blood flow to your heart.

• PCI received within 90 minutes of hospital arrival
  Percutaneous Coronary Interventions (PCI) are procedures that are among the most effective ways to open blocked blood vessels and help prevent further heart muscle damage. Improving blood flow to your heart as quickly as possible lessens the damage to your heart muscle. It also can increase your chances of surviving a heart attack.

• Smoking cessation advice/counseling
  Smoking increases the risk for developing blood clots and heart disease that can result in a heart attack, heart failure or stroke. Patients who receive even brief smoking-cessation advice from their physicians are more likely to quit.

Source: U.S. Department of Health and Human Services Hospital Compare

Additional Resources
To obtain more quality information regarding Heart Attack, please visit the websites: The Joint Commission and the U.S. Department of Health & Human Services Hospital Compare.